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ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />06/01/2011 <br />PRODUCER (gqg) 582-0964 <br />Roy Pal aoios Snauranca Agency, Inc. <br /> <br />CA: OD36891 NV:498645 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />26081 Merit Circle, Suites 101 <br />La una Hi11a CA 92653- <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED INS URER A: Farmers =nsuranca Exchana <br />Pacific Tra££io Data Services, Sno. wsuRER e: <br />27722 RL1YJ1 dOl.1X INSURER C: <br /> INSURER D' <br />M19910n Vi0 ? O CA 92692- INSURER E- <br />:OVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR ADD'L <br />INSRD <br />TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFFECTIVE <br />DATE (MM/DD/YY) POLICY EXPIRATION <br />DATE (MM/DD/YY) <br />LIMITS <br />A GENERAL LIABILITY 60501-36-25 0$/24 /2011 0$/24/2012 EACH OCCURRENCE S 1.000.000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br />PREMISES Ea occurrence 75 , 000 <br />8 <br /> CLAIMS MADE ? OCCUR / / / / MED EXP An one arson 9 $ , 000 <br /> PERSONAL 8 ADV INJURY 9 1 , 000 , 000 <br /> / / / / GENERAL AGGREGATE S 2 , 000 , 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 9 1.000.000 <br /> POLICY JECT LOC / / / / <br />A AUT OMOBILE LIABI LITY 60501-36-25 05/24/2011 OS /24/2012 COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea accident) 5 1 , 000 , 000 <br /> ALL OWNED AUTOS / / / / BODILY INJURY <br /> SCHEDULED AUTOS (Per person) s <br /> X HIRED AUTOS / / / / BODILY INJURY <br /> X NON-OWNED AUTOS (Per accident) s <br /> / / / / PROPERTY DAMAGE <br /> (Per accident) S <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 4 <br /> ANY AUTO / / / / <br />OTHER THAN EA ACC <br />9 <br /> AUTO ONLY: qGG 9 <br /> EXCESS/UMBRELLA LIABILITY ii AA cc?? <br />?????VF?i? /-1 .l T(l I (? / / <br />EACH OCCURRENCE <br />9 <br /> OCCUR ? CLAIMS MADE <br />? <br />/ AGGREGATE 9 <br /> /7 <br />f <br />j <br />?_ i? <br />q <br />/ <br />?? S <br /> DEDUCTIBLE / <br />/ <br />y <br />? ? <br />_.__ <br />_.??-°.-_.--_-.-. .. _.l _.___?..-?' / / s <br /> RETENTION S `? ? ? ?? ?.1 ?...._y <br />5 <br /> WORKERS COMPENSATION AND <br />' ? ?D' ' / / / / WIC g U <br />TORY LIMITS ER <br /> EMPLOYERS <br />LIABILITY <br />ANY PROPRIETOR/PARTN ER/EXECUTIVE <br />E.L. EACH ACCIDENT <br />9 <br /> OFFICER/MEMBER EXCLUDED? <br />I1 <br />d <br />rib <br />d / / / / E.L. DISEASE - EA EMPLOYEE S <br /> yes, <br />esc <br />e un <br />er <br />SPECIAL PROVISIONS below <br />EL DISEASE -POLICY LIMIT <br />9 <br />A <br />A <br />A OTHER Ep=,= <br />Huilcling Contents <br />Huainaas Pars Prop 60501-36-25 <br />60501-36-25 - <br />60501-36-25 05/24/2011 <br />05/24/2011 <br />05/24/2011 05/24/2012 <br />05/24/2012 <br />05/24/2012 net 52,500 100,000 <br />Dad 51,000 21,200 <br />D¢d 51,000 100,000 <br />DESCRIPTION OF OPERATONS/LOCATONSNEHIGLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />CartiFicata k>.oldar Hamad as additional insured. <br />V CR1Ir l?..A1C r'IVLUCR VANVCLLAIIVIV <br />( ) - ( ) - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br />C1ty O£ Santa Ana FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br />PWA - Tra££ic Engi nearing INSURER, ITS AGENTS OR REPRESENTATIVES. <br />20 Civic Canter Plaza, M-43 AUTHORIZED REPRESENTATIVE <br />- <br />Santa Ana CA 92701- ?? <br />ACORD 25 (2001/08) ©ACORD CORPORATION 1988 <br />INS025 (o?oe).os Page 1 012