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HomeMy WebLinkAboutCERT OF LIABILITY 11.13.18(DECO -1 OP ID: T9 '`'�''� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 01/1812018 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 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 endorsement(s). PRODUCER Brakke- Schafnitz Ins. Brokers License #OK07568 28202 Cabot Road, Suite 600 Laguna Niguel, CA 92677 -1251 Alice McLaughlin CONTACT NAME: Tanya Vogt PHONE 949- 365 -5176 ac No): 949- 313 -3293 A/C No Et ADDRESS: tanya.VOgt sig.us INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Everest Indemnity Ins. Co. 10/18/2018 EACH OCCURRENCE INSURED IDECO, Inc. 431 W Blueridge Ave Orange, CA 92865 -4203 INSURER B. American Fire and Casualty Co. 24066 INSURER C: Preferred Employers Ins. Co. 10900 MED EXP (Any one person) $ 5,00 INSURER D: PERSONAL & ADV INJURY INSURER E: GEN'L AGGREGATE LIMIT APPLIES PER: PRO- LOC POLICY JECT OTHER: INSURER F: $ 2,000,00 PRODUCTS - COMP /OP AGG r Vl =0AnPQ f_FRTIFICdTF NIIMRFR- 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. IN SR TYPE OF INSURANCE L UBR POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FRI OCCUR EF4ML05450 -171 10/18/2017 10/18/2018 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 50,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- LOC POLICY JECT OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP /OP AGG $ 2,000,00 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS X AUTOS BAA57032673 12/06/2017 12/06/2018 acid COMBINED SINGLE LIMIT $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EF4C000735 -171 10/18/2017 10/18/2018 EACH OCCURRENCE $ 3,000,00 X AGGREGATE $ 3,000,00 DED I X RETENTION $ 1 0,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE YIN N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A WKN157673 -4 02/05/2018 02/05/2019 X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A A Pollution Liab Professional Liab EF4ML05450 -171 EF4ML05450 -171 10/18/2017 10/18/2017 10/18/2018 10/18/2018 EachClaim 1,000,00 Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) License #744619 .►P"'/ 1Y 1AA'rr• Vie% r%co rANC_FI 1 ATInN VG r% 1 I V I%.#P% 11_ 11V CONTRAC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Contractors State License THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Board P.O. BOX 26000 Sacramento, CA 95826 AUTHORIZED REPRESENTATIVE �/ © 1988 -2094 AGURU GURPORA 11 N. All rlgnts reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD