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11
<br />Aif CERTIFICATE F LIABILITY INS
<br />DATE14/2 /Y4
<br />04/14/2014
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANDORI N E TIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEN V RDED 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 r ROGATION 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 />-46TH
<br />PRODUCER LIC #OB29370 1-925-244-7700
<br />Edgewood Partners Insurance Centers (EPIC)
<br />[San Ramon Branch]
<br />CONTAC gjgl
<br />NAME: n
<br />NCO-"o : (925 aC No: (925) 901-0671
<br />P. O. Box 5003
<br />ADDRESS: DDRESS: EPICCerts(8edgewoodins.com
<br />INSURER(S) AFFORDING COVERAGE NAIC#
<br />San Ramon, CA 94583
<br />_
<br />SURPLUS LINES INS CO 10172
<br />_
<br />INSURED
<br />Gettler-Ryan Inc.
<br />ERLESS!INS CO 124198
<br />ATE COSATION INS FUND 35076
<br />6805 Sierra Court, Suite G
<br />ESESTCHESTER
<br />Dublin, CA 94568
<br />GENERALAGGREGATE $2,000,000
<br />�GEIL
<br />COVERAGES CERTIFICATE NUMBER: 39245312 REVISION NUMBER'
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />'ADDUSUBR
<br />POLICY EFF POLICY EXP
<br />POLICY NUMBER MMIDD MWOD
<br />------
<br />LIMITS
<br />A
<br />GENERAL LIABILITY !G24014484007 04/01/14,04/01/15 EACH OCCURRENCEI_$ 1,000,000
<br />X DAMAGE TO RENTED —
<br />COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 50, 000
<br />CLAIMS I X
<br />-MADE j OCCUR j MED EXP (Any one person) $ 5,000
<br />PERSONAL & ADV INJURY $ 1, 000, 000
<br />GENERALAGGREGATE $2,000,000
<br />�GEIL
<br />AGGREGATE LIMIT APPLIES PER: I PRODUCTS - COMP/OP AGG $ 2,000,000
<br />POLICY X PRO- LOC j $
<br />B
<br />AUTOMOBILE
<br />LIABILITYiBA8404396 0 1 14 04/01/151 COMBINED SINGLE LIMIT 1, 000, 000_
<br />f t (Ea accident) _ _�. _
<br />X
<br />_ _
<br />ANY AUTO BODILY INJURY (Per person) $
<br />ALL OWNED'' SCHEDULED BODILY INJURY Per accident
<br />AUTOS $
<br />AUTOS )
<br />X
<br />AUTOS PROPERTY DAMAGE 7" _..
<br />HIRED AUTOS (Per accident)
<br />I 1 �$
<br />A
<br />UMBRELLA UAB i X OCCUR ;624014502007 04/01/11 04/01/151 EACH OCCURRENCE 1 $ 4,000,000
<br />g
<br />EXCESS LIALAI _MS-MADEiAGGREGATE - �$ 4,000,000
<br />DRETENTION $ 0 $
<br />C I
<br />1
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />905122914 ' WC QRYL 1U- 10TH -i
<br />04/01/14, 04/01/151 X.
<br />1 T�ORV L1091_T8�_ ER
<br />Y I N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? Y—]!N/A
<br />E_L. EACH ACCIDENT $ 1, 000, 000
<br />(Mandatoryin NH)
<br />describe
<br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000
<br />Dyes, under
<br />DESCRIPTION OF OPERATIONS below
<br />r 1,000,000
<br />E.L. DISEASE - POLICY LIMIT 1 $
<br />A
<br />Professional Liability 1G24014484007
<br />04/01/14 04/01/15 Per Claim 1,000,000
<br />B
<br />Rented/Leased Equipment iCBP8404796
<br />04/01/14 04/01/15IPer Item 100,000
<br />A
<br />Pollution
<br />G24014484007 04/01/11 04/01/15 Per Occurrence 1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Proof of Insurance
<br />I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />*EVIDENCE OF COVERAGE* THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />©1958-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />mcadinha-aro
<br />39245312
<br />
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