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. <br />ACORD'"CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYVV) <br />~2/16/2016 <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 ISSUHIG 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). <br />PRODUCER ~2AA~~CTDiAnna Martin <br />All-Cal Insurance Agency If,UgNrfo'"yt"(916)784-9070 I f,.e~No':(916)784-0158 <br />505 Vernon street ~~~~SS:dianna@all.-caJ.~nsurance.com <br />INSURERIS\AFFORDING COVERAGE NAJC# <br />Rosevi1.1e CA 95678 INSURERA~onnrofitsf Insurance Alliance of 011545 <br />INSURED INSURERB :North American Elite Insurance 29700A <br />Firefighters Burn Institute INSURERC: <br />3101 Stockton Blvd.INSURER0: <br />INSURERE: <br />Sacramento CA 95820 INSURERF: <br />COVERAGES CERTIFICATE NUMBER:CL161605112 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIODINDICATED,NOTWITHSTANDINGANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWlTH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFt==ORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POI.ICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSR TYPE OF INSURANCE A DLS s.&3lJ~~~I~UCYEXP UMITSLTRPOL.ICY NUMBER M/DDJYYYY <br />X COMMERCIAL.GENERAL llABIUJY EACH OCCURRENCE $1,000,000 <br />A I CLAIMS.MADE [i]OCCUR ~=~~J?E:~~~;'OO'$500,000 <br />~IMPROPER SEXUAL CONDUCT X 2016-14425NPO 1/1/2016 1/l/2017 MED EXP (Any one person)$20,000 <br />~$250,000 /250,000 PERSONAl &ArN INJURY $1,000,000 <br />~'LAGGREGATE LIMITAPPLIES PE",GENERAL AGGREGATE •2,000,000 <br />X POL.lCY D~r8T DlOC PRODUCTS -COMPfOP AGG •2,000,000 <br />OTHER:lIQUOR UABlLlTY $1,000,000 <br />AUTOMOBilE L.IAB!UTY 1:~~~~t\SINGlE UMIT •-BODilY INJURY (Per person)•ANY AUTO-ALlOVvNED -SCHEDULED $AUTOS -AUTOS BODILY INJURY (per accident)-NON"()WNED PROPERTY DAMAGE •-HIRED AUTOS -AUTOS Per accident •X UMBRELLA LIA8 --1 OCCUR EACH OCCURRENCE $•000 000- <br />A EXCESSLIAB CLAIMS-MAOE AGGREGATE $•000 000 <br />OED I X I RETENTION $10 000 2016-14425UMB 1/1/2016 1/1/2011 $ <br />WORKERS COMPENSATION I~f~TUTE I I~~H.ANI>EMPLOYERS'LlABtI.lTY YINANYPROPRIETORlPARTNERlEXECUTI\IE 0 NIA E.L EACH ACCIDE:NT •OFFlCERlMEMI3ER EXClUDED?(Mandatory In NH)E.L DISEASE.EA EMPLOYE •g~6~~8~'tJ~OPERAnONS below E,L.Dl$I;ASE -POLICY LIMIT • <br />B EMPLOYEE DISHONESTY cw.B000 3844-12 14425 1/1/2016 1/1/2017 LIMITS 100,000 <br />FORGERY &ALTERATION DEDUCTIBLE 250 <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEtiCLES (ACORD 101,AdditIonal R~arlm Schedule,may bc ~ttaehecllf rnoro space 1&requIred} <br />THE COUNTY OF SAN JOAQUIN,ITS OFFICERS,AGENTS,OFFICIALS,EMPLOYEES,AND VOLUNTEERS ARE NAMED <br />ADDITIONAL INSURED FOR THE "FILL THE BOO'.l'FOR BURNS"BOOT DRIVE ON MARCH 19 &20,2016 AT THE FOLLownlG <br />LOCATIONS.1.THORNTON RD/TURNER RD.2.THORNTON RD/PELTIER RD.3.THORNTON RD/WALNUT GROVE RD.FORM CG <br />20 12 APPLIES <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHEEXPIRATIONDATETHEREOF,NOTICE WILL BE DELIVERED INACCORDANCEWITHTHEPOUCYPROVISIONS. <br />AUTHORIZED REPRESEN.T AlIVEd~ <br />@1988.2014ACORDCORPORATIO <br />The ACORD name and logo are registered marks of ACORD <br />COllNTX OF SAN JOAQUIN <br />ATTN:KRIS BALAJI,DIRECTOR OF PUBLIC WORKS <br />1810 E.HAZELTON AVE. <br />STOCKTON,CA 95205 <br />ACORD 25 (2014/01) <br />INS025 (201401)