10181202_2243 E. SANTA CLARA - Plan (2)

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ACORD CERTIFICATE OF LIABILITY INSURANCE 4/16/2014 DATE (MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAnON 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 CER11FICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: Ifthe certificate holder Is an ADDI110NAL INSURED, the policy(les) must be endorsed. If SUBROGAMON 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). CONTACTPRODUCER NAME:Susan Remeika The Empire Company :1&14o. Ext):(714) 836-9945PHONE ,Nok (714)836-99,6 550 Parkcenter Drive ADDRSS· sremeika@empire-co.com Suite 205 INSURERCS) AFFORDING COVERAGE NAIC # Santa Ana CA 92705-3521 INSURERA :PeerleSS Insurance Company 24198 INSURED INSURER B National Union Fire Insurance Stellar Installations INSURER C : 3185 Armstrongs Drive INSURER D : INSURER E: Corona CA 92881 INSURER F: COVERAGES CERTIFICATE NUMBER:13/14 GL/WC/Auto 14/15 24 REVISION NUMBER: ™IS 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 CONDInON 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVT)POLICY NUMBER (MM/Dorerrn (MM/00/rrrO LIMITS A A GENERAL LIABILfTY X COMMERCIAL GENERAL. LWBILITY CLAIMS-MADE OCCUR CBP9895681 10/15/2013 10/15/2014 GENt AGGREGATE L[MIT APPLIES PER: il POLiCY Fl PRO- 1-11.rCT I 1 LOC AUTOMOBILE LIABILITY ..i ANY AUTO ALL OWNEDli. HIRED AUTOS SCHEDULED CBP9895681 10/15/2013 10/15/2014AUTOSAUTOS NON-OMNED AUTOS EACH OCCURRENCE DAMAGE TO REN I ED PREMISES CED occumence) MED EXP (Any one person} PERSONAL & ADV INURY GENERAL. AGGREGATE PRODUCTS - COMP/OP AGG COMBNED SiNGLE LIMII (Ee e©cident) BODILY INJURY (Per person) BODILY INJURY per accident) PROPERTY DAMAGE (Peraccident) $ 1,000,00 $ 100,00 $ 5,00 1,000,00 2,000,00 2,000,00 $ $ 1,000,00! $ $ $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS*LADE AGGREGATE S IDED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYANY PROPRIETOR/PARTNER,EXECUTIVE N/AOFFICER/MEMBER EXCLUDED? (Mandatory In NH)813258 6/4/2013 6/4/2014 If yes, describe under DESCRIPTION OF OPERATIONS below A Leased or Rented IM8407141 2/15/2014 2/15/2015 Equipment $ v V€ STATU-OTH· A TORY I IMITS FR E.L. EACH ACCIDENT $1,000,00' E.L DISEASE - EA EMPLOYEE $1,000,0Ol E L. DISEASE - POLICY L IMIT $1,000,001 $200,000 Limit $2.500. Deduable DESCRIPTION OF OPERATIONS; LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space I i required) CERTFICATE HOLDER CANCELLAnON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAHON DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.Evidence of Insurance AUTHORIZED REPRESENTATIVE Michael Condy/SUSAN 'V6-1...43-2_' E._.4 ACORD 25 (2010/05) @ 1988-2010 ACORD CORPOUTION. All rights reserved IKICA,4,9..r-.r=,r.V.- A--=- ---- --•-0 1---... .--:-•.....1 -*.1.- ..$ ABAO-