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/I CERTIFICATE CERTIFICATE OF LIABILITY INSURANCE DAT11 /4/2DIYYYY)
<br /> �-' 11 /4!2019
<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 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($).
<br /> NTA
<br /> PRODUCER NA 1E; Lisa Salciccla
<br /> Andreini & Company-San Mateo PHONE F
<br /> 220 West 20th Ave _tntC_tie.xatY 650.378-4238 • 650-378-4361
<br /> San Mateo CA 94403 A oA1L t Isaiciccia andreini.com
<br /> INSURERS AFFORDING COVERAGE NAIC9
<br /> _ INSURER A : Philadelphia Indemnity Ins. Co 18058
<br /> INSURED CHARL- i INSURER B : Insurance Company of the WBSI 27647
<br /> Charles E . Thomas Company , Inc
<br /> 13701 So Alma Avenue INSURER C ! Crum &Forster SDecialt Ins Co 44520
<br /> Gardena CA 90249 INSURER D :
<br /> INSURER E ;
<br /> L SURERFc
<br /> COVERAGES CERTIFICATE NUMBER : 440636047 REVISION NUMBER: 1
<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 /> DY
<br /> m5fl TYPE OF INSURANCE s 0 POLICY NtJMSER PMIDUY YFY P�U q/YYl'Y LIMITS
<br /> L7P.
<br /> C X COMMERCIAL GENERAL LIABILITY EPK120380 12/112010 12/112020 EACH OCCURRENCE 52,000 ,000
<br /> DAMAGETORENTE+: OLAIn+s-MADE 171 OCCUR PREMISEStEEv148ssi $ 100,000
<br /> MED EXP (Any one portion) $ 10,000 _
<br /> X ` CPL-Pollution PERSONAL 8 ADV INJURY s 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGQREGATE $ 2,000,000
<br /> POLICY L. - i PROoF�j LOC PRODUCTS - COMP/O_ PAGO ii ?;Q09;909
<br /> JECT
<br /> OTHER: CPI, . oerQwitranpe $ 2,000,000
<br /> A . AUTOMOBILE LIABILITY PHPK1012398 12/1 /2019 12!1 /2020 ^ nn dQpS L LIMI $ 1 ,000,000
<br /> 4 1
<br /> Ii X ANY AUTO BODILY INJURY (Per person) 11
<br /> ` OWNED SCHEDULED BODILY INJURY (Per accident) $
<br /> i AUTOS ONLY AUTOS PROPER7YDAMNGE
<br /> HIRED NON-OWNED fd 1 $
<br /> _t AUTOS ONLY AUTOS ONLY
<br /> a�X ! Cam $500 X cot ; 1 ,000 5
<br /> C UMBRELLALIAO X OCCUR EFX111896 12il /2019 12/1 /2020 EACH OCCURRENCE 54 ,000,000
<br /> X EXCESS ILIAD CLAIMS-MADE AGGREGATE $ 4 ,000,000
<br /> OED . X I RETENTIONS_ n _ S
<br /> B WORKERS COMPENSATION WPL504165501 1211 /2019 12/1 /2020 X aTA - TE R
<br /> t A140 EMPLOYERS' LIABILITY YIN _
<br />! AhYPROPRiETORrPARTNERIEXEGULVE E.L. DISEASE - EA EMPLOYEE $
<br /> 1000,000
<br /> E L, EACH ACCIDENT S
<br /> OFFICERIME&ISEREXCLUDED7 N I A
<br /> (Mandatory In NH) 1 ,000,000 -
<br /> i Ir yes, oasuiGo utWer
<br /> i , DESCRIPTION OF OPERATIONS Uesox E.L. DISEASE - POLICY LIMIT S 1 ,000,000
<br /> c Errors & Omissions EPK120380 12/1 /2019 12/112020 Occurrencec $2 000,000
<br /> ` Cla(ms Made
<br /> , I
<br /> i
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101 , Additional Roma rka Schedule, maybe attached Ir more apace Is required)
<br /> Evidence of Insurance
<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 /> Evidence of Insurance AUTHORIZED REPRESENTATIVE
<br /> clect
<br /> pq
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<br /> ACORD 25 ( 2016/03) The ACORD name and logo are registered marks of ACORD
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