CAZALES, RODOLFO DBA TOYAMA KARATE-DO ORGANIZATION 2-2017

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Policy Number: Date Entered: 02/07/2018 '`�C �® CERTIFICATE OF LIABILITY INSURANCE z/�mm0 ' 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on PRODUCER INSURED Reindeer Insurance Services 14037 Pioneer Blvd Norwalk CA 90650 Rodolfo Cazalez 1030 Moore Street Santa Ana. CA 92704 I PHONE No EAh (562) 406-8838 (AXc Noe (562) 406-8837 EMAIL .....e«�, esr@truckbypass. cow Insurance Company COVERAGES CERTIFICATE NUMBER: 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 ADOLISUBR. POLICY EFF POLICY EXP TYPE OF LTR D' POLICY NUMBER MM/DOIYYYV MMNOP/YYY LIMITS A X COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $ 2 r OOO, 000 AH-GA2692-004 01/01/2018 01/01/2019 DAMAGETO RENTED 100, DOD CLAIMS -MADE OCCUR PREMISES(Ea occurrence $ j MED EXP (Any one person) $5,000 _ PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $4,000,000 POLICY PRO LOC JECT _ __PRODUCTS-COMPIOP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) _ ANYAUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS - BODILY INJURY (Per accident) $ HIRED NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per acadenl $ UM BRELLA LIAR OCCUR EACH OCCURRENCE $ ```` EXCESS LIAR CLAIMS -MADE N i AGGREGATE ., $ DED RETENTION $ Pl $ MPIRISATION OTOR/PARTEWEXECUTIVE PER TIT ER AORPROPRIEKERS AND EMPLOYERS' LIABILITYY/N p� /.' �✓ VV !�JV ri -` E. L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? � N/A `—STATUTE V — _ _.- _- (Mandatory In NH),\"r" ,n ` E. L. DISEASE - EA EMPLOYEE $ It yes, describe under DESCRIPTION OF OPERATIONS be. I'rA A/,EL. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks SahaEule, may be attaohed it morelspace is req.ir.d) Karate School Additional Location:2320 N Grand Ave Santa Ana CA 92705 Certificate holder, its officers, agents, and employees are named as Additional Insured in regard to General Liability Att:PRCSA 20 CIVIC CENTER PLAZA M-23 PO BOX 1988 SANTA ANA CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I 1 1 ©1988-2015 ACORD CORPORATION. All riahts reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Produced usina Farms Bass Plus software. wvvW.FormsBoss.comImoressive Publishina 800-208-1977