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DATE (I/,MWNYYY)
<br /> -' 9/28/� 2020
<br /> IFICATE OF LIA131LITY INSURANCETHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NCERT
<br /> O RIGHTS UPON THE CERTIFY ; CATBY E HAUTHOfl1ZED
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY O DOES IVELOT CONS7 TDUTE AECONTRACT 13ETWEENND OR ALTER THE OTHE ISSUING INSUDE"� ER{S ), AU POLICIES
<br /> BELOW. THIS CERTIFICATE OF INS .-
<br /> 7ATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER . roviE
<br /> R£ PRESEN -- -"�
<br /> dorsed
<br /> —. . _
<br /> r- ----- - require an endorset�Tent. A statement on
<br /> IMPORTANT If the certlticate holder is an ADDITIONAL INSURED, the pollcype oiics� eTtain pollm Uzi have cDDImIONAq lNSUR p � ions or a en
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions o1 the p y, _
<br /> _—_ —
<br /> CONTACT ---
<br /> this certificate does not confer rights to the certifi'cale holder in lieu o1such endorsement(s).
<br /> �—--. .—..—. .—,.— NAME;, ..—.«_., _ -- r
<br /> R ODVCER PHONE 1I707 525'415D i jalc x;(707) 525 4175
<br /> Agency, InC . (AIC Na Ext): t ) —
<br /> eor a Petersen Insurance Ag Y. E MAIL t info@gPms. com —
<br /> ADDRES�. :
<br /> .p, N 3539 —�
<br /> ansa Rosa , CA 95402 tNSURERS),AFFORDING COVP.RAGE �^_ _ t44393
<br /> ICN_
<br /> _ — - -
<br /> tNsuRERR : HomelandlnsuranceComa _of _N�vYor
<br /> _ _
<br /> --- - - -
<br /> - -- - INSURE
<br /> B : West American Insurance Compan�r
<br /> ISURED INSURER c : State q"m ,ensation ,Insurance Funt:3C 35076 _,
<br /> Able Maintenance IDC . INSURER O : AfnnlCan f Ire $ CBS "
<br /> ally Coany — 24066
<br /> 322A Regional Parkway ---
<br /> Sonia Rosa , CA 95403 INSURER E
<br /> INSURER F
<br /> — -- - — REVISION NUM8E1., : —
<br /> IOD
<br /> OVERAGES CERTIFICATE NUMBERS - -- AE INSURED NAMED ABOVE
<br /> BELOW HAVE 13EEN ISSUED TO Tf
<br /> THIS IS TO CERTIFY THAT
<br /> AN THE POLICIES
<br /> NY EOUOF INSUI
<br /> ENT TERMDANCE ORDCONDI ON OF ANY CONTRACT OR OTHER DOCUMENT WITH Rt SpfCT TOLWHICHTHIS
<br /> INDICATED. ----
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY �O�ECPOFFCIEP DESCRIBED HEREIN IS SUBJE �-( TO ALL THE TE
<br /> L Suns
<br /> EXCLUSIONS AND CONDITIONS O, SUCH flnL su RR LIMITS SH OWE NUMBERMAY 10000000 BEEN Ri D ED P DD ryAl ��� 10 000,000
<br /> COMMERCIAL GENERAL—_ —
<br /> SR TYPE Or INSURANCE INSU. � —_ �.� —...� EACH OCCURRENCE_��, $
<br /> fR '---- RAL LIABILITY DAMAGETO RENTED — 50,000
<br /> 4 x 793 00-26-72-0006 1D/11 /202D 1 011 112 02 1 PREMISES IEa oeeverc.�_ � 8 000
<br /> CLAUV S-MADE ® OCCUR MED EXP An one erson ;
<br /> x Poll Ulion & PfOfessi PERSONAL & ADV INJURY s
<br /> — $ 102000,000
<br /> A
<br /> — GENERAL GGREGATE
<br /> _ — -- 10 ,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS � COMPIOPA4: - G S
<br /> POLICY [: 1Eco° ❑ LOG MOLD SEE REMAR 3•'C $ 1,000,000
<br /> COMSINEDSINGLE LIMIT 1 ,000,ODO
<br /> OTHER. --_.— _.— . Its accidence
<br /> — _—.,— .
<br /> 3 AUTOMOBILE LIABlilly5 4/112020 4/1 /2021 BODILY INJURYIPer Verso
<br /> B58661065
<br /> AW (21 ) 5866106
<br /> ANY AUTO _ _ BODILYP
<br /> OWNED ° SCHEDULED RERT
<br /> OPY DAMAGE v - -
<br /> _ AUTOS ONLY AUTOS Per accldenl
<br /> .�...—. $
<br /> HIRED NON-OWNED $
<br /> AUTOS ONLY AUTOS ONLY - - --"
<br /> EACH OCCURRENCE s
<br /> — UMBRELLA LIAR OCCUR — AGGREGATE
<br /> EXCESS LIAB �CLA1La5"MRDE
<br /> _.-
<br /> - x PER ER
<br /> ED RETENTION --"— - STATUTE .._
<br /> DED - _— --. _
<br /> - - - — 1 ,000,000
<br /> WORKERS COMPENSATION gp73419-20 1011 /2020 10/1 /2021 EL EACH ACCIDENT $
<br /> AND EMPLOVERS' LIABILITY YIN 1 QQp,000
<br /> ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ N IA E L DISEASE , EA EMPLOV•-E _
<br /> OFFiCEFUMEMBER EXCLUDED? 1 ,000,000
<br /> (Mandatory in NH) E.L. DISEASE • POLICY Ufv)t } � $
<br /> ti yes, describe under 4%1 /202D 411!2021 ggregat0focc . 4 ,000,000
<br /> DESCRIPTION OF OPERATIONS below - - ESA (21 58661065
<br /> _ -- —
<br /> Excess AtItJIWC only
<br /> arks Schedule, may be auacbed if more space is required)
<br /> 2SCRIPT-1ON OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 10 '1, Additional Rem
<br /> Proof of Coverage
<br /> ERTIFICATE HOLDER —
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF ,ACCORDANCE WrrHTHE POLICY PROVISIONS.
<br /> CE WILL BE DELIVERED IN
<br /> Able Maintenance, Inc ,
<br /> 3224 Regional Parkway - --
<br /> Santa Rosa , CA 95403 AUTHORIZED REPRESENTATIVE
<br /> —_ - - -- — © 1988-2015 ACCORD CORPORATION , All rights reserved .
<br /> CORD 25 (2016!03)
<br /> The ACCORD name and logo are registered marks of ACCORD
<br />
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