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ENVIRONMENTAL HEALTH <br />iUxaim Fteitty; PeOES ICE CREAM PALETERM * NEVERM <br />ACORtf CERTIFICATE OF LIABILITY INSURANCE <br />focrvwTwrx oo a tt/88rtl»4 <br />lo«t*wGtmfdL <br />CAMClIXATtOH <br />LtV« CERTIFICATE <br />ArfltaWtO U MtMWtATM <br />C*gt Q* K*n to »w-w <br />ACORO2f(M1M3) <br />• i ». >.ac;x< w <br />OATt WWTITT) <br />lO'T'ian <br />tMM guximfftci <br />AftCMOAft <br />FEILMIT TO OPTRA f T • 1412 • IOOD EST <JAE SQ FT WiO SlATING <br />Recwd IORPR0500153 <br />V.Md From 02/0f ZM7K To 01/31/2ME <br />C im-2018 ACOAO CORPORATION Afl righti rM«rv«d <br />The ACORD name and logo oro rogiotarod mart* of ACORD <br />SAN JOAQUIN < OVNTY ENVIRONMEM AL HEALTH OEPARTMENT <br />IM tla<rtl» A>.». Slxkln. < A < 1H) <br />l«.|H K»c. R.KH K. IMtKHr <br />ihouis un o» n» mm mkmuo >vuca> i <br />tx U»W*t«» 0»rt TMMOf. MOTKl Hi <br />ACOXOMCl WIN VM MUCT MOWM <br />r ERMrrs TO OPERATE >n NOT TRANSFERABLE <br />ud my bt SUSPENDED w REVOKED for tl<H. <br />ri;RMITl»> Valid only for: DE LA CRUZ. ANDREA ’ <br />_______________DBA: PEKE-S ICE CREAM PALETERIA 8 NEVERIA <br />•nns FORM MUST BK DISPLAYED CONSPICUOUSLY ON Till PREMISES <br />RtVISIOR NUMBER______________________ <br />I. ■•r»U«U t) HAMID AACTA. I OR IK KMJCY IX l«CO <br />OlHtR DOCVMtNT VdTH RtSFtCT TO WMCM THS <br />r sen wo htwh is su®jcct to ah the ttrwi. <br />Mrl kt <•?*” NT <br />MK»*tC«C»0M«At» <br />Th< Cen^x* HoM«« <v V <br />AAA <br />teim atkJ txvioczn <br />_____________________________I <br />TWO CTRTBTCATt IS ISSUEO AS A MAFTIR Of MFORMATlON OHLY ANO CONFERS NO RIGHTS UFON THE CERTFTCATE HOLDER TKS <br />CERTVICATE DOES NOT AFFIRMATTYELY OR NEGATIVELY AMEND. EXTEND OR ALTER TX COVERAGE AFFORDED BY TM POUdEB <br />BELOW THIS CERTIFICATE OF WBURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE tSSUTNG BtSUREIUSj. AUTHORIZED <br />REPRESENTATIVE OR PRODUCER. AND THE CERTVICATE HOLDER <br />WPORtANT W Wa cwW>ca<a haMw N an AOtMn6*AL xSURED »• acacyim) amM bava ADOiTiOnAL wSuRED provtMoat ot ba iMwhT <br />» SUBROGATION IS WAIVED, subject la Bh Herat and condMiona W *>e policy, carttm ponciat may raguaa an ondoesetnanL A statement on <br />tf»N coeWcate dope not confer righte to me cfUftcate boMe* m hew o< i <br />Mooocte <br />Po'lJo',wTi7,*A<* A^‘>',r< <br />pSoARoXAMICO <br />X Pwt (M5l~222 MH_____________ <br />tvpoonPneptnujFyexem <br />■mmaef arroeoMO coetaaot <br />ES BE CANCSUID BEFORE <br />NU BE DEUVEMO M <br />CLAW MW [x] COXIW <br />UOOMUALM j iocoje <br />L_J PA**? .•***'. <br />------ <br />u&tinonMiuMiT* T/- <br />*'r7^’v-r.>.TiL<.t&'*cvT'’1 [i <br />CERTIFICATE HOLDER <br />Moxtfxn&MwXAKMI <br />(L tXUAM NklOkUI | <br />AMfOHaaaaiMaun <br />’ANVAVIO <br />_ j SSR QM» <br />^^7 Ifv THAT TMt IllOtV HAVE been issued to Ii« <br />iNDCATtD NUlW4MSTASaNG ANY RtQUWlMthl It«M ON CUNC*’ ON C* AN* CONDUCT CM < <br />Cf ahficatc may nr issuto or may pcrtam t»« <nsu»iance afforded by the POucrs or <br />EXCLUfriOMS ANO CCMUTKPti Of SUCH POCtOES UMIlS SlKWN MAY HAV1 BLLN REDUCLD UY PA'D CLAMS <br />ttf, HMorrnuurac. xrawwu— ' <br />; pj <br />’ 'lUtr2<O\ : Il-VAL > AUVXAMV ! I!,<C0.WOO <br />SMKAfBBMME |»mWQW <br />"•cetera ccwoaoq I tJJtM.OOftOC