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1 ® <br /> A�o CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) <br /> 08/ 11 /2020 <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 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 CONTACT NAME: RUZANNA HERNANDEZ <br /> LARK INSURANCE SERVICES PHONE (909) 214-8668 ac No): <br /> no. E <br /> 11650 ROSSANO DRIVE E-MAIL ruzannahernandez@gmaii . com <br /> RANCHO CUCAMONGA, CA 91701 ADDRESS : vg <br /> CA Lie #OC38078 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURER A : COLONY INSURANCE COMPANY <br /> INSURED INSURER B : <br /> Corona Fueling & Electric, Inc. INSURER C : <br /> 1552 Pleasant Crest Lane <br /> La Habra Heights , CA 90631 -8254 INSURERD : <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 /> INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD/YYYY MMIDDIYYYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 <br /> DAMAGE TO RENTED <br /> A <br /> COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100 , 000 <br /> CLAIMS-MADE ® OCCUR 101 GL0060905-05 08/11 /2020 08/11 /2021 MED EXP (Any one person) $ 5 , 000 '.. <br /> PERSONAL & ADV INJURY $ 1 , 000 , 000 '.. <br /> GENERAL AGGREGATE $ 2 , 000, 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , 000 , 000 <br /> POLICY JEC LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ '.. <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOSAUTOS Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION $ $ <br /> WORKERS COMPENSATION WC ORYSTATU- OTHFP <br /> - <br /> AND EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN <br /> / A E.L. EACH ACCIDENT $ <br /> OFFICEWMEMBER EXCLUDED? <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ <br /> If yes, describe under <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101 , Additional Remarks Schedule, if more space is required) <br /> i <br /> I <br /> i <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 /> AUTHORIZED NTATIVE <br /> © 1988 -2010 ACORD CORPORATION . All rights reserved . <br /> ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br /> t <br />