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ABLEM-1 OP ID: Si <br />" CERTIFICATE OF LIABILITY INSURANCE <br />709130(MM/DDTYYYY) <br />TYPE OF INSURANCE <br />/11 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the <br />certificate holder In lieu of such endorsement(s). <br />PRODUCER 707-525-4150 <br />George Petersen Ins Agency <br />P. O. Box 3639 707-525-4175 <br />627 College Avenue <br />Santa Rosa, CA 95402 <br />CONNTTACT <br />HONE <br />o Eat , A <br />A1C No <br />MAIL— <br />ADDRESS; <br />INSURERS AFFORDING COVERAGE NAIC V <br />Douglas Dllley <br />INSURER A:ICW Group <br />INSURED Able Maintenance, Inc. <br />3224 Regional Parkway <br />Santa Rosa, CA 95403 <br />INSURER B ; <br />IN5URERC: <br />INSURER 0, <br />PREMISS 5� Ee p�ccurD— S <br />INSURER E; <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-v1ADE OCCUR <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER- bt%ncrnu w r►an- <br />. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />ILSR <br />TYPE OF INSURANCE <br />POUCYNUMBER <br />MWODIYYYLICY Y <br />MMIDO <br />UMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE S <br />PREMISS 5� Ee p�ccurD— S <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-v1ADE OCCUR <br />MED EXP (Any one parson)5 <br />PERSONAL A ADV INJURY S <br />GENERAL AGGREGATE S <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO LOC <br />PRODUCTS - COMPIOP AGG S <br />s <br />AUTOMOBILE <br />LIABILITY <br />COMBINdED SINGLE LIMIT <br />S <br />BODILY INJURY (Per parson) S <br />ANYAUTO <br />ALL OWNED AUTOS AUTOS �EO <br />BODILY INJURY {Peraccidenll S <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />PRO RTY pAMAGE <br />Paraccida I $ <br />to <br />UMBRELLA L1ABOCCUR <br />HCLAIMS-MADE <br />EACH OCCURRENCE $ <br />EXCESS LIAe <br />AGGREGATE $ <br />DED I I RETENTIONS <br />5 <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PR PRIEBER PA LC UD��ECUT� Y❑ <br />OFF(Mandatory <br />N / A <br />WPL500060303 <br />10/01/11 <br />10101/12 <br />IhIC STATU- DTH- <br />EL EACH ACCIDENT S 1,000,00 <br />EL DISEASE - EA EMPLOYEE 5 1,000,00 <br />In NH) <br />Ras , describe under <br />DCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT i S 1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES {Attach ACORD 141, Additional Remarks Schedule, It more space Is required) <br />RE: License #312844 <br />Proof of Coverage <br />CONDOM1 <br />Contractors State License <br />Board - Workers Comp Unit <br />PO Box 26000 <br />Sacramento, CA 95828 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />C�� <br />U 19BB-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />