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OP ID:C1 AC7"1?LX CERTIFICATE OF LIATE BILITY INSURANCE F DA 10104/10(MODDIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poilcy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER 707-525-4150 NAME: George Petersen Ins Agency 707-525-4175 (AIC, .ExsrFAx P,0.Box 3539 EMAIL -- - —- �a�PL-- -- ---- ...- - _-,-- 627 College Avenue ADDRESS: a�a13�R -_ .—._------- —-----------____�..__----------....----------- Santa Rosa,CA 95402 cu MER to ABLEM-1 �ll taS DIS INSURERS AFFORDING COVERAGE i NAIC ----------------._...------._.-.- _- .v-.--_ INSURED Able Maintenance,Inc. INSURER A:insurance Company of the West 3224 Regional Parkway INSURERS: Santa Rosa,CA 95403 INSURER c i - INSURER MSURER E_- ----------- ---- — i INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ lN9(Q A TYPE OF INSURANCE L daw POLICY NUMBER I M D/YYYY MMf ICY EXP LIMITS T GENERAL LIABILITY I EACHOCCURRENGE — I COMMERCIAL GENERAL LIABILITY PREMISES Ea o=rrence $ CLAIMS-MADE ��OCCUR i MEDEXP(Anyoneperson) !$ - ! i PERSONAL&ADV INJURY $ ---T ---------- GENERAL AGGREGATE $ G—E1N'L AGGREGATE LIMITAPPLIES PER I PRODUCTS_COMPIOPAGG $ r- r JECT POLICY - PRO- LOC I I $ AUTOMOBILE LIABILITY i i CO aaiE1DSINGLE LIMIT $ ) ANY AUTO BODILY INJURYPer ( Person) $ ALL OWNED AUTOS - _ i I BODILY INJURY(Per accident) $ !SCHEDULED AUTOS i i PROPERTY DAMAGE $ HIRED AUTOS (Per accident) _ I � -- NON-OWNEDAUTOS ! $-------_-__-- I UMBRELLA L1AB � EACH OCCURRENCE i ;$ � , OCCUR EXCESS LIAB I CLAIMS-MADE ISI I AGGREGATE —_ _- $ _�••� 1 DEDUCTIBLE 1 RETENTION $ WORKERS COMPENSATION ! + i �( 1 WC STATU- OTH- ANO EMPLOYERS'LIABILITY YIN 1 T4RY1AA1T5.. ER__. I A ; ANY PROPRIETOR/PARTNERIEXECUTIVE !NIA PL500060302 10/01/10 10/01/11 EL EACH ACCIDENT 1$ 1,000,00 OFFICER/MEMBER EXCLUDED? ; 1,000,01] (Mandatory in NH) I E.L.DISEASE-EA EMPLOYE EI$ If yes,desuibe under E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS below I i � I I DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) RE:License#3128" Proof of Coverage CERTIFICATE HOLDER CANCELLATION CONDOM1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Contractors State License Board-Workers Comp Unit AUTHORIZED REPRESENTATIVE PO Box 26000 Sacramento,CA 95828 �s-�- I ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD