Laserfiche WebLink
ASR" CERTIFICATE OF LIABILITY INSURANCE <br />05/18/20 2"" <br />THIS CERTIFICATE IS ISSUED AS A MATTER 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 />IMPORTANT: If the certificate holder is an ADDITIONAL 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 1-612-333-3323 <br />NANIACT Dawn Heinemann or Sara MCWethy <br />Brown & Brown Inc. <br />(PAR <br />Fard Ac 612-3]3-]2]0 <br />FC : <br />CN ,612-333-3233 No <br />E -MAR <br />FDDRESS: dawn. helnemann@bbrown. com <br />80 South 8th Street <br />INSURERS AFFORDING COVEMGE <br />NAIC# <br />Suite 700 <br />INSURER A: REGENT INS CO <br />29999 <br />Minneapolis, IMF 55902 <br />INSURED <br />INSURER B: GENERAL CAS M OF WI <br />29919 <br />TAR Communications CA, Inc. <br />INSURER INSURANCE M OF THE WEST <br />: <br />2]89] <br />INSURER D: <br />9125 NOLthgate Blvd. <br />INSURER E: <br />MED EXP (Any one person) $ 10,000 <br />INSURER F: <br />Sacramento, CA 95839 <br />COVERAGES CERTIFICATE NUMBER: 65519130 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. NOTMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />(NSR <br />TR <br />TYPE OF INSURANCE <br />1810 East Ha Zeltim Ave <br />SPUR <br />POLICY NUMBER <br />POLICYArm <br />MMDDATYY <br />XP <br />MOREY <br />MN YY <br />LIMITS <br />A <br />X <br />COMMERCNLGENEMLLNBIFIIY <br />MA1392212 <br />05/21/22 <br />05/21/23 <br />EACHOCCURREJCE $ 1,000,000 <br />CWMSMADE Ffl OCCUR <br />DAMAGRIUHNNIED <br />PREMISES Ea occurrence $ 500,000 <br />MED EXP (Any one person) $ 10,000 <br />PERSONAL &ADV INJURY $ 1,000,000 <br />IT AGGREGATE IT MIT APPLIES PER <br />GEJERALAGGREGATE $ 2,000,000 <br />GEN <br />POOLCY�jppCT � LOC <br />PRODUCTS-COMWOPAGG $ 2,000,000 <br />$ <br />OTHER <br />e <br />AUTOMOBILE <br />LIABILITY <br />CEA.392212 <br />05/21/22 <br />05/21/23 <br />Eaa77 $ 11000,000 <br />LODI LY LOUR Y(Per person) $ <br />x <br />ANY AUTO <br />O MED SCHEDULED <br />AUTOS ONLY AUTOS <br />LODI LY LOU RY(Per accident) $ <br />PROPERTY DAMAGE $ <br />(Per accident) <br />HIRED NONONMER <br />AUTos ONLY AUTOS ONLY <br />$ <br />E <br />X <br />UMBRELLA LIABX <br />OCCUR <br />CCU1392212 <br />05/21/22 <br />05/21/23 <br />EACH OCCURRENCE $ 10,000,000 <br />AGGREGATE $ 10,000,000 <br />ESEE SSFIAT <br />CWMSMADE <br />DED I 'v I RETENTION$ 10,000 <br />$ <br />C <br />WORNERS COMPENSATION <br />AND EMPLOYERSLIABILITY <br />A NYRRORRIETowRARTNEWEXE WTVE Y� <br />OFFICEWMEMBEREXCLUOED'1 N <br />(Mandatory in NH) <br />NIA <br />WNPF506569900 <br />05/21/22 <br />05/21/23 <br />X STATUTE F ER <br />EL EACH ACCIDENT $ 1,000,000 <br />EL DISEASE -EA EMPLOYE $ 11000,000 <br />!V describe under <br />DtSLaRIFTION OF OPERATIONS below <br />ELDISEASE -POLIL LMIT $ 1,000,000 <br />DESCRIPTION OF OPERATIONS (LOCATIONS (VEHICLES (ACORD 101, Additional Remarks Schedule, mous be aHabed Amore space is rop fres <br />Evidence of Insurance. <br />CERTIFICATE HOLDER CANCELLATION <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />ddebuhr <br />65519130 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />San Joaquin County <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />1810 East Ha Zeltim Ave <br />AUTHORIZED REPRESENTATIVE <br />Stockton, CA 95205 <br />V <br />USA <br />iii/// <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />ddebuhr <br />65519130 <br />