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C I ie nt #: 62862 G G I c7_v� -� 7 y -1.7 N ACOROTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD /1'YYY) 11/12/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER J. Smith Lanier 8a Co.- Atlanta 11330 Lakefield Drive NAME - PHONE 770 476 -1770 7704763651 ac No E :t : ac, No Bldg 1, $Ulte 1OO N�2008�0 %2�0�2 Duluth, GA 30097 ADDRESS: CUSTOMER ID #: INSURERS) AFFORDING COVERAGE NAIC # INSURED INSURER A: Philadelphia Indemnity Insuranc 1$05$ Henry Ramirez dba Bay Area Driving; Driving School Safety Drivers Ed LLC 1070 A- Street INSURER B $1,000,000 INSURER C INSURER D $2,000,000 Hayward, CA 94541 LIMIT APPLIES PER: PRO- LOC PRODUCTS - COMP /OP AGG $2,000,000 INSURER E $ INSURER F AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GOIV ERAG ES CERTIFICATE NDMRFRe RFVIR IrIN NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BV PAID CLAIMS. IN R TYPE OF INSURANCE DDL U POLICY NV MBER POLICY EFF MM/DD POLICY EXP MM/DD/VYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR PHPK631072 11/01/2010 11/01/2011 EACH OCCURRENCE $1 000000 PREMISES Ea occurrence $1 OO OOO MED EXP (Any one person) $8,000 PERSONALBADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: PRO- LOC PRODUCTS - COMP /OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS PHPK631072 �k''a ROVEll 11/01/2010 AS 'Y�iU 11/01/2011 F�� -- COMBINED SINGLE LIMIT (Ea accident) $5OO OOO �( BODILY INJURY (Per person) $ BODILY INJURY (Par accident) $ (PerOe eden[DAMAGE $ X X $ $ VMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE Laura � EAGH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION (itr _ iee ,n ilC $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDEDi � (Mantla[ory In NH) If es, tlascribe untlar DESCRIPTION OF OPERATIONS below N/A WC STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A A Building Bus Pers Pro art PHPK631072 PHPK631072 11/01/2010 11/01/2010 11/01/2011 11/01/2011 $357,000 $30,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD tOt, Atldltlonal Remarks $chetlule, If more space Is requlretl) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 'For Information Purposes Only' ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (r319 - D9 ACORD CORP�RATIDN_ All rights recB rvrd_ ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S 1021651 /M990867 AYM