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AC Ro " -- � DATE(MM/DD/YYYY) � CERTIFICATE OF LIABILITY INSURANCE ovzsrzo2o THIS CERTIFICATE IS ISSUED ASAMATTER OF INFORMATION ONLYAND CONFERSNO RIGHTS UPONTHECERTIFICATE HOLDER.THIS CERTIFICATE DOES NOTAFFIRMATIVELY OR NEGATIVELY AMEND, EXPEND ORALTERTHE COVERAGEAFFORDED BYTHE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE ACONTRACT BETWEEN THE ISSUING INSURER(5), AUTHORIZED REPRESENTATIVE OR PRODUCER, ANDTHE CERTIFICATE HOLDER. IMPORTANT: Ifthe certificate holderisan ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions orbe endorsed. if SUBROGATION IS WAIVED, subject to theterms and conditions of mepalicg certain policies mayrequire an endorsement. A statement on thiscertificate does notconferrights to the certifiateholder in lieu ofsuch endomement(s). PRODUCER I CONTACT Michael Brandon, Farmers Agent 31629 OUTER HWY 10 #A REDLANDS CA 92373 INSURED (WATER, INC 12 GOODYEAR STE 130 IRVINE COVERAGES CA 92618-3747 CERTIFICATE NUMBER: NAME: Michael Brandon PHONE FAX (A/C,NO,EXT): 909-794-8191 (A/C, No): 909-794-8193 E-MAIL ADDRESS: mbrandon@farmersagent.com INSURER(S) AFFORDING COVERAGE NAICN INSURERA: Truck Insurance Exchange 2_1709 INSURER B: Farmers Insurance Exchange _ _ 21652 INSURER C: _ Mid Century Insurance Company 21687 INSURER D: Fire Insurance Exchange 21660 INSURER E: INSURER F: REVISION NUMBER: THIS ISTO CERTIFYTHATTHE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANYCONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN 15 SUB,ECTTO ALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_ LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �—� TYPEOFINSURANCE PDUCY EXP POLICY NUMBER (MMLICY EF'W) - ILTR _ I ANSDL SW VD M ICYEFF I (MM/DD/YYYY) L LIMITS T COMMERCIAL GENERALLIABIUTY I i _.. I EACH OCCURRENCE $ — $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES( Ea Occurrence) , MED E%P (Any one person) $ PERSONAL&ADV INJURY $ GENT AGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ POLICY PROJECT ❑ LOC u PRODUCTS-COMP/OPAGG $ OTHER' $ AUTOMOBILEUABILITY COMBINED SINGLE LIMIT (Ea accitlenU $ j ANYAUTO $ BODILY INJURY(Per person) OWNEDAUTOS SCHEDULED 'i ! ONLY AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED ONLY AUTOS ONLY I PROPERTY DAMAGE (Per accidenq $ 1$ UMBRELLA LIAB OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTIONS WORKERS COMPENSATION $ PERTUTE 1 AND EMPLOYERS' RS'LILIABILITY � X STA I C ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVE OFFICER/MEMBER EXCLUDED?( Mandatary in NH) Y N/A Y a09505451 02/15/2020 02/15/2021 E.L. EACH ACCIDENT $ 1,000,0001 — E.L. DISEASEE4 EMPLOYEE 1,000,000 Ifyes.describeunder 0E5CRIPTION OF OPERATIONSbet.. EL DISEASE -POLICY LIMIT 1$ ,060,000 I 1 f DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101, Additional Remarks Schedule, may he attached ifmare space is requinvREVI W`U 011, •.. rtL Certificate holder is listed as Additional insured on the named Insured's general liability policy. BY RISk MANAGE.Mr °1ri51f�I Waiver of Subrogation applies in favor of the certificate holder on the workers compensation policy. CERTIFICATE HOLDER i CANCELLATION O ants a SHOULD ANY OFTHEABOVE DESCRIBED POLICIES B NCELLFD BEFORE THE EXPIRATION Risk Management Division DATE THEREOF NOTICE WILLBEDEL7 E CC RDAN GUH THE POLICYPROVISION5. 20 Civic Center Plaza, 4th Floor AUTHORIZEDREPRESENY TIVE Santa Ana.�A 92702 _._ �1 /" ACORD 25 (2016/03) @1988-2015 ACORD CORPORATION. All Rights Reserved 31-1769 11-15 The ACORD name and logo are registered marks of ACORD