COMPLIANCE INFO_2021 - Laserfiche WebLink

Home Browse Search

XPRES -1 OP D : CV ACORQ " �� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYW) 10/07/2020 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 209-847-3065 CONTACT Kenneth Verschelden NAME Basi Insurance Services, Inc. PHONE 209-847 -3065 FAX 209 -848-4931 1491 E G Street (A/c, No, Ext): (A/c, No) : Oakdale, CA 95361 E DAIS . kenny@basiinsurance . com Kenneth Verschelden INSURERS AFFORDING COVERAGE NAIC ti INSURER A : Insurance Company of West 27847 INSURED INSURER B : Xrens Technical Services Inc Dg IEC Services INSURER C : P.O. Box 11160 Oakdale, CA 95361 INSURER D : 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 SUB WVD POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE F OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT F-1LOC PRODUCTS - COMP/OP AGG $ OTHER: $ OAUTOMOBILE LIABILITY Ee acct dentSINGLE LIMIT $ ANY AUTO BODILY INJURY Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ L $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ A WORKERS COMPENSATION X I STATUTE I EORH AND EMPLOYERS' LIABILITY YIN SA5034491 -04 08/29/2020 08/29/2021 11000 , 000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E. L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH ) E. L. DISEASE - EA EMPLOYE $ 13000 , 000 If yes, describe under 13000 , 000 DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, maybe attached if more space is required): 'V V U 'r) iI ;V p 4 2021 ENVIRONMENTAL HEALTH CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Proof of insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE K,1 ACORD 25 (2016/03 ) © 1988 -2015 ACORD CORPORATION . All rights reserved . The ACORD name and logo are registered marks of ACORD