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7 ® I� (� pp /�� p D� ��NN C� pp pp rip C DATE(MM/DD/YYYY) <br />'ORO ( (� ri LC uJ L� G O L-� 0 TY I I � S U fu " fl �'J C L 10/28/2019 <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />R.V. Nuccio & Associates Insurance Brokers, Inc. <br />10148 Riverside Drive <br />Toluca Lake, CA 91602 <br />INSURED <br />Lincoln Music Boosters <br />6844 Alexandria Place <br />Stockton , CA 95207 <br />nnvco a n_cc <br />r`CDTICICATC All IMRFR• <br />Robert V. Nuccio <br />COVERAGE <br />INsuRERA: Fireman's Fund Insurance <br />21873 <br />INsuRERB: Nationwide Life Insurance Com an 66869 <br />INSURER C: <br />INSURER D: <br />RFVISI�N NUMBER: <br />1595 <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 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 />ILTR <br />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />MMIDD/YEYYI <br />POLICY <br />MID IYYXYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />✓ COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE ❑✓ OCCUR <br />✓ <br />XPK80998373 <br />NANP00045426 <br />10/25/2019 <br />10/25/2020 <br />EACH OCCURRENCE <br />$ 11000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$ 100,000 <br />MED EXP (Any one person) <br />$ 51000 <br />PERSONAL&ADV INJURY <br />$ 11000,000 <br />GENERAL AGGREGATE <br />$ 21000,000 <br />PRODUCTS -COMP/OPAGG <br />$ 21000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />rV/1 POLICY PEO 7 LOC$ <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />ANY AUTO <br />BODILY INJURY (Per person) <br />$ <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />HIREDAUTOS AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE <br />$ <br />DED <br />I <br />I RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />WC STATU- <br />I <br />'ER'_ <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE �N <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NH) <br />/ A <br />E.L. EACH ACCIDENT <br />$ <br />E. DISEASE - EA EMPLOYE <br />$ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />A <br />Directors and Officers <br />NPOD00051451 <br />10/25/2019 <br />10/25/2020 <br />$1,000,000 <br />B <br />AD&D Medical Plus <br />NPOAM0037485 <br />10/25/2019 <br />10/25/2020 <br />$10,000 <br />A <br />Sexual Misconduct Liability <br />NANP00045426 <br />10/25/2019 <br />1 10/25/2020 <br />16000,000 <br />DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) <br />Additional Insured: / Sexual Misconduct Liability included. Event Description: Band Review Start Date: 11/15/2019 End Date: 11/17/2019 <br />CERTIFICATE HOLDER <br />County of San Joaquin, Dept. of Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />1810 Hazelton Ave. <br />Stockton , CA 95205 <br />CELLATION <br />EXPIRATION DATE <br />THE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Robert V. Nuccio <br />©1988-2010 <br />istered marks of AC <br />ACORD CORPORATION. All rights reserved. <br />ACORD 7.5 (2010/05) The ACORD name and logo are regORD <br />