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• - ' ® °`�� CHER, `Ii IIFICA E OF LIABIL I `Y INSURAN E11/3/2012 DATE (MM/DD/YYYY) 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), AUTHORIZE® REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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). PRODUCER Milestone Risk Management & Insurance Agency License No. OB72766 8 Corporate Park, Ste 130 Irvine CA 92606 c0NTACr Teresa Shen NAME• PHONE (949)852-0909 FAX No: (949)852-1131 E-MAIL ADDRESS: ashen@milestOnepromise.aom INSURER(S) AFFORDING COVERAGE NAIC# INSURERA:Starr Surplus Lines Ins. Co. 13604 INSURED Wayne Perry, Inc. 8281 Commonwealth Ave. Buena Park CA 90621. INSURER B:American Economy Ins. Co. . 19690 INSURER c.Federal Ins. Co. 20281. INSURER D: INSURER E: INSURERF: r+nvcr=An=c r1C0TI9:IrrATIC NI"9fi62i=ta•11_/T2 REVISION NUIVIBiEH: 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. IlTR TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ® OCCUR SLSLEIL72023211 12/31/201112/31/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300 000 PREMISES Ea occurrence $ r MED EXP (Anyone person) $ 25, 000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: POLICYX PRO LOC PRODUCTS -COMP/OPAGG $ 1,000,000 $ P' AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOSAUTOS 02CE22508901 12/31/2011 12/31/2012 Eaac.lds.t) LE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident Comp. /Coll. Ded. $ 1,000 ::Xj UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE SLSLXNV73017211 12/31/2011 12/31/2012 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I X I RETENTION $ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED' (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 2 004472727 12/31/201112/31/2012 RY LATIU- OEH- XTWO E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 Pi A. Professional Liability Pollution Liability SLSLEIL72023211 SLSLEIL72023211 12/31/201112/31/2012 12/31/201112/31/2012 Limit (Per Claim) $1,000,000 Limit (Per Claim) $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) **PROOF ONLY** ACORD 25 (2010105) INS025 (201005).01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Sariana/TERESA 0d61z*1 & OOAc�— ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD