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A�COREPDATE jMhbO0,YVYVI
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<br />Y CERTI_ TE OF LIABILITY INSi 'DNCE 4/5/2010
<br />PRODUCER (866} 544-$273 FAX: (866)54.4-34E6 i THIS CERTIFICATE 1: ISSUED AS A MATTER OF INFORMATION
<br />Elizabeth Souther Insurance Grout, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />29395 Agoura Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Suite #202,.
<br />Agoura Hills CA 91301 INSURERS AFFORDING COVERAGE NAIC #
<br />IHSi1Nto PBC Holding Corp Inc; vaclflic Bu.ldi.ria First Mercury Insurance ossz
<br />Care I>tc PBC Solution One Inc; PBC A&0 Inv:" _-_: Phildelohia Indemni11 ty Ins Co >aaF,ff
<br />PSC Commercial Cleanina Systems Inc: ASerican Alternative Ins Corp
<br />3080 Airway Avenue, Ste 101 . Farmington Casualty Company 44ei
<br />Coata Mesa CA 92626
<br />TI4F P5. PCIF: t -."P INSOHAW -.F 1.1ti7F:1% I t I (>L'.+e'IAJ E r:!, ISSOE T : I101, NP ;Y %A%0...js :,� �- Fr -,P Ti{E F�...' I;v V1-- W(A) 1+ i'()Wf ATE.0 kJe)TV,1T#ISTANDIN1e
<br />ANY kE€23J13iEr�ENT TEIt6l C) f)P:f1;T(CI04 01 AI . r�)iPEs ' Tt7 4':4�'�:f� 7tl!T,SErv.i 1E F,ILf E3E Lx�atlFa.%C1#
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<br />50, 000
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<br />a 21000,000
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<br />B 01HERSu9 Pars Prop PFP£444ESS 3/25/2010 2/25/201I �: »y:r.4 Dad $1,004
<br />Cont Equip F'1tr ;.a z.* -- - Dad $1,000Spec Form, Rept Cast
<br />IP a kOF. Rai; TION5rlOCA31OKS'MEPII�"SES?EXCLl1S/^vk5A.t°ti^EaEr EhDd3R5EIxE!\; SgEwA,Lp#tCYYSitTN3
<br />He Cst 10098 Servsec 1acat-ten 1.0Q.1 L, Sar.t& Ara i:li ax-CLrazia:s osty 1ocat_019.
<br />t11,41 SantA An* sLAW9iaral '.ransportatsor. Crs:.wr +s ra=ad as Rdd;tscn-� %r au od, b-ut only as sespeccs Gene,=m1 Liability
<br />arising out of the operas_ans a£ the Naz�--d Ins-ared per _c— lir, ZO 10 007 04 attac2hed.
<br />Ian Brtrsa and S`nvQ Tvuta are excluded f,--= 'Wor"co-- s' CC= er.Satsc; Ceveragn
<br />GEK I11-1GAT1= HOL.UtR CANCELLATION
<br />'4fVu@sant+3.-ana.or SH•D'�'Lf+itiYDETMfA8O"dEDEBT,RkSEG1"•OLIG[f98EGANGEi1Sd131rRt7liETHE 7[PcRATIDN
<br />Santa Ana Regional Transportation Center OAft TIiEr-+EO#. THE MSSJING I1SSUAVt W LL ENDEAVOR TO MAIL 20 DAYS WRITTEN
<br />c/o .riaYit Ana P1,7,1?2„1. C Works }t` Sr,D+,CE TO Tf.E CfRtlFe.ATE NuLSEN *:4ME>r% TOT"# L..f,FT, 8UT FAILURE T4 04 SO SNgLL
<br />1000 E Santa Arta Blvd $108 a
<br />Santa Ana, Cis 92701. { °MPaS-S NO 090�1AMAs OR LIASkLITY OF ANY KIND UPON Tift IhSURPR, ITS AGENTS OR
<br />< aaro��¢cuTarnrra
<br />A%,fTitORInD PERRESE✓ TA.".r[
<br />r+t..vrsv sa lcevy+vII V 19,58-20438 ACORD CORPORATION. All rights reserved.
<br />IN50251 _1, The ACORD nalmo and
<br />apo aro registered marks of ACORD
<br />FK ES5'UMSRLLLA.LIAls1LItY
<br />:,.� " rn ,., =
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<br />5,000,000
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<br />8 2JL2 Ub r D C C, e .,
<br />"1 i/ 049 10,11/2010
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<br />AND LlaP1.CSYEilS`LfApItT
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<br />1,{'140,040.
<br />IMi+ndaiaryinlJtll
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<br />1,000,000
<br />- -
<br />� _ ,..,� •� r�
<br />,� = 1
<br />1,000,000
<br />B 01HERSu9 Pars Prop PFP£444ESS 3/25/2010 2/25/201I �: »y:r.4 Dad $1,004
<br />Cont Equip F'1tr ;.a z.* -- - Dad $1,000Spec Form, Rept Cast
<br />IP a kOF. Rai; TION5rlOCA31OKS'MEPII�"SES?EXCLl1S/^vk5A.t°ti^EaEr EhDd3R5EIxE!\; SgEwA,Lp#tCYYSitTN3
<br />He Cst 10098 Servsec 1acat-ten 1.0Q.1 L, Sar.t& Ara i:li ax-CLrazia:s osty 1ocat_019.
<br />t11,41 SantA An* sLAW9iaral '.ransportatsor. Crs:.wr +s ra=ad as Rdd;tscn-� %r au od, b-ut only as sespeccs Gene,=m1 Liability
<br />arising out of the operas_ans a£ the Naz�--d Ins-ared per _c— lir, ZO 10 007 04 attac2hed.
<br />Ian Brtrsa and S`nvQ Tvuta are excluded f,--= 'Wor"co-- s' CC= er.Satsc; Ceveragn
<br />GEK I11-1GAT1= HOL.UtR CANCELLATION
<br />'4fVu@sant+3.-ana.or SH•D'�'Lf+itiYDETMfA8O"dEDEBT,RkSEG1"•OLIG[f98EGANGEi1Sd131rRt7liETHE 7[PcRATIDN
<br />Santa Ana Regional Transportation Center OAft TIiEr-+EO#. THE MSSJING I1SSUAVt W LL ENDEAVOR TO MAIL 20 DAYS WRITTEN
<br />c/o .riaYit Ana P1,7,1?2„1. C Works }t` Sr,D+,CE TO Tf.E CfRtlFe.ATE NuLSEN *:4ME>r% TOT"# L..f,FT, 8UT FAILURE T4 04 SO SNgLL
<br />1000 E Santa Arta Blvd $108 a
<br />Santa Ana, Cis 92701. { °MPaS-S NO 090�1AMAs OR LIASkLITY OF ANY KIND UPON Tift IhSURPR, ITS AGENTS OR
<br />< aaro��¢cuTarnrra
<br />A%,fTitORInD PERRESE✓ TA.".r[
<br />r+t..vrsv sa lcevy+vII V 19,58-20438 ACORD CORPORATION. All rights reserved.
<br />IN50251 _1, The ACORD nalmo and
<br />apo aro registered marks of ACORD
<br />
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