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RC,- 11-11PC co CERTIFICATE OF LIABILITY INSURANCE ibmar.."' <br />DATE (MSEDONYTY) <br />12/21/2016 <br />I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN 111E ISSUING INSURER(S), <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />HOLDER. THIS <br />BY THE POLICIES <br />AUTHORIZED <br />IMPORTANT: If the certificate holder Is en ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subfect to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Milestone Risk Management s Insurance Agency <br />License No. 9B727 66 <br />8 Corporate Park, Suite 130 <br />Irvine CA 92606 <br />CONTACT Nvmc Catherine Mariana <br />PnCifiE . (949)852-0909 1 ta lisit (916)153-1131 IALOala Eel: <br />E-MAIL Almigncsarianaemilestonepromise.com <br />INSURER(S) AFFORDING COVEFIAGE HMCO <br />umm A :Starr Surplus Lines Insurance 13604 INSURED <br />Wayne Perry, Inc. <br />8281 Commonwealth Ave. <br />Buena Park CA 90621 <br />- - -- - - - -- <br />INSURERS General Ins Co of America 024732 <br />msutiaR c :Star Indaamity & Liability CassPanY 38 310 <br />Daum 0 :Travelers Property Casualty of 025674 <br />INSURER B: <br />INSURER F : <br />- INSR <br />LTR <br />THIS <br />INDICATED. <br />CERTIFICATE <br />EXCLUSIONS <br />IS TO CERTIFY THAT THE POLICIES <br />NOTWITHSTANDING ANY REQUIREMENT, <br />MAY BE ISSUED OR MAY <br />AND CONDITIONS OF SUCH <br />TYPE OF INSURANCE <br />OF <br />PERTAIN, <br />ADDL <br />WW0 <br />POLICIES. <br />SUBR <br />WVO <br />INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD <br />TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCJMENT WITH RESPECT TO WHICH THIS <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS <br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />POUCY EFF POLICY EXP POLICY NUMBER (MM/DD/YYTY1 NAUDDP/Yril L rT0 <br />A <br />X COMMERCIAL (MINERAL LIABIUTY <br />: X I OCCUR <br />Liab. <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />12 /31/3016 <br />12/31/2016 <br />12/31/2017 <br />12/31/2017 <br />L MIT r DEDUCTIBLE $250E / 52, 500 <br />L MIT/ DEDUCTIBLE $1501( / $2, 500 <br />DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, A001Iamal Remark* Behedule, may be easched It mole roam Is HomAred) <br />RS All CA Operations. <br />Certificate holder, its officers, agents and employees are named as additional insured per the attached <br />CG2010 & =2037 endorsements. <br />^wiwww......A.m................... <br />CANCELLATION <br />CERTIFICATE NUMBER:16/17 Master <br />City or Stockton <br />Risk Management Division <br />City Hall <br />425 N. El Dorado St. <br />Stockton, CA 95202 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WU. BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUYNORIZEO REPRESENTATIVE <br />Teresa Shen/TERESA <br />© 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />INS025 (200401)