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1 <br /> ' ACOR <br /> 4. CERTIFICATE OF L~p?~IL~T`Y ~IVSUR~I~CE DATEIMIUImDfYYrvl <br /> 03/24/2010 <br /> pRODucER phone; (951)786-6338 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> DFI - DiGerolamo Famlly Insurance Services ONLY AND cONFEI~s No RIGHTS UPON THE CERTIFICATE <br /> 2027 Hamner Ave HOLDER. THtS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> NOPCO, CA 92860 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELQW. <br /> License OD26889 rNSUliE12S AFFORDING COVERAGE NAIC <br /> INSURER A: F,gp/AMERICANSTATESINSURANCECOMPANY ~ <br /> ST1GE S7FtIpING SERVICES INC. INSURER B: MERCURY CASUALTY INSURANCE COMPANY _ <br /> 1054 RAILROAD STREET INSURER C: .I. ~ <br /> .~T/~'E COMPENSATION INSURANCE FUND <br /> CORONA, CA 92882 INSURER D: <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED sE1.OW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DtSCRIBED HEREIN IS SUBJECT TD ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> NY6R - POLICY EFFECTIVE POLI E?tPIRATION ~ <br /> POLICY NUMBER LIMITS <br /> A y r.FUaue~ uA~rlny 01 CG76837960 03/22!2010 03/22/2011 tACH OCCURRENCE S 1 000 0 _ <br /> X COMMERCIAL GENERAL LlA61LI'fY AIGfA0ET0 RENTED ~y9D0.000 <br /> FR k, o r.. 3 <br /> CLAIMS MADE ~ OCCUR MED ExP LAny one er~~r, s 10 D00 <br /> X _CON7IZACTI.IAL' PERSONAL&ADVINJURY $ 1 O 0 <br /> • - GENERAL AOGIi~GATE S 2 000 O <br /> C~N'L AGGRL-GATE uMIT APRLIES PER; PRODUCT6 - COMp/Op AGG $ 2 DOO <br /> POLICY P LOrr <br /> B Y AUTOMOBILE WdILlTY AC110>1675 04/29/2009 DC1./z9/2010 COMRINFA SINGLE LIMIT 3 <br /> X ANY AUTO (Ea aceiaant) <br /> 100 0 <br /> ALL OWNED AUTOS <br /> SCHEDULEDAUTOS B~ODIL~Y~j RY S <br /> HIRED AUTOS " <br /> AION~OWNED AUTOS BOD4Y INJURY $ <br /> F gl~i (Per acclaenh <br /> AS ~ ~P~o~an~'AMAGE s <br /> -°ARA~ L'"~'L"~ pR AUTO ONLY- EA ACCIDENT 5 _ <br /> ANYAUro ~ ~ ~ ~ .~DEtGK 2V OThIERTNAN tAACC s <br /> ,I/~. ` ~ S QY AUTOONLY: AGG $ <br /> ExCLS$/t7MBRELL4EIABILITY ~ <br /> a,C1t EACH OCCURRENCE $ <br /> OCCUR ~ CLAIMS MAD[ Ay$~5 Y/ A~~.~ s <br /> DEDUCTIBLE l!! ~ $ <br /> 5 <br /> RETENTION S - - <br /> S <br /> C WORHERS CO1WpeN5ATION AND 044-29766~20D8 06/01/2009 06/01/2010 X ~ STATU- RTy- <br /> EMPLOYEAS' LIABILITY _ <br /> ANY PROPRIETOR/pAFtTNEWEXECUTIVE l:. L. EACH ACCIDENT S 1 ODO O <br /> OpFlCERfA7EM81J2 ExCI.UDED7 <br /> If yens, duccxiDe antler E.L. DI8EA8@ - EA EMPI.QYG .1.000.000 <br /> SPECIAL PROVI810N3 Ix3tow <br /> OTHER E.L. DISEASE -POLICY LIMB S 1 ODD OO <br /> DE6CRIPTION OP ONI:RA77ON3 ! LOCATIONS 1 VEHICLES 1 k~XCLUS10N3 ADDeD BY ENDORSEMENT ! St'tGAL PROYI910N$ <br /> 10 DAYS NOTICE WILL BE BENT FOR NON PAYIINENT OF PREIUl1UM. <br /> CERTIFICATE HOLDER I$ NAMED A5 ADDITIONAL rNSURED. CovERAGE IS PRIMgRY ~ NON CONTRIBUTORY <br /> .JOC3: VARIOUS JOB LOCATIONS <br /> REVISING CERTIFICATE ISSUED 3/23110 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOV@ pE6CR18ED POLICIES F3L CANCELLED riEPORB THE 17fPIRA710N <br /> CITY OF SANTA ANA bATk TTIEREOF, THE ISSUING INSURER WILL ~ 1AgIL =3D ppyy WRITTEN <br /> ATYN: ROCK CyARCIA NOTICE 70 THt.CER7IFICATB NflLDER NAMED TO YHk LEFT, <br /> 305 E. 47N STRELCT, SU17'E 201 <br /> SANTA ANA, CA 92701 ~RIII <br /> AUTNDR¢ED REPkI?sENTATIVE <br /> <br /> AcORD z512001/os) ~ FH <br /> E X H ~ B ~ T ~ q ACORD CORPORATION 1968 <br /> f, Printed by Kt1T on Msrch 24, 2010 at 03:38PM <br /> <br />