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..'qe R 7 ® CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) 1/3/2012 THIS CERTIFICATE IS ISSUED AS A MAT'T'ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THiS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE® REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Milestone Risk Management: & Insurance AgencyPRONE License No. OB72766 8 Corporate Park, Ste 130 Irvine CA 92606 CONTACT Teresa Shen NAME• (949)852-0909Fa O, N0J:(949)852-1131 AE-E)mDARILEss:tshen@milestonepromise.com INSURERS AFFORDING COVERAGE MAIC# INSURERA:Starr Surplus Lines Ins. CO. 13604 INSURED Wayne Perry, Inc. 8281 Commonwealth Ave. Buena Park CA. 90621 IINSURER INSURER B.American Economy Ins. CO. 19690 INSURERc:}•''ederal Iris. CO. 20281 INSURER D: INSURER E: F: COVERAGES CERTIFICATE NUMBER. -11/12 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IlTR TYPE OF INSURANCE ADDL im SUBR AM POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ® OCCUR SLSLEIL72023211 12/31/201112/3112012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300 000 PREMISES Ea occurrence $ r MED EXP (Any one person) $ 25,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYX PRO- LOC PRODUCTS -COMP/OPAGG $ 1,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS [2CE22508901 12/31/2011 2/31/2012 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) . $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident Comp. I CoIL Ded. $ 1,000 XEXCESS UMBRELLA LIABOCCUR LIAB 6 CLAIMS -MADE SLSLXNV73017211 12/31/2011 2/31/2012 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I X I RETENTION $ C $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yyes, describe under DESCRIPTIONOFOPERATIONS below N/A 0044727227 12/31/201112/31/2012 xWCC STA �U- 10TH - -- E.LEACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYE4 $ 1,000,000 E.LDISEASE- POLICY LIMIT 1 $ 1 000 000 A A Professional Liability Pollution Liability SLSLEIL72023211 SLSLEIL72023211 12/31/2011 12/31/2011 12/31/2012 12/31/2012 Limit (Per Claim) $1, 000, 000 Limit (Per Claim) $1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) **PROOF ONLY** ACORD 25 (2010/05) INS025 (201005).01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Sariana/TERESA c ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marls of ACORD