ICHAEL P ALEXSON - Laserfiche WebLink

Home

ACORa CERTIFICATE OF LIABILITY INSURANCE DAT/ � 077/26/26 /22015 015 Y) 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 CONTACT NAME: CS &S/THE INSURANCE EXCHANGE INC -CHEF PHONE FAX (A/C, No, EM ): A/C, No): PO BOX 946580 EMAIL ADDRESS: Maitland, FL 32794 -6580 INSURERS AFFORDING COVERAGE NAIC # 1- 877 - 724 -2669 INSURER A: Valley Forge Insurance Company 20508 INSURED INSURER B: INSURER C: ICHAEL P. ALEXSON INSURER D: 31919 HARDEN STREET INSURER E: MENIFEE, CA 92584 INSURER F: COVERAGES CERTIFICATE NUMBER: 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. NOTWITHSTANDINGANY 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. INSR LTA TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MWDD/YY POLICY EXP MM /DD/YY LIMITS A GENERAL LIABILITY Y 2098050077 09/15/15 09/15/16 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurerxe) $ 300-10-0-0— COMMERCIAL GENERAL LIABILITY CLAIMS -MADE z OCCUR MED EXP (Any one person) $ 10,000 PERSONAL 11 ADV INJURY $ 1,000,000 e GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,00-0 ?� jn a PRO - POLICY JECT LOC A AUTOMOBILE LIABILITY 2098050077 09/15/15 09/15/16 COMBINED SINGLE LIMIT (Ea (Ea accident) 1,000,000 BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE (Per accident) $ H NON -OWNED X HIRED AUTOS AUTOS UMBRELLA LIAB HCLAIMS-MAD OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS DED I RETENTION $ $ WORKERS COMPENSATION WC STATU_ OTH- AND EMPLOYERS' LIABILITY WN TORY LIMITS ER ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICEWMEMBER EXCLUDED? N/A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ OTHER W TATU- TORY LIMITS TH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach Acord 101, Additional Remarks Schedule, It more space is required) Certificate Holder is named as Designated Person Location #1 31919 HARDEN STREET, MENIFEE, CA, 92584 CERTIFICATE HOLDER CANCELLATION CITY OF RIVERSIDE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3900 MAIN STREET RIVERSIDE, CA 92522 AUTHORIZED REPRESENTATIVE Q 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered darks of ACORD