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Vevc.uw/A hH Dtivu.tl A. IS <br /> co F. 1 4 I ry,-�.o1 -- 2 <br /> e. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 11/080017 <br /> THIS CERTIFIC TE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE OES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW, THIS ERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED <br /> REPRESENTA VE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: I he certificate holder is an ADDITIONAL INSURED,the pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATI N IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate oes not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER - CCT Daniel White <br /> NAME:ONTA <br /> Warner Pacific Neu nce PHONE (818)225-0101 FAx <br /> 32110 Agoura Rd EMAIL°'E"II' (AIC,No): (818)575-2394 <br /> ADDRESS: tlenieLWhlte®WarnBfpBCifiC.CGm <br /> INSURER(S)AFFORDING COVERAGE 3 <br /> We69dke Village CA 91361 <br /> INSURERA: State Comp Ins Fund 50 6 <br /> INSURED <br /> 35076 <br /> INSURER B: <br /> TH:j ACE AGENCY INC INSURER C: <br /> 221 SYCAMORE ST INSURER D: <br /> INSURER E: <br /> SA': AANA CA 92701 INSURER F: <br /> COVERAGES j CERTIFICATE NUMBER: CL1711805895 REVISION NUMBER: <br /> THIS IS TO CERT(:.Y THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NO THSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAI BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS ANC CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> -h TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXE <br /> INSD war) POLICY NUMBER (MMIDD/WYY) IMMIDDATYY) LIMITS <br /> COMMERCIAL GENERAL LIABILITY <br /> EACH OCCURRENCE 8 <br /> CLAIM i-MADE OCCUR DAMAGE TO REN ILD <br /> PREMISES(Ea occurrence) <br /> a 5 <br /> MED EXP(Any one person) 5 <br /> PERSONAL&ADO INJURY 5 <br /> GEN'LAGGREGA E UMR APPLIES PER: <br /> GENERAL AGGREGATE $ <br /> Racy I PROC- 1 <br /> JET I LOC PRODUCTS-COMP/OP AGG $ <br /> OTHER: <br /> $ <br /> AUTOMOBILE UL BIUTY COMBINED SINGLE UNIT $ <br /> (Ea <br /> ANY AUTO <br /> EIO accident)BODILY INJURY(Per person) S _. <br /> OWNED SCHEDULED _ <br /> AUTOS ONC BODILY INJURY(Per accident) 5 <br /> NON-0 <br /> HIRED NONOWNED PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLY <br /> (Per eccitlanil S <br /> UMBRELLA JAB - OCCUR <br /> EACH OCCURRENCE S <br /> EXCESS LIA3 CLAIMS-MADE <br /> AGGREGATE § <br /> DEO I RETENTIONS <br /> WORKERS COMP NSAT1ON X PER I DTH- 5 <br /> AND EMPLOYERS LIABILITY YIN . STATUTE ER <br /> A ANY PROPRIETORTPARTNER/EXECUTIVE I I <br /> 1,000,000 <br /> oFFICERNEMBER EXCLUDED? NIA Y 906810517 08/10/2017 08/10/2018 <br /> E.L.EACHnCC10ENT 5 <br /> (Mandatory In NH) 1,000,000 <br /> Lyes.describe unclip' E.L.DISEASE-EA EMPLOYEE S w <br /> DESCRIPTION OF�PERFTIONS below E.L.DISEASE-POLICY LIMIT § 1,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,Addalenel Remarks Schedule,may be attached II mora space b required) <br /> Walver of Subroalord <br /> CERTIFICATE HOWER CANCELLATION <br /> SHNOF THE <br /> GATE ABOVE DESCRIBEDNOTICE POLICIESBE BE CANCELLEDDELIVERED BEFORE <br /> THEOULD EXPIRATION THEREOF, WILL IN <br /> City Santa Ma ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 20 Ci is Center Plaza <br /> AUTHORIZED REPT ENT VE <br /> San IAne CA 92702 - 4 . <br /> T <br /> I <br /> ` ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/0') The ACORD name and logo are registered marks of ACORD �1 <br />