COMPLIANCE INFO_2024 - Laserfiche WebLink

Home Browse Search

A ® DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/03/2023 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 CONTACT Shala Pearson NAME: TLB Insurance Services HONE o Ext): (916) 790-5863 aC No): (888) 329-8842 CA License #OB82095 E-MAIL shala-pearson@leavitt.com ADDRESS: 2358 Maritime Dr, Ste 100 INSURER(S) AFFORDING COVERAGE NAIC If Elk Grove CA 95758 INSURERA : Westchester Surplus Lines Insurance Company 10172 INSURED INSURER B : Travelers Property Casualty Company of America 25674 Walton Engineering , Inc. INSURER C : Service American Indemnity Company 39152 P.O. Box 1025 INSURER D : Travelers Property Casualty Company, 36161 INSURER E : West Sacramento CA 95691 INSURER F : COVERAGES CERTIFICATE NUMBER: 23/24 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 , INSfl TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MWDD/YYYV LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED CLAIMS-MADE FX1 OCCUR PREMISES Ea occurrence .$ 502000 X Inc. Pollution Liability MED EXP (Any one person) $ 51000 A X Inc. Professional Liability G47393735001 03/06/2023 03/06/2024 PERSONAL & ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000,000 POLICY F JEo M LOC PRODUCTS - COMP/OP AGG $ 2 ,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 ,0001000 Ea accident X ANY AUTO BODILY INJURY (Per person) $ B OWNED SCHEDULED 8108L785302 03/06/2023 03/06/2024 BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Uninsured motorist $ 1 ,000,000 116111 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1 00000�000 A X EXCESS LAB CLAIMS-MADE 647393747001 03/06/2023 03/06/2024 AGGREGATE $ 101000,000 DED I X1 RETENTION $ $ WORKERS COMPENSATIONX STATUTE EORH _ AND EMPLOYERS' LIABILITY Y / N 110000000 C ANY PROPRIETOR/PARTNER/EXECUTIVE FN] N / A SAMTWC10020100 10/01 /2022 10/01 /2023 E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 100000000 If yes, describe under 1 ,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ Inland Marine D Leased/Rented/Borrowed 66081<816207 03/06/2023 03/06/2024 Limit $300,000 Deductible $2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN To Whom it May Concern Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988=2015 ACORD CORPORATION . All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD