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• �� _ ABLEM-1 OP ID:S4 <br /> A��Ro CERTIFICATE OF LIABILITY INSURANCE F °AT 09130Dn'vYY, <br /> 09/30/11 <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. It 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 707.5254150 °NA°NTF CT <br /> George Petersen Ins Agency <br /> P.O.Box3539 707-5254175 PHONE A <br /> B d: C.Na <br /> 627 College Avenue Ahfu <br /> Santa Rosa,CA 95402 ADDRESS: <br /> Douglas Dllley INSURERISI AFFORDING COVERAGE NAIC9 <br /> INSURER A:ICW Group <br /> INSURED Able Maintenance, Inc. INSURER 9; <br /> 3224 Regional Parkway <br /> Santa Rosa,CA 95403 INSURER c: <br /> INSURER D: <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 /> MSR TYPEOFINSURANCE UP <br /> POLICY NUMaER MMIDOIYYYY MMIU UNITS <br /> GENERAL LIABILITY EACHOCCURRENCE S <br /> COMMERCIAL GENERAL LIABILITY PREM lS S Es occa rmaca 5 <br /> CLAIMS-MADE O OCCUR MED EXP(Am mm Person) S <br /> PERSONAL S ADV INJURY S <br /> GENERALAGGREGATE S <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMPIOP AGG S <br /> POLICY PRO LOC S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT(Ep accident) S <br /> ANY AUTO BODILY INJURY Fr pemm) S <br /> ALL DINNED F7 6CHEDULE13 <br /> AUTOS AUTOS BODILY INJURY(Per accident) 5 <br /> HIRED AUTOS H <br /> AOTO6WNED Pa PERT AMAGE S <br /> 5 <br /> UMBRELLA UAB OCCUR EACH OCCURRENCE S <br /> EXCESS UAa CUJM54MDE AGGREGATE $ <br /> OED I I RETENTIONS is <br /> WORKERS COMPENSATION VA:STATII-IN _LMrrS OTN- <br /> AND EMPLOYERS LIABILITYER <br /> A ANRCROPHtEr EREACLUDEREKEC�WY�ED? NIA LSOODG0303 10(01111 10101112 EL EACH ACCIDENT S 1,000,00 <br /> IMandarary In NHl E.L DISEASE-EA EMPLOYE 5 1,000,00 <br /> Nyea,deeclbe under <br /> OEBCRIPTIONOFOPERATIDNSbeb# E.L.DISEASE-POLICY LIMIT 5 1,D00,00D <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACDRD 101,Additional Remarks Schedule,It mom space Is required) <br /> RE:License#312844 <br /> Proof of Coverage <br /> CERTIFICATE HOLDER CANCELLATION <br /> CONDOMI <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Contractors State License ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Board-Workers Comp Unit <br /> PO Box 26000 AUTHORIZED REPRESENTATIVE <br /> Sacramento,CA 95828 <br /> I <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/06) The ACORD name and logo are registered marks of ACORD <br />