|
<br />ACORD. CERTIFICATE OF LIABILITY INS~RANCE OP lilt ll~' rJAT~ (IlIMIDOfl"'iYY1
<br />RXVBLOl 10104/05
<br />"'fi:OOUt:!::M THfS C~TIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br /> ONLY 0 CONFERS NO RIGHT9 UPON TItS CERTlI'fCATE
<br />HGl InBu~ance Servieea HOLDE THIS CERTIFICATE DOES NOT AMEND, !XTI!ND OR
<br />2J2~1 South PolD~e Dr~ve ALTER T .E COVERAGE At'"FORDED BY THE 'POUCIE9 BELOW.
<br />Laguna Billa CA 92653
<br />~~eI949-460-8730 Fax.949-460-8733 INSURER' ^FFO~OING COVERAG!i; NAIC#
<br />,,,,,IJREO IHSUf'1~~k I't7LXC
<br /> INSUFl.EFl.El:
<br /> Luim It.i'V'$ra, IIII.D. INSUFlERC, ,
<br /> Lis& RiveJ:'f I
<br /> 2222 S. Ha n Street INSl,IRSRO;
<br /> Santa Ana CA Y2707 I
<br /> IN~UR.ER E:
<br />
<br />COVERAGES
<br />
<br /> T1~&; POLICIES or INSURANCE LISTED BELOW HAl/I! BEEN l!SU1:O to THI!: INSURED NAUEO ABOVE FO~ THE rgLlCY PliiRl0D INpICArED. NOTWTTHSTf\NDIMG
<br /> ANY ~UI~M!!NT, TERM OR CONDITION 01" ANY CONTRACT Ol'! OTHER DOCUMENT WITH A!;l;:~C'I' 'to WH OH THIS CERT1FICATE ",,,y IS!! IMUfD ort
<br /> MAY PERTAIN, Tf.lli INSUI\I.NCE: .-.FFORDED BYlHF. POLICII!.9 i:ll:~eMlED HffiElN IS SlJ'eJ.,CT m ~LL Tl-E 1C!W:i.. ~XCLUSION9 AND CONDrTlONS OF SUCH
<br /> POUClI:$, ,lI,(;IiNlf.G:.-.tf LIMITS SI~OWN r.lAY I-fA,Vli SEEN REDUCED BY PAID CLAIM&, ,
<br />~~ TYpt(iI'IN9IJR,lI,/'tC& POLlCY/'tU"'I'I~R ! DATE MM/lJDrfif I",. O-NY'!"' llMlTS
<br /> ~NmAL LIABILITY I I EJlCH OCCL,IRRENCF. S
<br /> COMMeRCIAL G!!NI!!IVIL LIABILITY "ftE:M\SI!.ST~oeevr<mCGI ,
<br /> I C:LAIMHfADE Doccu" MEDEX1'(AIl'JOOI!p~~l .
<br /> 1 PERSONAL 8. ADV INJUIW ,
<br /> , GEN'5RAL. AGGRE;(11,n: ,
<br /> n~AGG~EnE,lIMIT AI"M:I~PER: PRODUCT$-OOMrft~r~G ,
<br /> FOl.ley I ~& n Loe ,
<br /> ~Tot.\oerw::; UASIUlY COMBINED SINGLE l.IMIT ,
<br /> ANY AUTO IEaaccld!nl)
<br /> I- '----,-
<br /> N.J. OWN~ AutOS . OOCIl'r'INM'f I
<br /> c--- .
<br /> SCH"'tIlJL~ AUTOS (l"erpH~on)
<br /> I- ,
<br /> I- HIA.EDAlITOS , BODILYIN,IURY
<br /> (Pll/llteldont) ,
<br /> NON-fJWNED AUTOS
<br /> - .
<br /> - PROpeRTY DAW,GE ,
<br /> - (P~r~l;Qlll.ml
<br /> =i'.' L~"LITY ' "J AUTO ONLy - CAACCIDIONT 'I
<br /> NoN^UTD /'( l/ (J'I otHE~ T10lAN IiAACC .
<br /> 0::1, ,jk_ AUTO ONt.Y; AGG S
<br /> :5CESSlUIIDJl:Et.LA U.&BllrTY ~tJj . IOAr;H OCCURRt;NCi: S
<br /> OCCUR 0 CLAIMS M.....OE ". ",~( "' AGGREGATE ,
<br /> ,
<br /> , ,
<br /> lDEDUCTlBl.P, 1 S
<br /> R~ON S , .
<br /> WOI'lIl;lORS COMPENSATION AND TOR'r'l.IMn'8 I'"'~F[
<br /> EMPLOYl!fta"UAeILlT'Y !!.L EACH ACCIDENT
<br /> i At<< PROPI'lII!TOM'MUNERII!XI'.OUTIVI!: S
<br /> OFFICIEfWEUBMexcllmED? ELL DISW! - EA EMPLOYeE' $
<br /> ~~r~~~W~~v~S1or~ b!!low 1;.1., OISEASE - POLICY LIMIT .
<br /> """'.
<br />A ProffulDional Liob P93605 09101/05': 09/01/0. Per Claim 1,000,000
<br /> Aggre"lIh 3,000,000
<br />C11:.90RlPTIOH 0,," OPERATIONS I LOCA110NS lV!:lolleUiS I EXCLUSIONS A..Cf;O 8'1' ~/l/OOMEMI!N'T' I SI"ECIAL PflpVlSlON5
<br />'1'hie ill a claims: made poJ..te" with B retroacti"8 date ofL'/1/0S.
<br /> ,
<br /> ,
<br />CERTIFICATE HOLDER CANCELLAT!ON
<br /> B:t.ANXClO :lHOULtl ANY 9F THE ,ll,eoVE OF.iSC~IIEI) ,.oucre:s II! CAHCELI.E:C1 !l1ll'oR'" THO: E):JtIll:,II,T1QIII
<br /> OATil THEREO~. THE ISSUING INSlJAeR WILL ENDr:';"VOR TO't.lAlL ~ OAYSWAtTi~f'{
<br /> Luis aivera, H.D. NOTlC~ TO"H. CEflTlflCATEHOLOER N''''ME~to THE LEFT, IiUT "AlLURE TO DO l}.O SHALL
<br /> ItlPOSE ~ 0Ii~C,ll,T10N Oft 1.1A81L/TYO/' ANY PIlNO UP'ON TIlrE INSUR~R. rrs AOi!NTJl OR
<br /> A~PRUENTA,Tival,
<br /> AUTHORIZEO 1\Q'tl!:::SE.NTATIVE
<br /> Jassica 'L. RCDentbal
<br />
<br />ACORD 25 (200'108)
<br />
<br />@ACORDCORPORATION '.88
<br />
|