|
MJKCONS-01 DADACAYA
<br /> ACORO DATE(MM/DDIYYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 6/27/2018
<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(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER License#OE67768 CN E:ONTACT Stacy Ownbey
<br /> IOA Insurance Services
<br /> PHONE949 297-5960
<br /> 130 Vantis (AIC,No,Ext): (AIC,No):(949)
<br /> Suite 250 aDD'RILEs:Stacy.ownbey@ioausa.com
<br /> Aliso Viejo,CA 92656
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Everest Indemnity Insurance Company 10851
<br /> INSURED INSURER B:Everest National Insurance Company 10120
<br /> Sunwest Engineering Constructors,Inc. INSURER c:Midwest Employers CasualtV Company 23612
<br /> 4780 Cheyenne Way INSURERD:AIllanz Global Risks US Insurance Company 35300
<br /> Chino,CA 91710
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 /> INSR LTRTYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE F_X] OCCUR EF4ML05074-171 09/27/2017 12/01/2018 DAMAGE TO RENTED 50,000
<br /> X Pollution:$2MIL Occ MED EXP(Any oneperson) 5,000
<br /> X Pollution:$4MIL Agg PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY rx] PECT 1:71 LOC PRODUCTS-COM P/OPAGG $ 4,000,000
<br /> OTHER:Deductible:$5,000
<br /> B AUTOMOBILE LIABILITY CO aceoNED SINGLE LIMIT $ 1,000,000
<br /> X ANY AUTO CFICA00066-171 09/2712017 12/01/2018 BODILY INJURY Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS
<br /> yyN�p BODILY INJURY Per accident $
<br /> AUT OS ONLY AUTOS ONLY PPerOacEcandent AMAGE $
<br /> A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,000
<br /> X EXCESS LIAB CLAIMS-MADE EF4C000534-171 09/27/2017 12/01/2018 AGGREGATE $ 6,000,000
<br /> DED I X RETENTION$ 10,000
<br /> C WORKERS COMPENSATION XPER OTH-
<br /> ANDEMPLOYERS'LIABILITY BNUWC0140939 07/01/2018 07/01/2019 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE
<br /> YIN
<br /> E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? ❑Y NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> fyes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A PL-Per Claim$1 MIL EF4ML05074-171 09/27/2017 12/01/2018 Per Aggregate 2,000,000
<br /> D Leased/Rented-ACV SML93001210 09/27/2017 09/27/2018 Deductible:$1,000 250,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space is required)
<br /> RE:Proof of Coverage
<br /> CERTIFICATE HOLDER CANCELLATION
<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 /> Insured's Verification
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
|