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Last modified
4/23/2021 4:23:28 PM
Creation date
11/25/2020 4:42:44 PM
Metadata
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Template:
Contracts
Company Name
SUNSERI'S
Contract #
A-2020-206
Agency
Parks, Recreation, & Community Services
Council Approval Date
10/20/2020
Expiration Date
12/31/2025
Insurance Exp Date
4/1/2021
Destruction Year
2030
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MARKIACKSON INS <br />PO BOX 775 <br />YORBA LINDA, CA 92885 <br />1-714-779-2629 <br />Certificate of Insurance <br />RROGREJJ/UE` <br />COMMEAC/AL <br />Policy number: 04348527-9 <br />Underwritten by: <br />UNITED FINANCIAL CAS CO <br />September 16, 2020 <br />Page 1 of 2 <br />Certificate Holder <br />.............. .............. ............................ .............. .............. .............. ............................ .............. ................. <br />MICHAELSERENO <br />PO BOX 83 <br />GLENDORA, CA 91740 <br />Insured <br />Agent/Surplus lines Broker <br />MICHAELSERENO <br />MARKJACKSONINS <br />SUNSERIS <br />PO BOX 775 <br />PO BOX 83 <br />YORBA LINDA, CA 92885 <br />GLENDORA, CA 91740 <br />This document certifies that insurance policies identified below have been issued by the designated insurer to the insured <br />named above for the period(s) indicated. This Certificate is issued for information purposes only. It confers no rights upon <br />the certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies listed below. <br />The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, and <br />conditions of these policies. <br />............ ............... ............... ............................. ............... ............... ............... ............... .................. <br />Policy Effective Date: Apr 16, 2020 Policy Expiration Date: Apr 16, 2021 <br />Insurance coverage(s) <br />limits <br />BODILY INJURY/PROPERTY DAMAGE <br />$2,000,000 COMBINED SINGLE LIMIT <br />............... ............................. <br />EMPLOYERS <br />EMPLOYER'S NON -OWNED AUTO BIPD <br />............... ............... ............... ............... .................. <br />$2,000,000 COMBINED SINGLE LIMIT <br />............ ............... ............... ............................. <br />HIRED AUTO BODILY INJILIMmOPERTY DAMAGE <br />............... ............... ............... ............... .................. <br />$2,000,000 COMBINED SINGLE LIMIT <br />Description of LocationNehicles/Special Items <br />Scheduled autos only <br />............ ............... ............... ............................. ............... ............... ............... ............... .................. <br />2000 FORD ECONO/CLUB WGN 1FTNE24L2YHA46448 <br />............ ............... ............... ............................. ............... ............... ............... ............... .................. <br />1995 TOYOTA TACOMA 4TAVN53F5SZO81379 <br />............ ............... ............... ............................. ............... ............... ............... ............... .................. <br />2015 NISS NV 2500/3500 1 N6AFOKX8FN804326 <br />Stated Amount $33 244 <br />2018 NISSAN NV 3500 1 N6AFOLY2JN808873 <br />Stated Amount $38 842 <br />........ ......... ......... ......... ......... ......... ...... ......... ......... .......... <br />2018 ISUZU NPRJALC4W169J7008662 <br />Stated Amount $53,200 <br />Rime Managonent Diaisian <br />REVIEWED&APPROVED By: <br />'� Risk Management Analyst <br />
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