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ACORD <br />CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br />TM 12 23 2008 <br />PRODUCER phone: 916-925-2525 Fax: 916-925-3595 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />James C. Jenkins Ins. Services Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />PO Box 13847 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />i ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />L <br />cense No 0545478 <br />Sacramento CA 95853 <br /> INSURERS AFFORDING COVERAGE NAIC # <br />INSURED INSURERA: State Com ensation Ins Fund <br />Frasco, Inc. <br /> <br />215 W <br />l <br />d INSURER B: <br />. A <br />ame <br />a Ave. <br />Burbank CA 91502 INSURERC: <br /> <br /> INSURER D: <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR DO POLICYNUMBER POLICY EFFECTIVE POLICYEXPIRATK)N LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY DAMA T R N ED <br />PREMISES Eaoccurence <br />$ <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ <br /> PERSONALRADVINJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $ <br /> POLICY PRO LOC <br /> AUT OMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT $ <br /> ANY AUTO (Ea accident) <br /> ALL OW NED AUTOS <br />BODI <br />I <br /> LY <br />NJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br /> BODILY INJURY $ <br /> NON-0WNED AUTOS (Per accident) <br /> ~ <br /> l <br />~~ PROPERTY <br />A <br /> ~ D <br />MAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO EA ACC <br />OTHER THAN $ <br /> AUTO ONLY: AGG $ <br /> EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR ~ CLAIMS MADE AGGREGATE $ <br /> $ <br /> DEDUCTIBLE _ $ <br /> RETENTION $ $ <br />A WORKERS COMPENSATION AND <br />' 3 8 0 9 2 0 0 9 1/ 1/ 2 0 0 9 1/ 1/ 2 010 X wR SIAM u- orH- <br /> EMPLOYERS <br />LIABILITY <br /> ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1 Q 0 Q (7 Q Q <br /> OFFICERIMEMBER EXCLUDED? <br /> E.L. DISEASE - EA EMPLOYEE $ 1 Q Q Q Q Q Q <br /> If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$ <br /> OTHER <br />DESCRIPTION OFOPERATIONS / LOCATK)N8 /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />E: Evidence of coverage. 10 day notice of cancellation will apply if cancelled for non-payment of premium. <br />Evidence of Coverage <br />Insureds use only <br />215 W. Alameda Ave. <br />Burbank CA 91502 <br />ACORD 25 (2001/08) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER <br />WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE <br />CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO <br />SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON <br />THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />1988 <br />