COMPLIANCE INFO_2019 - Laserfiche WebLink

Home Browse Search

ABLEMAI -CL CMEES1 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 9/20/2019 THIS CERTIFICATE IS ISSUED AS A MATTER 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 ), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT : If the certificate holder is an ADDITIONAL INSURED, the policy( ies ) must have ADDITIONAL INSURED provisions or 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 License # 0603247 CONTACT AME: George Petersen Insurance Agency, Inc . PHO, N FAX 707 525 =4150 (AIC, E Ext): ( ) (A/C, Ne): (707 ) 525 -4175 P .O . Box 3539 Santa Rosa , CA 95402 E-MAILADDRE S info@gpins . com INSURERS AFFORDING COVERAGE NAIC # INSURER A : Homeland Insurance Company . of New York 34452 INSURED INSURER B : West American Insurance Company 44393 Able Maintenance Inc . INSURERC : State Compensation Insurance Fund 35076 3224 Regional Parkway INSURER D : American Fire & Casual Company 24066 Santa Rosa, CA 95403 INSURER E : INSURER F : '.. COVERAGES CERTIFICATE NUMBER : 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, To_DL SUBR POLICY EFF POLICY EXP MSR TR TYPE OF INSURANCE NS WVD POLICY NUMBER D DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 101000 '000 TO CLAIMS-MADE ® OCCUR 793 -00-26 -72-0004 10/11 /2018 10/11 /201RE9 DAMAGEo rr 501000 ESS (EaEa occurre ce $ _ X Pollution-Occurrence MED EXP (Any oneperson) $ 51000 X Proffes -Claims Made PERSONAL & ADV INJURY $ 10 '000 '000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10 '000 '000 POLICY Fx] JERt° El LOC PRODUCTS - COMP/OP AGG $ 10000 '000 MOLD $ 10000, 000 OTHER: B AUTOMOBILE LIABILITY Ea anciden SINGLE LIMIT $ 1 , 000,000 X ANY AUTO SAW (20) 58661065 4/1 /2019 4/1 /2020 BODILY INJURY Perperson) $ OWNED SCHEDULED BODILY INJURY Per accident $__,,.,,,,, AUTOS ONLY AUTOS yy� p Hr OS ONLY ATOS ONLY (Deer acEcd4 ant AMAGE $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ C WORKERS COMPENSATION X I PTR TE OTH- AND EMPLOYERS' LIABILITY YIN 9073219=19 10/1 /2019 10/1 /2020 1 , 000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ _ (Mandatory in NH) EXCLUDED? N / A 1 , 000 ,000 E.L. DISEASE - EA EMPLOYE $ If yes, describe under 1 ,000, 000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ D Excess Auto/WC Only ESA (20 ) 58661065 4/1 /2019 4/1 /2020 Aggregate/Occ. 41000, 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached If more space is required) RE: Proof of Coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Able Maintenance, Inc , ACCORDANCE WITH THE POLICY PROVISIONS . 3224 Regional Parkway Santa Rosa , CA 95403 AUTHORIZED REPRESENTATIVE ACORD 25 ( 2016/03) © 1988-2015 ACORD CORPORATION . All rights reserved . The ACORD name and logo are registered marks of ACORD