WP0040695 - Laserfiche WebLink

Home Browse Search

ROADDRI-01 CDAVIS ,4Co/eo` CERTIFICATE OF LIABILITY INSURANCE FDATE(M/202YYY) 312712020 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),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 License#OB50501 CONTACT NA E: Armstrong&Associates Insurance Services PHONE FAX 239 W Court St,Bldg A (A/C,No,Ext):(530)668-2777 ac,No):(530)668-2779 Woodland,CA 95695 AbD E : INSURERS AFFORDING COVERAGE NAIC# INSURER A:Financial Pacific Insurance Company 31453 INSURED INSURER B:Everest Premier Insurance Company 16045 Roadrunner Drilling&Pump Company Inc. INSURERC:Western World Insurance Company 13196 80 Bee Jay Way INSURER D: Woodland,CA 95776 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS ILTRA X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR 60466220 8/26/2019 8/26/2020 DAMAGE TO RENTED $ 300,000 MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY❑JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY t $ X ANY AUTO 60466220 8/26/2019 8/26/2020 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY ALTNOpSyyNE BODILY INJURY Per accident $ AUTOS ONLY AUTOS ONLY PPeorr ardent AMAGE $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE 60466220 8/26/2019 8/26/2020 AGGREGATE $ 2'000'000 DED RETENTION$ B WORKERS COMPENSATION X PERTUTE OTH- AND EMPLOYERS'LIABILITY YIN 7600020146201 3/1/2020 3/1/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N 1 A WE.L.EACH ACCIDENT FICF_R/MEMBER EXCLUDED? andatory in NH) E.L.DISEASE-EA EMPLOYE 1'000'000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Installation Floater 60466220 8/26/2019 8/26/2020 10,000 C Excess Liability GLX1000949-01 8/26/2019 8/26/2020 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE San Joaquin County Environmental Health Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN q tY P ACCORDANCE WITH THE POLICY PROVISIONS. 1868 East Hazelton Ave. Stockton,CA 95205-6232 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD