Laserfiche WebLink
ABLEMAI-CL HFAHY <br /> DATE IMMIDOMYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE vonizols <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CO NP ERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> ORDED BY THE POLICIES <br /> BELOW. THIS CERTNC <br /> IFICATEOFINSURANCE DOES VELY OR NEGATIVELY <br /> CO'NSTTUTE%AECONTRACT ND OR T BETWEEN ER THE OHEISISSUING GE FNSUR RSL AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HC4DERSue 1 IION IS 10 <br /> - <br /> 'OES <br /> IMPORTANT: If the certificate holder Is an ADDITIONAL INSURE-an ?dPo)�mient A statement on this f certificate Ados$hot VconferOrigh s)totthe <br /> the terms and conditions of the policy,certain Policies may req <br /> uire <br /> certificate holder in lieu of such and..annent(0. cDNraCT <br /> PRODUCER I 17071626.4176 <br /> PnaNE ,q,(707)626-4160 <br /> George Petersen Insurance Agency,Inc. q� info inslcom <br /> P.D.Box 3539 AODR Se: ---'-- -- NAIGa <br /> Santa Rosa,CA 95402 INSURER(SI AFFORDING COVERAGE <br /> I aUHERA Homeland Ing urende Company of New York 27881 __ <br /> INSURED INSURER,:National Sure Co .oration 36076 <br /> INSURERC:State Com enation'Insurance Fund <br /> Able Maintenance Inc. INSURERD: <br /> 3224 Regional Parkway <br /> Santa Rosa,CA 95403 INSURERE_�____. - <br /> INSURER F: <br /> COVERAGESCERTIFICATE NUMBER: <br /> REVISION NUMBER: <br /> HIS IS TOED. CERTIFY <br /> YH THAT <br /> NDING ANY REQUIREMENT, TERMNCE OR CONDITIONSTED AOF ANY CONTRACT OR OTHER DOCUMENT W77fi RESPECT OVE BEEN ISSUED TO THE I U E NA FOR THE LIWHICHCY RTHIS <br /> NOrMTCERTIFICATE <br /> MAY BE ISSUED <br /> S UEDOR O SUCH POLCEIS. THE <br /> H ISHOWN MPY FFORDED BY THE L <br /> HAVE BEEN REDUCED BY IPAID CLAIMS.ES 110 ED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> OL EFF ICY EXP LIMITS <br /> TNSRPOLICY W11.9ER MMIODnT MMIDOM"Y1' 5,000,000 <br /> LTR TYPEOFINSURANCE I EACH OCCURRENCE S <br /> A X COMMERCIAL GENERAL LIABILITY 1011112014 1011112016 50,000 <br /> OCCUR 93-00.26.72-0000 PREMISES S ..— 5,00 <br /> CLAIMS-MADE MED E%P lAny one person) S <br /> X Pollution&Profess. 5,000,00 <br /> - PERSONA44.AOVITF S <br /> GENERALAGGREGATE S 5,000,000 <br /> GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAGG S 5,DDD,DO <br /> LI <br /> POLIcv JPERCO.❑ 7LOC MOLD E 1,000,00 <br /> C MBINE SI G EU IT a 1,000,00 <br /> OTHER Ea ddent <br /> AUTOMDBILELIAMLITY 04/01/2016 0410112016 BODILY INJURY(Pat heron) Y _ <br /> B X ANY AUTO MZA 80310913 <br /> BODILY INJURY(PereNdent) S <br /> ALL OWNED SCHEDULED PMP DAMA _S <br /> AUTOS AUTOS Pda <br /> NONOWNED <br /> HIREDAUTOS AUTOS S <br /> EACH OCCURRENCE S 4,000,000 <br /> UMERELLa U X OCCUR 0410112015 04/01/2016 A00REGATE S 4,000,00 <br /> B X EXCESS LNU CLAIMS-MADE AE 32147605 $ <br /> DED RETENTIONS X 6 AT E R <br /> WORRERSCOMPENSATION1,000,0'0 <br /> AND EMPLOYERS'LIABILITY YIN 073219.15 1010112016 10/01@016 EI EACH ACCIDENT i 1,000,00 <br /> Rd <br /> C ANY PROPRIETORIPARTNERIEXECUTNE NIA E.L.DISEASE-EA EMPLOYE S <br /> OFFICEREMBER EXCLUDED? 1,000,00 <br /> IMmdatory In NVO E,L DISEASE-POLICY LIMIT f <br /> IIy r,deacba OfO <br /> DESCRIPTION OF OPERATION6DMo+ I <br /> DESCRIPTION OP OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.AddhIOPat AmiMsschedule,may McMch.d lr"Ie a pace la rogNrtd7 REG`S <br /> G P■. b j <br /> Proof Of coverage ■■\\VVII <br /> DEC 11 2 15 <br /> NTAL <br /> CANCELLATION AACAIT <br /> CERTIFICATE HOLDER <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIESBE CANCELLED BEFORE <br /> NOTI <br /> THE EXPIRATION ATE TIH,nop, <br /> Proof Of Coverage <br /> ACCORDANCE WITH DHE PO LIC PROViS ONSCE WILL BE DELIVERED IN <br /> AUTHORRED REPRESENTATIVE <br /> p 114 ACORD CORPORATION. All tights reserved. <br /> ACORD 25(2014101) The ACORD name al4d logo are registered marks of ACORD <br />