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Ate` °R°Y CERTIFICATE OF LIABILITY INSURANCE <br />UATEiMM/UUIYYYY) <br />TYPE OF INSURANCE <br />0611812015 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />AFFIRMATIVELY OR g��EEAND tCONFERS <br />OTHE�ISSUINGF <br />BELOW THIS INSURANCE DOES C09�lTTE X� Ci)WfRACTTBETWEEN INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADD? A 1"11JRF IW <br />)? li (j, nmust be endorsed. If SUBROGATION IS WAIVED, subject to <br />the tames and Conditions of the policy, certain poll tttav Iragtei a an p�ic)grl <br />L Il d 4 1 , <br />rf� dt. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement (s). I l <br />N <br />PRODUCER <br />CONTACT <br />NAME: <br />_ yy�� <br />Ron Al— 00 � {� �— { V � <br />_r- _ <br />PHONE 9*0. 530-877 -7656 I rpL� Ne) 530 -877 -2940 <br />— <br />Clark(9531339) <br />5778 Clark Rd <br />EMAIL <br />AoORESS93�rj4R6�9�faC1iL £L.zaBEIlII&40L_ —. —_ <br />_ <br />$ 75_000 <br />,-,_„ INSUREfiLS)AFFOROINO COVERAGE. -__ NAIC It <br />Paradise 95969 -5135 <br />INSURER A: Truck Insurance Exchange <br />21709 <br />INSURED <br />INSURERS: Farmers insurance Exchange _ _ <br />21852 <br />ALVAREZ- GLASMAN & COLVIN <br />INsuRERc: , Mid Century Insurance Company <br />21687 <br />13181 CROSSROADS PKWY, ST 400 <br />_ <br />INSURERO: <br />C <br />INSURERE: <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />HIRED ALITOS X AUTOS <br />INSURER F: <br />604848930 <br />CITY OF INDUSTRY CA 91746 <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, 1 "HE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />^ - - -- <br />INSR <br />Lm <br />TYPE OF INSURANCE <br />D <br />BR <br />- -- <br />POLICY NUMBER <br />POLICY EFF <br />MMIOOI YY <br />POIICYP - <br />MWDD /YYYY <br />- -- — '-' - - -'- <br />LIMBS <br />C <br />GENERAL <br />X <br />. —. <br />LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS�MADE a OCCUR <br />_ _._. -. _. <br />Y <br />N <br />604848930 <br />08131/2014- <br />08/31/2015 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />MA0- �REHTEO <br />- PREMISES Ea ovcurtoncut <br />_ <br />$ 75_000 <br />MEDEXP &ymgpp.T'on) <br />$ 5,000 <br />PERSONAL &ADVINJURY <br />$ 2,00_0,000_ <br />AGGREGATE <br />. <br />$__ 4,000,000 <br />GEN'L AGGREGATE <br />X POLICY <br />LIMIT APPLIES PER: <br />F PRO- LOO <br />_GENERAL <br />PRODUCTS- COMP /OP AGO <br />$ 2,000,000_ <br />$ <br />C <br />AUTOMOBILE <br />- <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />HIRED ALITOS X AUTOS <br />604848930 <br />08/31/2014 <br />08131/2015 <br />COMBINED SINGLE LIMIT <br />AGE, - iidAnll__ <br />$ 2,000,000 <br />BODILY INJURY (Per person) <br />' - <br />$ <br />-� - -' <br />e001LY INJURY (Fur uctldenU <br />--- - - - -'— <br />$ <br />PROPERTY �AMKGE ' <br />,(Per acultlgnll_._.- <br />$ <br />UMSRELLAUAE <br />EXCESS LIAR <br />_OCCUR <br />CLAIMSMADE_ <br />_EAGHOC_CURRENCE <br />$ <br />AGGR_E_C E <br />$ <br />DED RETENTION$ <br />_ <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YINL---- <br />ANYPROPRIETORIPARTNCRIEXECUDVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mendarory inNH) <br />If yee, tleticrihu under <br />DESCRIPTIONOFOPERATIONSbaluw <br />N/A <br />N05095611 <br />09104/2014 <br />09)04(2015=------------- <br />X WCG'rATU- H. <br />EL EACH ACCIDENT <br />5 <br />B.L. DISEASE -EA EMPLOYE <br />- - - - -- <br />$ <br />- -'— <br />C.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES (Attaob ACORD 101, Additlonal RemarMS Schedule, B more space is requiretl) <br />13181 CROSSROADS PKWY, ST 400, CITY OF INDUSTRY, CA 91746 <br />�✓ O 1 { 5 <br />ltY 4 O. HODGE <br />bital it aty Attomey <br />CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />SANTA ANA <br />CA 92702 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />ACORD 25 (2010105) p 1988F2$10 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks 41Y /ACORD <br />