Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2014_PS-1401001 thru PS-1401500_ - PS-1401232

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Amp CERTIFICATE OF LIABILITY INSURANCE D17/IDD/Y4 L..,i SU CE 3//1„2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER ACT NAME: DiAnna Martin. All-Cal Insurance Agency PHONE (916)784-9070 No:(916)784-0158 505 Vernon Street ADDRESS:dianna@all-calinsurance.com ADDRESS. INSURERS AFFORDING COVERAGE NAIC# Roseville CA 95678 INSURERA:NOnprofits I Ins Alliance of CA NXAC INSURED INSURERB:Fidelity And De Osit Company Firefighters Hurn Institute INSURER C: 3101 Stockton Blvt3 INSURER D: INSURER E: Sacramento CA 95820 1 INSURER F: COVERAGES CERTIFICATE NUMBER:CL13102303605 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INS POLICYNUMBER POLICY EFF MMLD�/YYYP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X i COMMERCIAL GENERAL LIABILITY PREMISES E occurrence $ 500,000 A CLAIMS-MADE OCCUR X 2013-14425UPO 11/7/2013 1/7/2014 MED EXP(Any one person) $ 20,000 XJ IMPROPER SEXUAL CONDUCT PERSONAL&ADV INJURY $ 11000,000 $250,000 / $250,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC FULLLI1 .1 .ABILITY $ 11000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 2013-14425XPO 11/7/2013 11/7/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAR A CLAI AGGREGATE $ 41000,000 MS-MADE DED I X I RETENTION 10,000 X 2013-14425-UMB 11/7/2013 11/7/2014 $ WORKERS COMPENSATION I wC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE II N/A E.L.EACH ACCIDENT $ OFFICERNEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ [fes,describe under DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE-POLICY LIMIT $ B EMPLOYEE DISHONESTY CCP 0060574 10 /19/2014 /19/2015 LIMITS 100,000 FORGERY/ALTERATION DEDUCTIBLES 1,()00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD f 01,Addltlonal Remarks Schedule,If more apace is required) MONIES & SECURITIES, POLICY * CWB 000 3844-08 14425, EFF. 11/7/2013, EXP. 11/7/2014, LIMIT $25,000, DEDUCTIBLE $250 SAN JOAQUIN COUNTY PUBLIC WORKS, ITS OFFICERS, AGENTS, OFFICIALS, EMPLOYEES & VOLUNTEERS ARE NAMED ADDITIONAL INSURED FOR THE BOOT DRIVE TO BE HELD ON MAY 10, 2014 AT E. H” 26 / N DUNCAN RD. FORM CG 20 12 APPLIES. CERTIFICATE HOLDER CANCELLATION (209)468-3000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SAN JOAQUIN COUNTY PUBLIC WORKS ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: THOMAS M. GAU 1810 E HAZELTON AVE AUTHORIZED REPRESENTATIVE STOCKTON, CA 95201 ACORD 25(2010105) 1 8-2010 D ORPORATION. All rights reserved. INS025(201005).Di The ACORD name and logo are registered m of ACO