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Click here to clearForm <br />[Click here to Send Form <br />ACOROTM CERTIFICATE OF LIABILITY INSURANCE <br />Y Y) <br />DAT12/29/201 <br />1 2/2 912 01 6 <br />PRODUCER <br />C <br />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 />LIN ASSOCIATES INSURANCE AGENCY <br />24705 NARBONNE AVE, #200 <br />LOMITA, CA 90717 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMB MADE 0 OCCUR <br />INSURERA: THE HARTFORD <br />29459 <br />CENTURY STRUCTURAL ENGINEERING CO. INC. <br />24719 NARBONNE AVE <br />LOMITA, CA 90717 <br />INSURER B, <br />INSURER c: <br />INSURER D: <br />INSURER E: <br />MED EXP (Any one person) $ <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTH POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />D)'IPOLICY <br />C <br />POLICYNUMBER <br />EFFECTIVE <br />TE MM 00 <br />POLICY EXPIRATION <br />E MMIDDIYV <br />LIMITS <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMB MADE 0 OCCUR <br />EACH OCCURRENCE $ <br />PREMISES Ea orrwrrance $ <br />O <br />MED EXP (Any one person) $ <br />PERSONAL&ADV INJURY $ <br />D <br />GENERALAGGREGATE $ <br />GEN'LAGGREGATE LIMIT APPLIES PER: <br />7 POLICY PRO- LOC <br />D <br />PRODUCTS.COMPIOPAGG $ <br />O <br />Ell <br />AUTOMOBILE <br />LIABILITY <br />ANYAUTO <br />ALLOWNEO AUTOS <br />SCHEDULEDAUTOS <br />HIREDAUTOS <br />NON -OWNED AUTOS <br />0 <br />COMBINED SINGLE LIMIT $ <br />(Ea accident) <br />O <br />BODILY INJURY F� <br />(Per Person) $ L_J <br />O <br />BODILY INJURY <br />(Peraccident) $ ����''I <br />O <br />PROPERTY DAMAGE $ <br />(Peraccident) <br />E]ANYAUTO <br />mGARAGELIABILITY <br />O <br />AUTO ONLY -EA ACCIDENT $ <br />EAACC $ <br />AUTOONILYN <br />AGO $ <br />EXC ESSIUMBRELLA LIABILITY <br />OCCUR M CLAIMS MADE <br />DEDUCTIBLE <br />RETENTION $ <br />D <br />EACHOCCURRENCE IS <br />0 <br />AGGREGATE $ <br />$ <br />O <br />$ <br />$ <br />?J <br />WORKERS COMPENSATION AND <br />EMPLOYERS'LIABILRY <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLU DED? <br />If d000 <br />SPECIALPROVISIONS below <br />57WECDW3167 <br />01/18/2016 <br />01/1812017 <br />WCSTATU- OTH. <br />- TORYLI I R <br />57WECDW3167 <br />01/162017 <br />01/1812018 <br />E.L. EACH ACCIDENT $ 1,000,000 <br />E.L. DISEASE -EA EMPLOYEE $ 1,000,000 <br />EL OSEASE-POLICY LIMIT $ 1,000,000 <br />OTHER <br />DESCRIPTION OP OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />, ., <br />1 .491nL9a1c <br />EVIDENCE OF COVERAGE ONLY <br />LANNING AND BUILDING AGENCY <br />ITY OF SANTA ANA <br />TTN: MARIO ESPINDOLA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY QrANY KINH 11£4 N THE INSURER, ITS AGENTS OR <br />I --J I ILIN ASSOC IATCS INSURAN>;w- VENNI <br />ACORD 25 (2001108) C I—r ©A(IO"D CORPORATION 1988 <br />