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ACCWL), <br />a.....- CERTIFICATE OF LIABILITY INSURANCE <br />DATEIMMNOMYYYI <br />6190017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPOR ANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions ofthe policy, certain policies may roquire an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in Iiolr of Such ondorsumenl(s). <br />PRODUCER <br />CGNIACI <br />NANO: Pal) Runw," <br />Paid Romero bwlranca .AgJncy <br />gIC�Ro, Erll_ RL<S9C—ifi'4 INS, Ntll: SQS.-'81-J329 <br />Ao0 ess�-. Iumoroin.Efianl.can <br />2569 Ngvnh vUu <br />_ <br />INSVRERISI AFFORDING COVERAGE+� <br />_ NAIC. <br />INSURER A COLONY INSUR:ANCC CO <br />Simi Vail,) CA <br />INSURED <br />INSURER S; CAS['.1..TY�..MW. <br />S t11 <br />SI:\TOR LP.:\Cili li 1.\IiliLDil.\C. <br />INSURER C: FALLS I-AKY, HlkhN(,AS( At, IN CU)11' <br />I?%it <br />?II?I'.Chof Afl A\R )) i) - <br />�I ej �f ljt//ii �.5 <br />Falltlnon `(-}>%� )"I `L,C ! CA Q,132-21115 <br />INSURER D: <br />INSURER E:..--..J <br />..._._.v.. <br />INSUNERF: <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. N01 WITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER <br />OOCUMENTWO'H RESPECT" TO WHICH THIS <br />CERTIFICATE MAY HE ISSUED OR MAY PERTAIN, THE INSURANCE ArFORDED BY THE POLICIES DESCRIBED <br />HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OP 5UCI1 POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID <br />CLAIMS. <br />LEK <br />TYPE OF INSVRANCE a _ <br />RHO <br />y' <br />NAV <br />POLICY NUMBER <br />POLICY EFF <br />MM,DUIYYYY) <br />AP <br />IMMI�dtlMIYYI <br />LIMITS <br />X I COMMERCIAL OENERAL LIAeIUIY <br />�i CLMAtSAffJJ@ OCCUR <br />_ACNOCCURRENCE <br />t I,IHI169LQi <br />FRLMI ES(b, o<rnl 0 JI <br />a IOnO(In <br />M O EKP IAnv ens P' ) <br />a 5..000 <br />\ <br />Y <br />I 0I(ILIX)232flb03 <br />0/01/17 <br />n/DI%IF <br />PRSONA-AADVINJURY <br />p I,000L000 <br />6EI,0RAL ACOREGAIE <br />Grr_ A Ci UA:E"Ib11 AC `- Es PGrl <br />XIPCLIc fens. <br />„ Cr 'GC <br />I <br />-RGO <br />" <br />CrS et'-`dP -P Aq3 <br />S Pv(IUDLD��- <br />OTn V <br />AVYOMOSIL6 LIASILIYY <br />A:IYA n) <br />( <br />ICI caal o CGr"T <br />,)� <br />ORT <br />t ILn-U-n�O(XI <br />-� <br />R�ff�I <br />ALL OWNED IcHO OR KD <br />AJ p5 <br />ON OWNr'C <br />NOR ATOS ,1, Oa-- <br />Y <br />) <br />BAO401N)g0.517. <br />222,15 <br />12?JI7 <br />^10L1 'INJURYn <br />"L'CTINI+^UJR <br />R*'tATOS <br />�tlenl <br />• S <br />UMBRELLA UAS OCCUR <br />�I1 t"CESS LIAO �CIAIhW.MNOR i <br />uip_D <br />IGACVI OCGURAeNGGV` <br />AGGREGATE S <br />f I R£TP"N;'ICNS <br />WORKERS COMPENSATION <br />NO EMPLOYERS UABILITY <br />( S <br />nN-PROPR IORMARTN R Y,:IJTIV; YIN I <br />C �rcl£E NIA I FL A003110.01) - OI01:201'" <br />YM ntlm `y,n NH, <br />6<vtltl tiSCR,1IPTIO"N OF OPERA j I <br />.El. .CHACCIG:N' IS I.0(0.000 <br />OI01,201S <br />8= DISEASE - EA IiMPLOYEw' S I000-000 <br />:.DISEASE-POLICr yiM1T $ I,nlln.nnG <br />OESCRIPTION OF OPERATIONS I LOCANON91 VEHICLE$ ACORO 105 A4ditendl R&MArW SeMMI010MAY be scathed if PIANO A900 la faetlir <br />CI RJIFICATE HOLDH, ITS OI k ICCRS, AGENTS, AND E6fPLOYI.f S ARI. NAN11 <br />TOGENERAL LI.A131L[TY PEIR:A7IACI[FD CG'201i 11/88. 10 DAY N O1 ICE OF <br />D AS }'I IONAL INS[: N REGARDS <br />C/�y�i J1A I"ION OFP" ,.YFOR NON <br />PAYN-117NT. TI IIS POLICY IS PRINIARY AND NON-CON'I-RI13UTORY. <br />' <br />`\J` <br />(I t % OF 4AN'fA A`A. 11'S 04 f ICLILS, <br />P IIPLUYFGS_ AOFNIS AND R FPRPSILXI'A'Il Vi <br />?II [ IN WON I ERN ALA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREDF, NOTICE WILL BE DELIVERED W <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />PAUI. ROMLRO <br />All rlehta recorvrtrt. <br />ACERB 25 (2014101) The ACORD name. and logo are registered marks Of ACORD <br />