Laserfiche WebLink
'4� CERTIFICATE OF LIABILITY INSURANCE DATE 0`20 4' <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(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 NAME:ONTACT Mary Nathan <br /> Mid-Central Valley Insurance PHONE (209)334-4242 FAX (209)369-0684 <br /> 301 S. Ham Lane, Suite F AR E-M .mnathanemcvins.com <br /> P.O. BOX 490 INSURERS AFFORDING COVERAGE NAIC# <br /> Lodi CA 95241 INSURER A:Nauti lus Insurance Company <br /> INSURED INSURER B: <br /> Linden-Peters Chamber of Commerce INSURER C: <br /> P. 0. BOX 557 INSURER D., <br /> INSURER E: <br /> Linden CA 95236 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:2014-2015 Liab Cert 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 /> INSR ADDL SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE POLICY NUMBER MM D M__DDtfYYY1 LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE $ 11000,000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAG18 <br /> PREMISES o rt nce S <br /> A CLAIMS-MADE FOOCCUR X NW502306 1/1/2014 11/1/2015 MED EXP(Any one person) S 5,000 <br /> PERSONAL BADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GENL AGGREGATE LIMIT APPLIES PER: PRODUr FCTS-COMP/OP AGG $ Include <br /> X POLICY PRO- LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea .cidrej <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS BODILY INJURY(Per accident) $ <br /> NON-OWNED PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS Per accident) $ <br /> $ <br /> UMBRELLA LIABOCCUR EACH OCCURRENCE $ <br /> EXCESS UAB CLAIMS-MADE AGGREGATE LS <br /> DED I RETENTION$ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERT LIABILnY Y!N <br /> ANY PROPRIETORIPARTNERIEXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? ❑ N 1 A E.L.EACH ACCIDENT $ <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,dribe under <br /> DESCRIPTescION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) <br /> Linden-Peters Chamber of Commerce Tree Lighting Ceremony 2014. <br /> San Joaquin County is additonal insured per attached CG2011 01 96 <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 /> San Joaquin County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 1810 B. Hazelton Ave. <br /> Stockton, CA 95205 AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2010/05) @ 19813l,2010 ACORD CORPORATION. All rights reserved. <br /> INS025(201005).01 The ACORD name and logo are registered marks of ACORD <br />