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Ate- Op r C1 <br />II.. CERTIFICATE LIABILITY INSURANCE DATE 1041rYYYY) <br />10/04H 0 <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terns and conditions of the policy, certain Policies may requite an endorsement A Statement an this certificate does not confer rights to the <br />PRODUCER 707.525-4150 VNIACT <br />George Petersen Ins Agency 707-525-4175 PHONE Ax <br />P. O. Box 353$ <br />327 College Avenue A S' <br />3anta Rosa, CA 95402 ABLEM-1 <br />Able Maintenance, Inc. <br />3224 Regional Parkway <br />Santa Rosa, CA 95403 <br />of the West <br />COVERAGES CERTIFICATE NUMBER- ®cvtctew ut rWIMCo. <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 ANO CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />wmTTPE oP INSURANCE Anew Pot lcv NUMSEROUCY POLICY EXP <br />LIMtiffi <br />THE EXPIRATION DATE THEREDF, NOTICE WILL BE DELIVERED IN <br />GENERAL LIABILITY <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Board - Workers Comp Unit <br />REPRXaENTATE <br />REPRESENTATIVE <br />PO Box 26000 <br />Sacramento, CA 95828 <br />EACH OCCURRENCE S <br />10 RtNTW-- <br />P i S <br />COMMEtaCIAL GENERAL LIABILITYLIABILITYDAMAM <br />i <br />CWMS-MADE DOCCUR <br />( <br />j <br />PERSONAL& ADV INJURY- I S, <br />GENERAL AGGREGATE — $ <br />I <br />I <br />I GENL AGGREGATE LIAPPUES PR <br />POLICY 1 PR LOC <br />PRODUCTS - COMP/Op AG(s S <br />S <br />AUTOMOBILE LIABILITY <br />COMBINED SMGLE LIMIT <br />i <br />E <br />i <br />S <br />ANY AUTO <br />i <br />I BODILY INJURY (Par Parson) $ <br />ALL OWNED AUTOS <br />1 <br />+� <br />! <br />BODILY INJURY(Per aedden0 S <br />•��SCHEDULED AUTOS <br />HIRED AUTOS <br />IffI <br />j <br />PROPERTY DAMAGE <br />NOW -OWNED AUTOS <br />. <br />11A01BRELLA L1A8 <br />') <br />EACH OCCURRENCE 1 S <br />EXCESSUAe <br />CLAIMS.MADE""'-----------_ <br />AGGREGATE S <br />DEDUCTIBLE <br />-- <br />— <br />RETENTION <br />WORMERS COMPENSATION <br />wNO EMPLOYERS' LIABILITY <br />t <br />WD STATU- OTH <br />X I0 -u ZS.. <br />A (A.VY <br />YIN <br />PROPRtETORlPARTNER/EXECUTNE- ❑ <br />OFFICERNEMBER EXCLUDED? + <br />N / A <br />�WPL500060302 <br />I <br />10101!10 <br />10101M I <br />-y _ _lm-'— _ .__ _ _� <br />E.L.EACH ACCIDENT 16 1,000,0 <br />— <br />E.L DISEASE • EA EMPLOYE S t.000,00 <br />I <br />iM H M andNH) (j <br />n <br />E.L. DISEASE • POLICYLIMtT S 1100010 <br />D S PTIONwft <br />DESCRIPTION OF OPERATIONS list°w <br />i <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANach ACORD tot, Add(Conal Remarks Schedule, Xmom spam Is squired) <br />RE: License #312844 <br />Proof of Coverage <br />CERTIFICATE HOLDER CANCELLATION <br />CONDOM1 <br />SHOULD ANY OF THE ABOVE: DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREDF, NOTICE WILL BE DELIVERED IN <br />Contractors State License <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Board - Workers Comp Unit <br />REPRXaENTATE <br />REPRESENTATIVE <br />PO Box 26000 <br />Sacramento, CA 95828 <br />G 1088-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (200=11)) The ACORD name and logo are regiatarod marks of ACORD <br />