Laserfiche WebLink
92$5517888 Line 1 09:31 09-28-2012 2/2 <br /> r <br /> Certificate Preview Window-close when finished Page 1 of 1 <br /> CertlNcate'Prell <br /> A�& CERTIFICATE OF LIABILITY INSURANCE (W/DD YYw ) <br /> 03/30/2012 <br /> THIS C8RTIFICATE IS ISSUED AS A HATTER OF MFORMAnON ONLY AND CONFERS NO OUGHTS'UPON THE C9RIFICATE HOLDBN.THIS CERTIFICATE <br /> DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORI,M BY THE POLICIES BELOW.THIS CERTIFICATE OF <br /> INSURANCE DOES NOT CONSTITUTE A COXTRALT BETWEEN THE ISSUING IMURPR(S),AUTHORLOED REPRESENTATIVE OR PRODUCER,AND THE <br /> CERTTFICATE HOLDER. <br /> oilt <br /> 1MPORTAM:If the tartlfiute Halder le an ADDITIONAL INSURED,.the p ,(lu)me De NHdmee L If SUBROGATION IS WANED,sutdeR to the tsrrrla. <br /> end eand1two.of Ma Peft,.certain paid"may neuln an a icicnmmenL A stateagent oD 01.certificate dose not cenfar rights 10 the cadlOeats holder <br /> In Iles of each andon.nen s. <br /> Produce UC*M29370 011-925-244-7700 CONFAB <br /> E:Ed ewood Partners Insurance Center <br /> P.0,Rood PadnPla ImurelKe Centers(EPIC)l5an Ramon Bnr )AH <br /> P.0.Bae 5003 HONE FAX <br /> Na Ext: 925 244T/00 C ho:M51 9014671 <br /> San Ramon,G 94583 EMAIL <br /> Agent; ODRE55:EDlrsrts@etl ewoodms.mm <br /> Insured INSURERS)AFFORDING COVERAGE NAICA <br /> GB[tlO-Ryan'InI, Insurer A: WEST CHESTER SURPLUS LINES INS CC 10172 <br /> 6747 Slerra Court,Sues 3 Insurer Si PEERLESS INS CO 24198 <br /> Milo,CA 945M Insurer C: TRAVELERS PROPERTY CAS CO OF AMER 25674 <br /> Insurer 0: <br /> Insurer E: <br /> Insurer F. <br /> COVERAGES ICEMIFICATT NUMBER 26415125 IRFASICN NUMBED <br /> B IS TO CERTIFY THAT THE POIJOI S OF INSURANCE LIFTED BETOW HAVE BEEN ISSI.M TO THE NBURED NAMED ABOVE FOR THE POUCY PERIOD NDIGTED,HOTVATH$TAtDNC <br /> NEWIPH.IEIT.TER11 OR CONO(nON M ANY coMRILT OR OTHER DOCUMENt BrMREeflEGT TO HIBCH THIN CFATIFICAIE MAY Bfi LSBnD7 p(MAYPERTNN,TH@ NSIRIIYE IFPOIaI® <br /> TEPOUCIE9 DESOUBED>E!&1Y IF SIIHI�ITONITM:TEg15,E%CLUSD1G M1000MI110N$OFSULMPWCF9. <br /> UMDB SHOYM AMY HAVE EE81 PFLUCEO BY PADClgAAS <br /> unMe P Number roncy Pollry Linea <br /> APEffrroa FaPotoo <br /> A GENERALLIABILITY G24014484005 04/01/12 04/01/13 ED&O.].a SODOOD <br /> IXI Commercial General UDIARty .maga to Ponied <br /> I Calms Hada IXI 0=, Premises(Ea <br /> II "encs <br /> II 50000 <br /> en'l Aggnegate=it Apples Per: Hed EV ("°n. <br /> II PollcylXl Ro3edli tog naeni 5000 <br /> PenmNl B Adv <br /> n u 000 0 <br /> eneml Aagamte 2000 <br /> "dugs-CamP/Op <br /> 2 00000 <br /> B AUTORHOSILIELLIBILITY U8404396 04/01/12 04/01/13 bined$Ing[. <br /> IXIMyAVtO mE Ea aWdeld 10(X100 <br /> II AE OwnedAutosll Shcedulad Autos Padlyl.jo, (Per <br /> IXIHIm Autos IXINon-Owned Autos on <br /> II II Bodily Injury (Per <br /> ddent <br /> rty Damage <br /> P-&Wlcn[ <br /> A II YMBRELIA LIAR IXI OCCUR 24014502005 04/01/12 NIDII13 DDOl Oavmerce 4(l00 <br /> 11 EXCESSLIAS II CLAIMSMADE <br /> ragaW 40000 <br /> II DEDUCTIBLE 1XI WENT70N ; 0 <br /> C WORKERS CONDENSATION AND EMPLOYELS'LIAB=Y N/A DTIUB7827P4151 04/01/12 04/01/13 1 WC <br /> Y PROPRIETOR/PARTNER/INECU AVE OFFICEWMEMBER EXCLUDED?Y/N XIStaUbry IIOUIe <br /> Mandatory In NH) Y UNU <br /> Lyes,dcsoibeunder DESCRIPTION OF OPERATIONS We. E.L.Each AWONn 100000 <br /> EL.Disease-Ea 1,000, <br /> EMI, <br /> EL. <br /> R Disease-PoIRy S,OOop <br /> A THER <br /> B IAHon 24014484005 04/03/12 04/01/13 Per 0 ton"arca $1,000, <br /> nl¢d/feaaed Equipment 008404796 01/OL/12 Oa/01/13 Pentam $100, <br /> A Nssbnelllatlll 2,1014984005 090312 040113 Por Calm 1000 <br /> DESCRIPTIONOF OPERAnMSIMO nONIVEHICLES(Atmeh ACORI101,Additional Remarks S1uDdWe,Ifmanspacehi required) <br /> CERTIFICATE HOLDER ICANCELLATION <br /> -EVIDENCE OF COVERAGE SHOULD MY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH <br /> THE POLICY PROVISIONS. <br /> AUNodood ReprBaamative <br /> Btlan F.DVMO <br /> dohnsenl O 1995-2010 ACORD CORPORAn01t.All rights reerved. <br /> 26415125 <br /> ACORD 25(2010105) Tha ACORD name and logo are mplatored mels a ACORD <br /> Contlnu0 Dose Y/ndow <br /> httos://certificatesnow.confirmnet.com/Common/certificatePreview.jhtml jsessionid=Z41H... 4/10/2012 <br />