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May 17 '13 08:47a Woodbridge Fire District 12093694568 p.8
<br /> CERTIFICATE OF LIABILITY INSURANCE DATE(MMiDD.rYYYY)
<br /> 4/15/2013
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS Na RIGHTS UPON THE CERTIFICATE HOLDER,THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AlIKEND,:EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE-OF INSURANCE 130M NOT CONSTITUTE A CONTRACT 13E'iWEEN THE ISSUING INSURER(S), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE BOLDER.
<br /> IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the.policylles)must be endorsed. If SUBROGATION IS WAIVED,subject to
<br /> Ihe•terms.and conditions-of the policy,certain policies may require.-an endorsarnent, A statement on this certificate does notconfer rights to the
<br /> certificate holder in lieu of such endorsemsnt(s),
<br /> PRODUCER LUTA Di-Anna Ldartin
<br /> a E:
<br /> All-Cal Insurance Agency PHONE (916)784-9070
<br /> 1=APC
<br /> 505 Vernon Street MAIL A�No:(91b)794-0151)
<br /> AODR S:dianna@all-caLinsurance.com
<br /> INSURERS AFFORDINGCOVEIS
<br /> NAIC
<br /> Roseville' CA 95678 INSURtei A.Non r0fits I Ina Alliance'of CA NIAC
<br /> tUSURE'D imuRms;F16-allty And Dapoait Com-pan
<br /> Firefighters Burn Institute INSURER C
<br /> 3101 Stockton Blvd, InIsuRElt a-
<br /> - _ Q•iSURER 8
<br /> Sacramento CA 95820 INSURER F:
<br /> COVERAGES CERTIFICATE NUMB ER:CLI 121203093 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'CONDIT(OlH'OF ANY OONTRACT OR OTHER DCCUM-ENT WTH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY FERTAN, 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 CLAILTS.
<br /> ILTR TYPE OF INSURANCE AODL
<br /> I POLCYEPQUY Exp
<br /> GENERAL L►B!UTY MM IODNY
<br /> CATS
<br /> I EACH OCCURRENCE $ 1,000,000
<br /> X COMMERCIA:GENERAL LIA9ILITYDAMAGE
<br /> PREMISES Is occurrenoe s 500,000
<br /> A CLAIM -MADE a OCCUR K 2012-14425NEO 1/7/2012 1/7/2013 MED EXP( am person) $ 2D,000
<br /> x xMPROPER SEXUAL CONDUCT
<br /> $250,000 / $250,000 PERSONAL&ADV INJURY i 2,OOD,000
<br /> GENERAL AGGREQATE S 2,004,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER:
<br /> PRO- PRODUCTS-COLiprOP AGG 5 2,000,000
<br /> X POLICY LOC FULL LIQUOR LIABILITY S 1,000,000
<br /> AUTOMORILE LIAB rrY OMBI NEDtl SINGLE LIN111a
<br /> ANYALITO (E9 a0dun
<br /> All OVID - BODILY INJURY(Per person) S
<br /> $CHEaULED
<br /> AUTOS AUTOS NED + BCDILY INJUf;Y(Perdccident) $
<br /> HIRED AUTOS AUTOS leer a PROPERTY DM!
<br /> AGE
<br /> 1
<br /> X UIdSRELLA LIASOCCUR
<br /> Excess LIAR CtAlMS-MaoE
<br /> EACH OCCURRENCE 4,000,000
<br /> p�
<br /> AGGREGATE 5 4,000,000
<br /> DFo X RETRrTIHDN$ 1-0,00a X 2012-14425-trt-s x/7/2012 1/7/2013
<br /> WORKERS COIMPENSATion Z
<br /> ANO EMPLOYERS LIABILITY S
<br /> OFFICERRAEWBER EXXCLIXEIMI
<br /> ANY D? JU'fIYe YINN/0,
<br /> (Mandatary Jn NH) (_J E.L.EACH ACCIOEM g
<br /> If yes,descnte under E.L.DISEASE-EA.EMpLoyFE S
<br /> DESCRIPTION OF OPERATIONS below
<br /> I E.L.DISEASE-POLICY LIINIT S
<br /> B EMPLOYEE DISSONESTY
<br /> E'aRGERY/ALTERATION CCP 0060574 09 /19/2013 1I9/2014
<br /> uWTS 100,004
<br /> 003LIC71BLES 1,000
<br /> DESCRIPTION OF OPEit0,T10NS!LOCATIOli51 tll"HICLES(Adich ACORD 101,Adcallorral Remarks3chodule,Ifmora s ice is required)
<br /> 24MISS G SECQRITTES, POLICY # CWS; 000 3844-08 14425, EFF`. 11/7012, EXP. 11/7/2013, LnaT $25,000,
<br /> DEDUCTIBLE $250
<br /> THE.COUNTY OF SAN ;OAQUIN, ITS OFFICERS, AGENTS, OFFICIALS, ED+lPLOFEES, AND VOLUMMERS ARE NAMED
<br /> ADDITIONAL INSURED'FOR MM BOOT DRIVE -ESLD 041 MAY 26, 2D13 AT THE Zcrr$RS>=CTION 4F MAF�LUI�.`'rE ST AND LOWER
<br /> SACRAMNT'O RD IbT -A70QDBRIDGE, CA, FORM CG 20 12 APPLIES_
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DEWRII3ED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREcOF, NOTICE WALL BE DELIVERED IN
<br /> COUNTY OF SAN JOAQUIN ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> AT TN: -TH014US-GAV
<br /> 1610 E HAZIELTON AVw AUTHORIZED REPRESENTATIVE
<br /> STOCKTON, CA 95205
<br /> ACORD 26(2010106i © -2
<br /> tNSu2S(zoioa5)a> 1. ORPORATIDN. All rights reserved.
<br /> The ACORD narne and logo a m re�Istered ma f ACO
<br />
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