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A� CERTIFICATE O LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/16/2015 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HDLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 NAME, Robert V. Nuccio R.V. Nuccio&Associates Insurance Brokers, Inc. PHONE — — FAx -- - -- AIC No Ext1_ (800) 364-2433 _ A/c NoL- 818 980_.1595 10148 Riverside Drive E-MAa DRESS: supppoA@rvnuccio.com Toluca Lake, CA 91602 — ----- INSURER(S)AFFORDING COVERAGE NAIC# wsURERA: Fireman's Fund Insurance Company _21873 INSURED INSURER B: Nationwide Life Insurance Compann�— _ 66869 Lincoln Music Boosters — -- -- INSURER C: 6844 Alexandria Place INSURER D: _ Stockton , CA 95207 INSURER E: INSURER F: ----_- -- - COVERAGES CERTIFICATE NUMBER: 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. INSR ADDL SUBR POLICY EFF POLI Y EXP - _--- LTRI PE OF INSURANCE N WV POLICY IJUMBER MM DD/YYYY MMI D/YYYY LIMITS GENERAL LIABILITY A Y/ XPK80963012 10/1/2015 10/1/2016 EACH OCCURRENCE $ _ 1,000,000 `� COMMERCIAL GENERAL LIABILITYDAMAGE TO RENTED - ---- NANP00028781 PREMISES(Ea occurrence)-- _$_ 100,000 CLAIMS-MADE IVI OCCUR MED EXP(Any one person) $ 5,000 - -- PERSONAL&ADV INJURY S_ 1,000,000 -- --- - GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER - ✓ POLICY _ LOC PRODUCTS-COMP/OPAGG $ -_ —.2,000,M000 T $ — — AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS -. AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LIAB OCCUR -- $ EXCESS LIAB CLAIMS-MADE EACH OCCURRENCE - -- -- - AGGREGATE $ DED -- WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY WC STATU- OTH- Y/N T RY LIMIT IE ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ N/A $ (Mandatory in NH) - — -- ----" If yes,describe under E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Additional Insured: Event Description: Band Review Start Date: 11/21/2015 End Date: 11/21/2015 CERTIFICATE HOLDER CANCELLATION County of San Joaquin, Dept. of Public Works SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1810 Hazelton Ave. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Stockton , CA 95205 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Robert V. Nuccio ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD