|
CERTIFICATE OF LIAR ILITY INSURANCE pATR(hlEl 131yYYY] e
<br /> • zzlaz/zrJzs
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAT)ON ONLY AND CONFERS NO MGHTS UPON THE CERTIFICATE HOLDER'THIS
<br /> GJERTINGATE DOES NOT AFFIRMATIVELY OR NEWITPIELY AMEND, EXTEND OR A4TER THE COVERAQ� AFFORDED BY THF- POLICIES
<br /> BELOW. THIS 0FR71FICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWE' I 'THE ISSUING INSURER{S), AUTHORIZED I
<br /> REPRESENTATIVE OR PRODUCER,AND THE CFRTIMCATE HOLDER.
<br /> IM[PORTAI�'3". If the cerfifeate holder Is sn ADDITIONAL INSURED,the,policyfiesj must be endoreetf. If SUBROGATION IS MANED,su ]eat to
<br /> the tarms and candltIona of the pn[foy,certain policies may require an endorsament A statement on tills carfiflceie does not confer rights to the
<br /> GO ID hRider In]leu at such endorsements),
<br /> PsflnvcEe ° Acr Catherine Sax3.ana
<br /> Mileatone Risk Management Ix 1xssuranee Agency, rlloraE (949)852-09D9 PAX Ho:(gas)asa-szsx
<br /> Tiaense Na. 0872766 ndqLas:cEariaUa Leeto7sepsamise,Dom
<br /> $ CQ=porate Park, Suite 130
<br /> INSUREKS)AFF>7ApING Gf7VERAGE NAI,f
<br /> Twine CA. 92606 WSLIMRA:Sta= Su lug lines 1nrura=9 1360+1
<br /> INSURED
<br /> tSsuRERa.Gsneral Tna Dp Qi: ,'t3mexi.ca 024792
<br /> Wayl'13e PerrYr InC. INSURERGrStax rndewunit +, Liability Cc=pau 3831.9
<br /> 5261 Co=uanwealt h Ave. INsuFiER Q:T=aLV-al.era Pre ert �SUalt:V at 025617A
<br /> INSURER B
<br /> Buena. Park 90521 INSURER F:
<br /> COVERAGES CE13TIFiCAT1=NUMS15H,16/17 Master IiVI51bNNUIdBER
<br /> THIS IS TD CER'nFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED To THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDINGANY RECILJIFIEMENT,TERM OH'CONDITJCN OF ANY CONTRACT OR OTHER DOCUMENT VVJTH RESPECT TO WHICH'THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANGE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SU3dECT.TO ALL THE.TERMS,"
<br /> EXCJI]SIONS AND CONDITIONS OF$UCH POLIGIES.L)Mrm SHOWN MAyfiAV£BEEN REDUCED BYPAIP CLAIMS.
<br /> I[NTR TYPE gFINSURRNCE AQnL3DSR POLICYHI113HER POLIGYEFF POLICYExp �MIrS
<br /> DOMMEROJAL CENERAL LIABILITY EACH OCCURRENCE 1r 000,000
<br /> OLAIMS-MADE Fx-]CCCUR L0000650471E1 Q.WAGETORENTED 300 DOD
<br /> PREMISES Esaccurm m $ t
<br /> X Caatx. Pollution Liab, AL,CDp,I100 14=h Da===re MEBEiCP(AnYonaparson) $ 25,000
<br /> X Prof. Z5.ab - Claims made 4,000,0op �Kcuh C7.w-im, PERSONAL&ADV NARY $ 1,OOU,000
<br /> GEN"ACsGREGATE I IMIT APPLIES PEH: Za subject to $2,Qnn,Qc70 GENIIIALAGGFlEGA7E $ 2,0170,000
<br /> POLICY JECT E Lot) Fox3cy 215gzegata [ROAUOTS-COMNOPAGG $ 2,000,000
<br /> OTHER:
<br /> dort
<br /> AuU' MOEILJ;WABILTIY � )SINGLELIL41T $ 1,Lrt)p,000
<br /> $ X ANY AUTO BODILY INJURY(Par p9srnr) $
<br /> AU70S BCHEDIJLet? Z4-cc�317o15 2Q 1213IJ2DIE 12131/2n17 9ODILYINJURY
<br /> AlJTOS .�Ur'OS (Per eccldeR3) $
<br /> HIRED AUTOS NO"WWD PROP nAH,p,GE
<br /> Auros er
<br /> $
<br /> JJUBRELLAIJAB X OCCUR EACH03GURHENOF $ 9 000 000
<br /> A X EM=ESS IJAB CLAIMS-MADE AGGREGATE $ 9 000 ODD
<br /> AEP I x i RETENTION n 16003351304.7.51 1$19112Q18 x2/31/2017 $ .
<br /> WWK9)m COMPENSAT10N
<br /> ANAFMPL.OYERS'LIAER11Y' ;,/H K STA UTE EER
<br /> ANY PROPRIETORIPARMEWEXECUTIVE
<br /> OFF10II )rL..)=ACHRCGIDENT _$ 000 IYOC
<br /> 4MiE 1GEIi EXCLUDED? ❑ N J A
<br /> C �u andaturyInNfiI xa0DOfl18S1 12J31f201S 12/31/2017 E-DiSEASE-EAEMP LO $ 11000 000
<br /> Ifys,q describe under
<br /> DE6LIREPT104OFOPERA77DAEsbelawy IE.LDISEASE-POLICYUMIT 1000 D00
<br /> 11 Installation Floater 55Q1d79C861 12/31/201H 12/37./2017 LIMIT/DE©UCTIME ,5250 / *2,500
<br /> 1tcat2@/7,ea8ed Equypment 5Sa1#79cab1 12/31/2035 12/31/Z9x7 LIF,�rf/PEDI1gTTBI.E $].bOIC / 2,50p
<br /> 17ESCRIYMGN OF OPERATIDN&I LO-DA-rinNS 1 VEHICLES(AGORA 76t,Addlllnnal Remarks Schedule,may be Effacbed If mute sPacels required)
<br /> RM: A-Zl Operatzona_
<br /> CerLi;�ieate holder is named as an orMit:Lmn.al insured, where ragui"red by wnittan aontcact, per the
<br /> attached endorsemeat.. "`�
<br /> RE� - u
<br /> CERTLFIGATE HOLDER CANCELLATION
<br /> SHOULD ANY OFTHE ABOVE DE,SGRIBE13 POLICIFS BE CANCELLED B1;FORE'-' —HTHE EXPIRATION DATE FII
<br /> THFFMOF, NOTICE WILL BE DELIVED IN
<br /> ACGOFMANUEE W171i THE POLICY PRCMSIONs.
<br /> AUTHORIZED REPRESENTATIVE
<br /> Teresa Shen/TEF�XSA,
<br /> O 1888.2014 ACORD CORPORA'nON. All rights reserved.
<br /> AGORD 25(2014/01) The AGORD name and Ingo are reglstered marks of ACORD
<br /> INS320{201401)
<br />
|