Laserfiche WebLink
® DATE (MM/DD/YYYY) <br />CERTIFICATE OF LIABflLITY Jed BURANCE; <br />10/16/2019 <br />THIS CERTIFICATE IS ISSUED lAS A W%I TER OF INFORMATION 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 CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />Imrvlt IAn I: Ir the certlrtcate nolaer Is an wDDITIVnAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />AssuredPartners of Minnesota LLC <br />2361 Hwy 36 W <br />St. Paul <br />INSURED <br />TA(C Communications CA, Inc. <br />4125 Rorthgate Blvd <br />Sacramento <br />COVERAGES <br />Kelly St <br />(651) <br />INSURERS) AFFORDING COVERAGE <br />MN 55113 INSURERA: Employers Mutual Casualty Co <br />INSURER B : State Compensation Ins Fund <br />INSURER C : Burlington Ins <br />CA 95II3n I INSURER <br />CERTIFICATE NLIM9ER� '19120 Master <br />CO <br />DCVICIAIJ a111aaDCD• <br />(651) <br />NAIC S <br />21415* <br />35076 <br />23620 <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 CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />ILTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MM/DPNYY POLICY LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />6N03821 <br />05/21/2019 <br />05/21/2020 <br />EACH OCCURRENCE <br />$ 11000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$ 500,000 <br />MED EXP (Any one person) <br />$ 10,000 <br />PERSONAL BADVINJURY <br />$ 130001000 <br />GEN'LAGGREGATE LIMITAPPL.IES PER: <br />POLICY ❑X PECT LOC <br />X OTHER: $5,000 PD Deductible <br />GENERALAGGREGATE <br />$ 21000,000 <br />PRODUCTS -COMP/OPAGG <br />$ 21000,000 <br />Employee Benefits <br />$ 11000,000 <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANYAUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PD Deductibl <br />6803821 <br />05/21/2019 <br />05/21/2020 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 11000,000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />X <br />Underinsured motorist <br />$ 750,000 <br />AEX <br />UMBRELLA LIAB <br />CESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />6J03821 <br />05/21/2019 <br />05/21/2020 <br />w, I t�II ,.." "It 3a MI 18 L <br />EACH OCCURRENCE <br />$ 10 000,000 <br />AGGREGATE <br />$ <br />DED <br />X <br />RETENTION $ 10,000 <br />$ <br />B <br />WORKERS COMPENSATION <br />EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBEREXCLUDED7 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />9254138-2019 <br />05/21/2019 <br />05/21/2020 <br />XSTATUTE <br />ETH <br />AND <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE • EA EMPLOYEE <br />$ 13000,000 <br />E.L. DISEASE -POLICY LIMIT <br />$ 11000,000 <br />C <br />Excess Umbrella <br />HFF0009475 <br />05/21/2019 <br />05/21/2020 <br />Each Occurrence <br />Aggregate <br />$10,000,000 <br />$10,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />LGIiL�I��Ja:l <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE I?XPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />San Joaquin County ACCORDANCE WITI� THE POLICY PROVISIONS. <br />1810 East Hazelton Ave <br />AUTHORIZED REPRESENTATIVE <br />Stockton CA 95205qwyfl <br />9� <br />©1988-2015 ArIORCl CORPORATION. <br />All rights reserved. <br />ACI�F+;fj 25 (7,cN16/03) 1'fle,AF'.(JE:13 lnaolEe arld logo are registered marks of A,CORD <br />