Laserfiche WebLink
OURLADY-02 LWHITEAKER <br /> DATE(MMIDDIYYYY) <br /> A�oRo CERTIFICATE OF LIABILITY INSURANCEF 9/1/2015 <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 <br /> HE 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). CONTACT <br /> PRODUCER NAME: <br /> Rico Pfitzer Pires and Associates Insurance PHONE (800)399-7473 ac No):(209)854-2520 <br /> AIC No Ext: <br /> P.O.BOX 129 EJMADDRIL ESS:Info rppins.com <br /> Gustine,CA 95322 MAIC* <br /> INSURER(S)AFFORDING COVERAGE <br /> SURER A.Burlington Ins.CO. 23620 <br /> IN <br /> INSURED INSURER B: <br /> Our Lady of Fatima Society of INSURER C: <br /> Thornton, Attn:Secretary INSURERD- <br /> P.O.$OX 611 INSURER E: <br /> Thornton,CA 95686 <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: REVISIONNUMBER: <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 CONTRACTOR 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 /> POLICY EFF POLICY EXP LIMITS <br /> INS <br /> STYPEOFINSURANCE INSD WVD POUCYNUMBER MIDD MMIDDIYYYY <br /> EACH OCCURRENCE $ 1,000,000 <br /> A X COMMERCIAL GENERAL LIABILITY - - <br /> CLAIMS-MADE OCCUR 100,000 <br /> X 9048000197 10/17/2015 10H912015 PREMISES Ea occurrence $MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: <br /> PRODUCTS-COMPIOPAGG $ <br /> X POLICY❑JECT 0 LOC S 1,000,000 <br /> LIQUOR LIAR <br /> OTHER: COMBINED SINGLE LIMIT g <br /> AUTOMOBILE LIABILITY Ea accident <br /> BODILY INJURY(Per person) $ <br /> ANY AUTO BODILY INJURY(Per accident) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS NAUTOS ON-OWNED PROPERTY DAMAGE $ <br /> Per accident <br /> HIRED AUTOS AUTOS $ <br /> EACH OCCURRENCE S <br /> UMBRELLA LIAB OCCUR <br /> AGGREGATE $ <br /> EXCESS L1AB CLAIMS�JIADE <br /> $ <br /> DED RETENTIONS PER OTH- <br /> ER COMPENSATION STATUTE ER <br /> AND EMPLOYERS'LIABILITY YIN EL EACH ACCIDENT $ <br /> ANY PROPRIETOR, RTNERJEXECUTiVE ❑ N I A <br /> OFFICERMIEMBER EXCLUDED? EL.DISEASE-EA EMPLOYE $ <br /> (MandatoryIn-der E.L DISEASE-POLICY LIMIT $ <br /> If yes, <br /> describe <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD fol,Additional Remarks Schedule,may be attached Umore space Is required) <br /> Certificate Holder is named as Additional Insured with respect to General Liability in regard to the Bodo Lie Leit being held on 10-17-15 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> County of San Joaquin&Its Board of Supervisors,Officers THE .EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> q ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Employees and Agents <br /> P.O.Box 1810 <br /> Stockton„CA 95201 AUTHORIZED REPRESENTATIVE <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> Ar-nnn 9c I?nenrnat TI—Arman —A I---pro•�,:�f�.o� ^�:"�^F errirzn <br />