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'4 CERTIFICATE O LIABILITY INSURANCE 2/3/2015 YY' <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 INSL RED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may re luire an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT Lori Unger <br /> g <br /> Dohrmann Insurance Agency PHONE (209)478-1400 FAC No):(209)478-1414 <br /> P. O. Box 7956 E-MAIL ADDRESS:Lori@dohrins.com <br /> 3255 W. March Lane Suite 200 INSURERS AFFORDING COVERAGE NAIC# <br /> Stockton CA 95267 INSURERA:Travelers Prop Cas Co of Amer 25674 <br /> INSURED INSURERS Em to ers Preferred Ins Co 10346 <br /> Sims-Grupe Management Corp. , Inc. INSURER C <br /> DBA: Lincoln Center Merchants Assn INSURERD: <br /> 374 Lincoln Center INSURER E: <br /> Stockton CA 95207 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:15--16 All Lines REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 13ELOW 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP <br /> LTR POLICY NUMBER MM/DDIYYYY MM/DDIYYYY LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br /> PREMISES Ea occurrence $ 100,000 <br /> A CLAIMS-MADE a OCCUR X 630-6C801347-TIL-15 1/1/2015 1/1/2016 MED EXP(Any one person) $ eXcl <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> X POLICY PRO LOC $ <br /> JECT <br /> AUTOMOBILE LIABILITY (Ea accident)SINGLE LIMIT 1,000,000 <br /> A X ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED -6C792487-'CCT-15 1/1/2015 1/1/2016 BODILY INJURY Per accident $ <br /> AUTOS AUTOS ( ) <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS Per accident <br /> Uninsured motorist combined $ 60,000 <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 11,000,000 <br /> A X EXCESS LIAB HCLAIMS-MADE AGGREGATE $ 11,000,000 <br /> DED RETENTION$ X-6C801347-'.CIL-15 1/1/2015 1/1/2016 $ <br /> B WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY YIN IT <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICERIMEMBER EXCLUDED? ❑ N/A <br /> (Mandatory in NH) IG2157606-00 1/1/2015 1/1/2016 E.L.DISEASE-EA EMPLOYE $ 1,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> San Joaquin County Department of Public Works is named as an additional insured as required per written <br /> contract per the attached form CGD144 0196. <br /> Re: Lincoln Center Live Car Show - Road Closure <br /> Event Date: August 21, 2015 <br /> *(10) Ten day notice of cancellation for non-payment of premium <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 /> Department of Public Works <br /> 1810 Hazelton Ave AUTHORIZED REPRESENTATIVE <br /> Stockton, CA 95201 <br /> Gregory Dohrmann/LORI — <br /> ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> INS025 rgmnnsi ni TI-Arr)Dn ­/,1„<,,, <. L� of Annan <br />