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ISSUE DATE(MMIDDIYY) <br /> 3130/90 <br /> NNW � � TlF)CATE DOES NOT AMEND, <br /> [` 1NFORMAT40N ONLY AND CONFERS <br /> ISS <br /> HtS <br /> f !�(� ���v <br /> `+ THIS CEH S UPON TtiE CERTIFICATE <br /> ERAGE FORDED BY THE POLICIES BELOW <br /> NO RIG <br /> EXTEND DR ALTER THE CO COVERAGE <br /> PRODUCER "'-Y+ I�'c. COMPANIES AFFflRDIt1G <br /> Angie Lorm+e <br /> 11 Insurance Ag GdMpA a��� <br /> p, Box 201004 gD'34 Y C <br /> GA �52UI- COMPANY A Fremont Coo'ensation InsuranCe�ti� r <br /> $tOCktOSI% LETTER 1�� <br /> COMPANY <br /> SUB-CODE LETTER <br /> CODE <br /> COMPANY C' <br /> LETTER <br /> INSURED <br /> COMPANY <br /> Larry 41. Akslands Inc• LEER <br /> veritas AVenue COMPANY E <br /> GA 95336 LETTER <br /> Via,nteCa ABOVE FDR THE POLICY OWHICHT HIS <br /> THE INSURED NAMED IS SUBJECT TO ALL THE TERMS. <br /> BEEN ISSUED TO OR OTHER DOCUM7 NT WITH RESPECT TO <br /> BELOW HAVE HEREIN <br /> BY THE POLICIES DFSpL CLAIMS <br /> N COVERAGES TERM OR CONDITION OF ANY GE <br /> BY PAID <br /> PERTAIN SHOWN <br /> MAY HAVE BEEN POLICY <br /> EXPIRATION ALL LIMITS 1N THOS <br /> )5 TO E THE 1NSUAANCE AFFORDED 1 <br /> i IS CERTIFY TgTANDING�NYIREP UI ESMENT CE LISST L <br /> TH $ <br /> NOTWI7 MAY LIMITS <br /> INDICATED, MAY BE ISSUED ORF SUCH POLICIES. PATE(MMIODfYY) <br /> 1 OER7fFlCA7E CONDITIONS POLICY EPpECT4VE P <br /> POLICY NUMBER DATE(MM1DDNY) GENERAL AGGREGATE <br /> EXCLUSIONS AND <br /> _ PRODUCTS-CON1PrOPS AGGREGATE <br /> TYPE OF INSURANCE &ADVERT4S4NG INJURY $ <br /> CO PERSONAL S <br /> LTR <br /> EACH or <br /> CURRENG $ <br /> I GENERAL LIA13lL17Y E(Anyone fire) <br /> GENERAL L4A731LITY FIRE DAMAGE( gSeen) <br /> OOMMERC4Ai OCCUR. one R <br /> I CLAIMS MADE MEDICAL EXPENSE(Any <br /> COMBINED $ <br /> OWNER'S&CONTRACTOR'S PRO SINGLE <br /> LIMIT <br /> t BODILY S <br /> 4{ INJURY <br /> I AUTOMODILE L4ABILfTY <br /> (Per person) <br /> BODILY S <br /> ANY AUTO INJURY <br /> accident) <br /> ALL OWNED AUTOS (Per <br /> l ;,:S SCHEDULEO AUTOS PROPERTY $ <br /> DAMAGE <br /> HIRED AUTOS EACH <br /> NON-O NNED AUTOS OCCURRENCE <br /> $ <br /> IILJr,I GARAGE LIABILITY <br /> r � ) STATUTORY <br /> 1 EXCESS LIABILITY 1J90 41/ 1 <br /> 41 <br /> UM1fBREI LA $ sj0"t3 <br /> OTHER THANii�9u�9��i�9—�1 <br /> N <br /> 'S COMPETISATIO <br /> 4 A WORKERAND <br /> �I EMPLOYERS'LIABILITY <br /> r <br /> 111 OTHER <br /> SIGN I <br /> SCRIFTION OF <br /> OPERATIONSfLOCATIONSfVEHICLESIRESTR1CT10NS!SPECIAL ITEMS <br /> DE <br /> Redit) All California ()PPratiorks CAt4CB.L1.ATION <br /> POLICIt <br /> ANY OF THE ABOVE DESCR46ED <br /> I SHOULD ISSUING <br /> r HOLDER DATE THEREOF, THE THE CER` <br /> CERT4FiCATB EXPIRATION NOTICE TO <br /> tltal Health D#�#sz°n MAIL�U--DAYS WR(T7EN NOTICE Sr <br /> �pYi ronrk TO MAIL SUCH COMPANY, <br /> I" <br /> San 3oaq <br /> ui)1 LoCal Kcal th Il}stri ct LEFT, BUT FAILURE <br /> BOK 2009 LIABILITY OF ANY KIND UPON THE, <br /> StOCI�tOn� �� 9�20IEPRESENTATIVE <br /> AUTHORIZED 7x / � <br /> Y i _fir <br /> �) ACORD as-s t3lsai <br />