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<br /> CERTIFICATE DATE(MWDDVYYYf�
<br /> E OF LIABILITY INSURANCE 1/14/2014
<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, ECTEND 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 POIIC)(les)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 DiAnna Martin
<br /> All-Cal Insurance Agency PHONE (916)784-9070 F
<br /> 505 Vernon Street .I91a17aa-ossa
<br /> NAIL diannaSall-aalinsurance.co®
<br /> Roseville CA 95678 'NSUAFFOEmINOCOVERAGE MAIC#
<br /> INSURED INSURERA lopprofits, Ins Alliance of CA AC
<br /> Firefighters Burn Institute 114SURERS:0idelit And De sit C
<br /> 3101 Stockton Blvd INSURER C:
<br /> INSURER 0:
<br /> SacramentoINSURER E:
<br /> cA 95sao INSURERF:
<br /> COVERAGES CERTIFICATE NUMBER:CL13102303605 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 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 /> LTR TYPE OF INSURANCEmaim POLICY NUMBER POLICY EFF POLICY EXP
<br /> GENERAL LIAsnmr LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0001
<br /> A CLAIMS-MADE [i]OCCUR X 9013-14493 1/7/2013 1/7/2014 EM $ 500,000
<br /> X s1apltoP1*al 68Z>t1AL co>apvCT
<br /> MED EXP one erean $ 10,000
<br /> $?50,000 / $]50,000 PERSONAL 3ADVINJURY $ 1,000,000
<br /> _
<br /> GENERAL AGGREGATE $ 2,000,00o
<br /> GEN'L AGGREGATE L1MTT APPLIES PER.
<br /> X M ECT PRO- LOC PRODUCTS-COMROPAGO $ 1,000,000
<br /> AUTOMOBILE LIABILITY
<br /> FULL LIQUOR LIABILITY $ 11000,000
<br /> LIMIT
<br /> A ANY AUTO BODILY INJURY
<br /> ALL OWNED (Per
<br /> AUTOS TOS 2013-14425 1/7/2013 1/7/2014 BODILY INJURY Peracd�) $
<br /> HIRED AUTOS �OOSS NED ( d $
<br /> $
<br /> UMBRELLA UAB $
<br /> OCCUR EACH OCCURRENCE LIAR CLAIM&MADE $ 41000,000
<br /> qEXCESS
<br /> AG $
<br /> OED X RETENTION 10,00 9013-14425—Ui® 1!7/2013 1/7/2014 GREGATE 4,000,000
<br /> WORKERS COMPENSATION $
<br /> AND EMPLOYERS,LIABILITY WC STogy wat OTH-
<br /> ANY PROPRIETORIPARTNER(EX
<br /> OFFICERIMEMBER EXCLUDED?ECUTIVE a N/A E.L.EACH ACCIDENT
<br /> (MendMURY In NH) $
<br /> M yyeeaa,describe under E.L.DISEASE-EA EMPLOYE $
<br /> OESgi1PT10N OF OPERATIONS below
<br /> E.L.DISEASE-POLICY LIMIT $
<br /> WIOLOMM DISSONESTX CCP 0060574 10 /19/2014 /19/2018 LIMITS
<br /> FORGERY/ALTERATION 100,000
<br /> $
<br /> DEDUCTIBLES 1,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES Wwh ACORO 701,AddMwW Rolm8chsdue,,0 mors Is regelred)
<br /> MONIES & SECURITIES, FOLICr # COM 000 3844-10 14423, EFF. 11/7/2013, BRP. 11/7/2014, LIMIT $25,000,
<br /> DEDUCTIBLE $230
<br /> TIM COUNTY OF SAN JWtQII N, ITS OFFICERS, AGENTS, OFFICIALS, HIMLOYSM, AND VOLUNTEERS ARE MUt6D
<br /> ADDITIONAL 2RSUREb FOR THE
<br /> THORNTON FILL THE HOOT FOR BURNS BOOT DRn% EVENT FROM X&RRCH 15-16, 2014
<br /> AT THE FOLLOWING LOCATIONS: I. THORNTON RD / TURNER RD/ 2. TRORapM RD / PELTIER RD FORM CO 20 12
<br /> APPLIES.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE; EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN
<br /> COUNTY OF SAN JOAQUIN ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> ATTN s THOMAS G1AU, DIRECTOR OF PMLIC > OMM
<br /> 1810 E MMXLTON AVE AUTHORIZEDREPRESENTAIWE
<br /> STOCKTON, CA 95205
<br /> ACORD 01 (2010/05) ®1=)-1-0—A ORPORATiON. All rights reserved,
<br /> INS02S(zmoos).o1 The ACORD Hams and logo are registered rrtaCOR
<br />
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