Laserfiche WebLink
L? F = <br /> I oc Rn° CERTIFICATE OF LIABILITY INSURANCE <br /> DATE IWNE301YYYr. <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 11/16/ CIO <br /> 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 <br /> REPR SENTATWE OTR CERIFICATE PRODUCER,AND THE CERTIFICATE HO INSURANCE DOES M07 NLDIER STITUTE A CONTRACT BETWEEN THE ISSUE INSURER(S), AUTHORIZED � <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poffcy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject tc I <br /> the terms and conditions of the poricy,certain Policies stay require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder In Ifeu of such endmement(s). <br /> PROCUCER j COPITAC*. <br /> N(4ME: x8:11'] J9runc <br /> MLd-Cen`.ral Valley xrss,:i--a.^.c:e 'PrtolE , - A - <br /> GNo.E_rLt• {-'a5J3'F-a2d? (PA,•C No}-t709i ia4 <br /> 3 D 1 S. Ham Lane, S i to r EMAIL 9-068 <br /> A3c>brun00miavins.com --- <br /> DDRESS• <br /> IP-C. Bcx 490 PRODUCER AaoaSo9C -- <br /> i (`.:1c4l:jaER LD K <br /> 40di +rs 95191 ( INSURERS iAFFORDING COVERAGE <br /> AMC rt <br /> MSURER A:Wester_n Sevar ty Surplus <br /> Linde:L-Peters Chamber of Cotrmerae WSURER 9• <br /> I INSURER C <br /> ;P. G. Box ..J? <br /> INSUREA D: <br /> CA 97236 4 INSURER E; <br /> 1NSUfiER`r: <br /> COVERAGES CERTIFICATE NUMBER:2a10-2011 Liabi-lity REVISION NUMBER: <br /> IS TO CERTIFY THAT THE POLICIES C=INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NSUREDIcAME0 ABOVE FOR-'IE POLICY PERIOD <br /> INnT <br /> D1C =D. NOnIATHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY^,ONTRACT OR CT4ER DOCUMENT VU:TH 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,L M17S SHOWN MAY HAVE BEE14 REDUCED BY PAID CLAIPl,S. <br /> NSRI <br /> QTR TYPE OF LVSURANCE JADDL INSR y�,.D POLICY <br /> X13WRERI P!L(Lr1LpI7(YYyyt fuMinoLYExp <br /> YYy' LIMITS <br /> X <br /> EACH OCCURRENCE _,G 00,OO O+ <br /> ,C_0_MA1£RCiAL tiEt9 R.'J.L:AL'':'T' � ) <br /> �EP�sE$Lr- -soctvlSn�'• S <br /> r A <br /> CLAW -MAC X I OCCUR NC351Q3C _111/2010C_.. <br /> MED EXP(Any am passaj' S 5,0 0 0 <br /> - _ <br /> PERSONAL dPZfINJURY S _,aoa,000� <br /> - - 'GENERALAGGREGA7E 5 21000,000 <br /> GEK'L AGGRECXTE LIMrT AP-LIES PER <br /> X:POLICY PRO- OC FRODUCTS-CCWP.'DP AGG 5 Inci-ade <br /> AUTOA10671=LfA6IUTY 'v COMBINED SINGL--UMr <br /> ANY AQTO (ED acrdenl) S <br /> '-,--'ALL 01'LNEL AUTO S ? BODILY INJURY(Per parsor) S <br /> .'SC.'0-:0ULE0 AVMS _ i.POD11 iNJURY(%r a=enq(S $ <br /> -Up[-:D ALTP,S - <br /> PROPERTY 0AW.Gr <br /> 'JON-OWNED AJrOS <br /> L'PaBRF,LA LIAS <br /> OCCUR <br /> EXCaSS:.IAS k -� I '`1CHCCCURREI.CE <br /> .. -'----------_._._1 Ci.AfbiS.M1iCF: I s �AOGnEGATE y <br /> - 5 <br /> ?EL'•UCTIBLE - <br /> aETEN ION S .__--- — <br /> WCRXERS COYPENSATI0.ti Y'PC 57ATU- iOTh- J <br /> AND EMPLOYERS'LIABILITY f <br /> Y•N - .APY L GAITS ER <br /> OFFIC P MEN EXCLUCE07 <br /> L-!I!N i A' E.L EACH ACCIDENT S -� <br /> (r yes.idary dizcre Nrd EL DISEASE-EA E.MP_OVEE5 <br /> I � -i yes.deuu..ae ur.Cor ', - <br /> DESCPo IrDA OF OPERATIONS aelanv ! EL DISEASE-POLICY LlfgR;S <br /> r <br /> I I <br /> (zESCR1pTioN OF OPERA'noxs!LoCA'noNs i vanci Es(Adel.ACRD 101,Ada1:1enal Remarks ScradWo.1f mare spaca is roquimc) <br /> F Ceti=icate Holder is listed as F.d.-`.i*, .onal =rac=ed For :?s_sta!! _ree *ightin mo or. Dec <br /> 3 acid egsc+r 41 20_0 <br /> q <br /> L_ L <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIED POLICIES BE CANCELLED BEFCRE <br /> THE EXPIRATION DATE THEREOF, NOT-CE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> sa-n JcaQ'1in CD1IY1l-y i <br /> 7epa«:merit of Public Works <br /> 1810 E. Hazietcn AUTI OftZW REPRE5`ItTA'nvE <br /> Stocktc_^_, a& 95201 CI <br /> i <br /> ACORD 25{2009109') �9)1S88 2609 ACORD CORPORATION, Ali rights reserved. <br /> !NS025;-vMC9l The ACORD name and logo are registered marks of ACORD <br />