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1® <br />CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DDIYYYY) <br />9/22/2017 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br />THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br />ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACT Linda Meinzer <br />NAME: <br />Canyon Crest Insurance Service, Inc. <br />PHONE FAX <br />(951) 784 -0311 <br />License # OD51775 <br />A/C No: (951)789 -5433 <br />E-o AIL <br />@canyoncrestins.com <br />5051 Canyon Crest Dr. #104 <br />.Linda <br />$ 11000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />Riverside CA 92507 <br />INSURERS AFFORDING COVERAGE <br />NAIC# <br />INSURERA:UNITED STATES FIRE INS. CO. <br />$ 300 r 000 <br />CLAIMS -MADE OCCUR X SRPGP101 -0716 4/26/2017 4/26/2018 <br />INSURED <br />MED EXP(Any one person) <br />INSURER B M41UZEL INSURANCE CO, <br />ANGELICA GONZALEZ DBA: E -Z JUMPERS <br />$ 1,000,000 <br />281 HANOVERIAN DR. <br />INSURER C: <br />APPLIES PER -. <br />INSURER D. <br />$ 2,000,000 <br />X POLIGREGATEEIMIT <br />X POLICY PRO LOC <br />APPROVED <br />INSURER E, <br />HEMET CA 92545 <br />rnVFRerFC <br />INSURER F: <br />-_. _... ._..._.- _...... -__. -- KIEVISIUN NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN <br />ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED <br />DOCUMENT WITH RESPECT TO WHICH THIS <br />HEREIN IS SUBJECT TO <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID <br />ALL THE TERMS, <br />INSR CLAIMS. <br />ADOL SUBR <br />LTR TYPE OF INSURANCE POLICY NUMBER POLICYYYY POLICY <br />YYYY <br />GENERAL LIABILITY }{ <br />LIMITS <br />EACH OCCURRENCE <br />$ 11000,000 <br />X COMMERCIAL GENERAL LIABILITY <br />DAMA ET RENTED <br />A <br />PREMISES Ea occurrence <br />$ 300 r 000 <br />CLAIMS -MADE OCCUR X SRPGP101 -0716 4/26/2017 4/26/2018 <br />MED EXP(Any one person) <br />$ 5,000 <br />PERSONAL B ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />APPLIES PER -. <br />PRODUCTS AGG <br />$ 2,000,000 <br />X POLIGREGATEEIMIT <br />X POLICY PRO LOC <br />APPROVED <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea ao.d.ntl <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />BODILY INJURY (Per person) <br />$ <br />AUTOS AUTOS <br />BODILY INJURY(Per acciden0 <br />$ <br />HIRED AUTOS NON-OWNED <br />AUTOS <br />PROPERTY DAMAGE <br />$ <br />Per amid nl <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EXCESS LIAB <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />CLAIMS -MADE <br />DEED RETENTION$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />WCSTATU- OTH- <br />X <br />ANY PROPRIETOR/PARTNER /EXECUTIVE YIN <br />C0094209 -02 <br />4/27/2017 <br />4/27/2018 <br />B <br />OFFICERIMEMBER EXCLUDED? F-1 <br />NIA <br />E.L. EACH ACCIDENT <br />$ 1 000 000 <br />(Mandatory in NH) <br />If yes, describe under <br />EL DISEASE- EAEMPLOYE <br />$ 1 000 DDO <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1 000 000 <br />A <br />MEDICAL BENEFIT <br />X <br />US518846 <br />4/26/2017 <br />4/26/2018 <br />$10.000 PER CLAIM <br />$100 DED <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, a rnore apace is required) <br />THE CERTIFICATE HOLDER IS RECOGNIZED AS AN ADDITIONAL INSURED AS THEIR INTEREST <br />MAY APPEAR. <br />CERTIFICATF Flnl PI <br />CITY OF RIVERSIDE <br />3900 MAIN STREET <br />RIVERSIDE, CA 92522 <br />ACORD 25 (2010105) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />Meinzer /LM c'"'' =^-�': �•�< <br />© 1988 -2010 ACORD CORPORATION. All rinhtss racurvud <br />I ne AI UKu name and logo are registered marks of ACORD <br />