ADLERHORST INTERNATIONAL, INC. 5 - 2015

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ACV RL> , CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) F11/18/2016 �. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .......__. ...._.....,._. 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(ie's) 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 CONTACT Carole Nix COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 0OCCUR NAME: Kellogg & Moreland Agency, Inc. DBA PHONE (909}792-8'950 FAX (909)792-2030 (AlD,..N9 EM __. (A1C Not .,, .... Arroyo Insurance Services E-MAIL SS:carolen@arroyoins.com .� 1654 Plum Dane INSURER(SI AFFORDING COVERAGE NAIC if Redlands CA 92374-4532 INSURER A Mercury Casualty Company 11908 INSURED m...,., INSURER B INSURER C: .Adlerborst International, Inc. A-2015-044 13951 Vernon Avenue INSURER D: INSURER E PERSONAL &ADV INJURY .._.$. INSURER F: '..Riverside CA 9250 COVERAGES CERTIFICATE N'UMBER:Cz1692803474 REVISION NUMBER° 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 ANY 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 BY PAID CLAIMS. .......__. ...._.....,._. INSR. LTR TYPE OF INSURANCE ADD.L SUBR. m. POLICY NUMBER _...P®LICY EFF MMIDDIYYYY POLICY EXP MM1DDIYYYY __- .................-... LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 0OCCUR EACH OCCURRENCE DAMAGE TO RENTED PREMISESEa occurrence $ $ MED EXP (Any one person) $ PERSONAL &ADV INJURY .._.$. GENERAL, AGGREGATE GEN LAGGREGATE LIMIT APPLIES PER: W PRO- POLICY _ JECT [:] LOC PRODUCTS - COMPIOP AGO ... $ $ OTTER` AUTOMOBILE LIABILITY CC7MBINEO SINGLE LIMIT Ea accidenk $ 1,000,000 BODILY INJURY (Per person) $ '' ANY AUTO ALOSCHEDULED AUTOSS AUTOS CCA.0017177 8/29/2015 8/29/2017 BODILY INJURY (Peraccident) $ WRFC) AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE ......_ Per acciden{ $ $ UMBRELLA LAS OCCUREACH OCCURRFNCE $ EXCESS LAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY Y f N OTH _.... STATUTE ER E -L. EACH ACCIDENT ...,... $ ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED" NIA E:. L. DISEASE - EA EMPLOYE --_.--� $ (Mandatory In NH) If yes, describe sunder DESCRIPTION' OF OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Verification of Coverage r,rmm I IrI'l,eH I c rivLur-m UANGtL.I..A.I IUN ]rose@Sana—ana.crg Santa Ana Police Department 60 Civic Center Plaza Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION (DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PR'OVISION'S, AUTHORIZED REPRESENTATIVE Carole N:i,x/CAROLE 1988-2094 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS02:512nwi)