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ACC <br />ATE( f_1O*D'y_yY'y_y_)__ <br />->R - <br />CERTIFICATE OF LIABILITY INSURANCE 10/2712016 <br />N <br />ONLYAND C014FERS NO R16FITS UPCq4 TH E COO IFICATEHOLDER, THIS CERTIFICATE DOES NOl' AFF[RhaTIV LY R �GATIVFLY <br />THIS CER I-IFICATE IS 155VEDAS A MATI ER OF INF URMATON <br />AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BYTHR POLICY ES BELOW. THIS CERTIFTCATE OF INSURANCE DOES NOT CONSTITU TEA CON'T'RACT BETWEEN THE ISSUING IMSURER(s), <br />AUTHORIZED RFPRESE NTAI IVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />9 the certificate holder Is an <br />ADDITIONAL I N SURED, the PofiLy(lo') Must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGA(ION IS WAIVED, Nub*t to the terms and <br />IMPORTANT. <br />ccmcilflon.�of tile Policy, cerulln pollcies corky <br />require in Lndorsoment.A statement oil this cortiftCOtO does not confer ilghts to the "rtifiCatc holder in lieu of such nnelorsunreark( ). <br />PRODUCER <br />CONTACT <br />NAME: <br />Michael Brandon, insurance Aqancy <br />II PHONE FAX <br />tA/C,NQEX-r): (AX, NO): 900 -794-8193 <br />31629 Outer Highway 10 to A <br />, 909-791-'§191 <br />E -MAIL <br />AWDRESS: mbrandon@farrnersagont.corn <br />Redlands CA <br />92373-7590 - ----- <br />INSU RER(S) AFFORDING COVERAGE NAIL P <br />R.A No dnce Companyny <br />k.SU�. <br />I Farmers Insurance Exchange 21652 <br />I WATER INC, <br />12 GOODYEAR STE 130 <br />...... ..... <br />CA 92618 <br />IRVINE <br />COVERAGES CERTIFICATE NUMBER: REVISION NVMUhR: <br />THIS IS To CERTIFY THAT TI IE POLICIES OF INSURANCE LISTED BELOW HAVE MIN (SSULIJ TO I HE INSURED NAtAh ABOVE FOR 1Hh VOIACY PERIOD I NOICAI ED. NOTwil HSTANDING ANY <br />RKIJIRLMLN 1, 1 ERM OR ()Nr)i n(>N OF ANY CONIRACT OR 011 IER r Wi � H RESPECTTO WHKH THIS C.D17 IFICArE MAY UE ISSUED OR MAY PER I AIN, THE P,ISURANCE AFFORDED AY FHE <br />PC! I(IIII-S DESCRIBF.L) HEREIN Is S06JLC I 10 Al.I. THE JEwAS, EXCLUSIONS AND CONDI I IONS DSUCH FIOUCIFS, LIMITS SHOWN MAY I {Avk BEEN REDUCED BY PAID CLAINTS, <br />P0TtCyExP <br />IN"R ADDTL $UBR POLICY NU B MM/L)D/YYYY) (MM/DD/YYYY) ..LINUTS <br />TYPEOFINSURANCE INSD WVD <br />ITR <br />rA0 I OCCURRENCE <br />DAMAGE TO RENTED <br />CIAIMS-MAO� X I OCCUR ;rRFMISFS (Eo Gccum"nce) S 100,000 <br />PERSONI INJURY iS <br />1012112016 10/2712017 <br />A y <br />GENERALACCREGATE 2000 <br />(,FN'L ACGRL(jA114LIYW APPLIES PER; <br />.1vill/011 ACXI� 2,000,DOOi <br />PROJECI LOC C0 <br />PotlCy <br />OUIL <br />COMIANIF-D.YNGLI, TWO <br />AU rOMOHILE <br />UTOMOHILE LIANU (Y <br />A' I'll KOLAILY INJURY (Per Person) 5 <br />NEDNIfroq SC'4CDULEO 80011Y INJURY (Pel 4C16000 $ <br />B All', 010 00104/2016 09/04M17 <br />EU <br />Y 05861543 <br />ONLY <br />""V <br />PROPERJY DAMAGE <br />ONLY AUTO$ONLY (P(, oculderit) <br />OCCUR EACH OCCUPQKN(l <br />I{p <br />DED L rE"N T I ON <br />AG G RH <br />� <br />,7 <br />tvORKERS COMPENSATION T, DOTEK <br />AND EMPLOYEMS'LIABILIIY <br />CIOEj�7T <br />Y/PI ��C H A C . <br />ANY PPOPRIF IOR,PARI NEk' <br />N <br />E1 DISFASt -EAEMPLOY17T $' <br />'atoryinNH) <br />DESCRIPTIONOF Til, LL. DI5&6E POLICy LIMI $ <br />D ' E - SCRfPTION OF 0 PFR All ONS JLGC ATIONS/VEHICLES (AGGRO 101, Additional Remarkr, Scheomle., may be aRiched If more space Is rtqWred) <br />Wditional ln%Ured: Uty of Santa Ana <br />CLZIFICATE HOLDER CANCELLATION <br />jj SHOULD ANY OFTHI, ABOVE DESCRI43ED POLICIES BE CANCELLED 8EFORE7HE EXPIRATION <br />20 Civic Centof Plwa 1 DAr. THEREOF. NOTICE WILL BE DELIVERFE), IN A!XBRqANCE WITH I HE POLICY PROVISIONS. <br />Ross Annex (M-1) AUTHORIZED REMITL f T it <br />ACORD 25 (2016/03) @1988-2015 ACORD CORPORATION, All Rights Reserved <br />31-1769 1 1-15 flio ACORD name and logo are registered marks, of ACORD <br />dt" <br />