Laserfiche WebLink
'..,.,IACORD"CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDDNYYY) <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 ISSUING INSURER(S},AUTHORIZED <br />REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, <br />IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to <br />the terms and conditions of the policy,certain poJicies 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 />PROCUCER ~2~~~CTDiAnna Martin <br />All-Cal Insurance Agency Ifl:8NNEoExt.(916)784-9070 I fti~N~:(916}7B4-01SB <br />505 Vernon street ~~DA~~SS:dianna@all calinsuranoe _com <br />INSUREf=({S)AFFORDING COVERAGE NA.1C;';f <br />Rosev.ille CA 95678 INSURER A :Nono.rofits f Insurance Alliance of 011845- <br />iNSUREO INSURERB:North American Elite Insurance 29700A <br />Firefighters Burn Institute INSURERC: <br />3101 Stockton Blvd.INSURER0: <br />INSURERE: <br />Sacramento CA 95820 INSURER F; <br />COVERAGES CERTIFICAl1=NUMBER'CL161605112 REVISION NUMBER' <br />1,000,000 <br />500,000 <br />20,000 <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />1,000,000 <br />$ <br />$ <br />$ <br />, <br />$ <br />lIMITS <br />EACH OCCURRENCE <br />~~~~~~-YE~~~~~nca' <br />MEO EXP (Any -one persoil) <br />PERSONAL &ADV INJURY <br />BODfLY INJURY (Perace;denl)$ <br />Pp~~~~pAMAGE $ <br />$ <br />GENERAL AGGREGATE <br />PRODUCTS>COMP/OP AGG $ <br />LIQUOR UAfllUTY $ <br />~~~~~~d~l,SINGlElIM!T $ <br />BODILY INJURY {Per person)$" <br />1/1/20171/1/20162016-14425NPOx <br />,-------SCHEDULED <br />I-~~~<]WNEO <br />I-AUTOS <br />ANY AUTO <br />AllOVvNEDAUTOS <br />HIRED AUlDS <br />A <br />THIS is TO CERTIFYTHAT THE POLICiES OF INSURANCE LISTEDBELOW HAVE 8EEN ISSUED TO THE INSUREO NAMEDABOVE FOR THE POLICY PERIOD <br />INDICATED.NOT'MTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTINlTH RESPECT TO \I\Il;ICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCR.lBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />I~f:TYPE OFINSURANCE r.~~;SUER POl-lCYNUMBE:R ~gM~}'J~~I~g~%~~ <br />X COMMERCIAL GENERAL L1ABIUTY <br />I CLAIMS-M;\DE:W OCCUR <br />X IMPROPER SEXUAL CONDUCT <br />$250,000 /250,000 <br />~GlEN'LAGGREGATE LIMITAPPLIES PER: <br />X POLlCY D fmr DLOC <br />OTHER: <br />AUTOMoelLE LIABll.llY-~ <br />- <br />- <br />I~UMBRELLALIAS r--l--OCCUR <br />A EXCESSLIAS nCLAIMS-MADE <br />OED I X I RETENTION $10 000 <br />WORKERS COMPENSATION <br />AND EMPLOYERS'WASIl.ITY Y !N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE 0 N/AOFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />II yes,describe ul'1derDESCRIPTIONOFOPERAllONS below <br />B EMPLOYEE DISHONESTY <br />FORGERY &ALTERATION <br />2016-144;25t)MB <br />CWB 000 3844-12 14425 <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />1/1/2016 1/1/20n $ <br />I~~~nrrEI I~~11- <br />E.L EACH ACCIDENT $ <br />E.L DISEASE.EA EMPLOYE $ <br />E.L DISEASE-POLICY LIMIT $ <br />1/1/2016 1/1/2017'llMITS <br />DEDUCTIBLE <br />4 000,000 <br />4 000 000 <br />100,000 <br />250 <br />DESCRIPTION OF OPERATIONSl LOCATIONS 'VEHICLES (AGORD 101,Mdltlonlll ReTIl.ttrks SchocitJle,mny beattacf10d 1fmorespacc lsraqulrcdj <br />THE COUNTY O~SAN JOAQUITN,IT$OFFICERS,AGENTS,OFFICIALS,EMPLOYEES,AND VOLUNTEERS ARE NAMED <br />ADDITIONAL INSURED FOR THE "FILL THE BOOT FOR BURNSll BOOT DRIVE ON MARCH 19 &.20,2016 AT THE FOLLOWING <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 OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF,NOTICE WILL BE DEUVERED iN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVEd~~c.. <br />@1988.2014ACORDCORPORATIO <br />The ACORD name and [ago are registered marks of ACORD <br />COUNTC(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 (201'101}