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CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDDIYYYY) <br />0211212020 <br />THIS CERTIFICATE IS ISSUEDAS'A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />FIELOIN. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE IS -SUING INSURER($), AUTHORIZED <br />REPRESENTATIVE OR.PRODUCER. AND THE. CERTIFICATE HOLDER. <br />IMPORTANT, If the certificate holder Is on ADDITIONAL INSURED, the polldy(ies) mast have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED,subJect tothe terms and conditions of the policy, certaln policies may require an- endorsement, -A statement on <br />thls.certificate does not confer rights to the Certificate holder In lien of such endorsement(s <br />PRODUCER <br />.t4AMb Fred Dean .. <br />Premier One. Insurance Services <br />100 Padlica.ste 480 <br />PAt 6.t: n NE (gd9}.727-2b26 (949)127-9219 <br />AIG o:� <br />E-MAILIreS;dea(ii PrernlerOne,eoln <br />nnnREss: <br />INSURER(S)AFFORDING GOVCRAQE <br />NAIL N. <br />ilvine CA 92.518 <br />INSORERAr Bea4ay Insurance Company <br />37540 <br />INSURED <br />INSURER'B": <br />lWater, Inc, <br />INSURERC: <br />12 Goodyear #1130 <br />INSURER '0 <br />INSURIER E , <br />Irvine CA :92618 <br />INSURER FT <br />G(JVEKA13ES UERHFIGATE NUMBER: ULCU4IM5664 Rr-vIgIoN NtImAl=R+ <br />THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LI$TE D BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANpiNO ANY REOWREMENT, TERM OR CONDtTIQN OF ANY CONTRACT OR OTHER OCCUMENT WITH RESPECT TO WHICH.THIS <br />CEktlRLATE MAY RE ISSUED OR MAY PERTTA1N, THE INSURANCE AFFORDED BY THE POLICIES RESCRiBED HEREIN IS SUBJECT TO ALL THETERMs, <br />EXCLUSIONS AND CONDITIONS: OF SUCH POLICIES. LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLA.MS. <br />INSR <br />LTR <br />TYPE OF:INSURANCf! <br />€NSD <br />- WVD <br />POLICY NUMOEk <br />P <br />YY <br />MRD YYY- <br />LIMITS <br />COMMFRC€ALGENERALiAiILIT <br />CLM1iMS-MADR CiGCUR <br />EACH.00CORRENCE <br />$ <br />AM lU�l't RENTED ». <br />- ReMISES' Ea conufrer5m - <br />5 <br />.MED EXP (Any weperson) <br />$ <br />PERSONAL8,ADVINJURY <br />S . <br />LIMIT 'APPLIES -PER: <br />� <br />.isOLICY [IJEFRCT F-1_LOC <br />GENERALAGGREGATE <br />i <br />r?EN1,A0GREGATE <br />PRCTDUCTG-GQMP1oPAGG <br />3 <br />OTHER: <br />AUTOMOBILE'UAMUTY <br />COMBINED GIN LE LIMIT <br />. Easecfderll <br />BODILY INJURY (Parperaonl <br />��...... <br />3 <br />ANYAUTO <br />AWNED $CH> DULEO <br />AUTOSD14LY AUTOS <br />BQDILYINJUFIY P <br />{ er.avJdent) <br />s <br />HIRED NOWOWNED <br />AUTOS ONLY -� AUTOSONLY <br />PROPERTY PA6�S .OE- <br />Par.accf eh{ <br />- <br />$ <br />. <br />VikF1REi,LA.UAD <br />OCCUR <br />EACH OCCURRENCE <br />$ . <br />AGGREGATE <br />$ <br />EXCESS LIAR <br />CLAIMS•MADE <br />pEiS RETENTION <br />S <br />WORKERSCOMPEN$ATION <br />AND EMPLOYERS` LIABIUTY YIN <br />PEFT <br />FST I E <br />141..FACHACCICENT <br />$ <br />ANY PROPR3ETQRJL?ARTNEFVEXFQGYEiVE r--j <br />OFF[CFrYtAEMUERiEXCIAIDED? u <br />N1A <br />El_ DISFAS4 EA EMPLOYEE <br />S <br />(Mandatory InNN) <br />3 yes, desw€be under <br />E,L, DISEASE � POLICY LIMIT <br />$: <br />DESf,R.IPTIONOF t7PERAT*W bafew <br />A <br />PROFESSIONAL LIABILITY <br />V13070190801 <br />10104/20.19 <br />1010412020 <br />LIMIT PER OCC <br />OEDUCTIBEE <br />$1,00D,p00 <br />a15,(i0.0 <br />RETR <br />08 04-2911 <br />DESCRIPTION OFDPERATIONSILOCATIONS 'IVEHICLES (ACORD101,AddIIIonaIHernarksSchedule, maybe attachedlir - - <br />t�` A iG�T �1V�04� <br />CERTIFICATE HOLDER %AWIPI I ATiAN <br />SHOULD]ANY OF THE ABOVIE DESGRIBED POLICIESSE CANCELLED BEFPQRE' <br />THE emrt iok DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City Hof .Banda Ana Rlsk Managsm eni Division <br />ACGCIIDANcE. WITH THE POLICY PROVISIONS. <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />atn Floor <br />Santa Ana CA 92701 <br />@ t988=2015 ACORD CORPORATION. -All rights rosewed.. <br />ACORD 25 (2016/03) The ACORb nam8 and logo are registered marks of AC.0RD <br />