ENGINEERING SOLUTIONS SERVICES (2)-2017

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A.- 2-o1*1- Zay w,e CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) L...�' 01/09/2018 THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND ORALTERTHE 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 this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER CONTACT NAME: Jim Miller(9761314) PHONE FAX 4160 Temescal Canyon Rd Ste 206 (A/C, NO, EXT): 951-777-2450 (A/C, NO): 951-398-4377 E-MAIL Corona CA 92883-4627 ADDRESS: jmillerl@farmersagent.com INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURERA: Truck Insurance Exchange 21709 INSURER B: Farmers Insurance Exchange 21652 ENGINEERING SOLUTION SERVICES 23232 PERALTA DR INSURERC: Mid Century Insurance Company 21687 INSURER D: SUITE 112 INSURERS: LAGUNA HILLS CA 92653 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT W ITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BVTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPEOFINSURANCE ADDTL INSR SUBR WVD POLICY NUMBER POLICY EPP (MM/DD/YVYY) POLICY E%P (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ❑ OCCUR DAMAGETO RENTED PREMISES (Ea Occurrence) $ MED EXP(Anyone person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ POLICY ❑ PROJECT ❑ LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 2,000,00 ANVAUTO BODILY INJURY (Per person) $ D OWNEDAUTOS �/ SCHEDULED ONLY ^ AUTOS Y 605822922 03/12/2017 03/12/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ HIREDAUTOS X NON -OWNED X ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEAD RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY PER STATUTE OTHER $ ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVE OFFICER/MEMBER N/A E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF O P ERATIONS below EL.DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 2014 TOYOTA PRIUS V; VIN: JTDKN3DU1 E1759055 �y CERTIFICATE HOLDER CANCELLATION CITY OF N A ANI O RS AGENTS Aid SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 20 CIVIC CENTER PLZ DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE SANTA ANA CA 92701 J+ ACORD25(2016/03) 31-1769 11-15 ©1988-2015 ACORDCORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD