PROOF OF INSURANCE (2024) CLOSEDDATE (MM/DDNYYY)
A� RL> CERTIFICATE OF LIABILITY INSURANCE
6/28/2023
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 have ADDITIONAL INSURED provisions or 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
...
Ed ewood Partners Insurance Center PHONE � 0 (AOPA � .._
Certificate Unit
San Francisco CA 94111 AftLrR:r ss. ,.c rtGfiCal9 .
One California Street, Suite 400 11) 404 781 170
I... frictrorokers com
INSURERS) AFFORDING COVERAGE
t1 937 INSURERA Am ri ... . li ..
—Llcprgq „ ,? ,.w , encan Zunch InsurancI'lle Company .. 40142
EOUIINC-01 INSURE ....... __ P y ...... .. _ .
One Lagoon Drive Rc h American Insu INSURED Ve INSURER B Zurich ranCe COm an 16535
Redwood City, CA 94065 INSURER D
i--- __ .. INSURER E, -- --------------- -
INSURER F : —
......�.�.i.�� ^111=1T11=1^ATC u111RA000-onoc'27ann7 RFVICIAN NIIMRFR-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY 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. __..... .........�.........--__ ... ..-- ......
. . ... .. — ... .._,,,,.__._._
FiafYL ....... ... P --- � OLICYE�-T--
...,. u ---POLICY
....... .TYPE
FF POLICY EXP LIMITS
NUMBER..
} OF INSURANCE MM/OD MM/DD
'.. LTR ,
B
X
COMMERCIAL GENERAL LIABILITY
GLO 7898715 02
7/1/2023
7/1/2024
EACH OCCURRENCE
$ 2,000,000
........
CLAIMS-MADE,OCCUR
�
2 00 ------
X
Red.....__. uctible $100K
MEDX.( n one person) rson)�$15000
..
....�...X.---
...$
PERSONAL t: AD INJURY
$ 2 000 000
GEN'...........................
. ........__ —
TELIMILIMITAPPLIES PER:
AGGREGATE
_
GENERAL AGGREGATE
�µ..,...... —
II $4,000,000
POLICY JEC FLOC
PRODUCTS -COMP/OP AGG
l $ 4,000,000
JEC"F"
-_ _ --
�µ_$...
OTHER°
B
AUTOMOBILELIABILITY
BAP 7879625 02
7/1/2023
7/1/2024
COMBINED SINGLE LIMIT
fEa accudera)p.__
$1,000,000 _.
X ANY AUTO
BODILY INJURY (Per person)
$
OWNED SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS
HIRED NON -OWNED
P%ti?@�ERPY CYAMAGE
$
--. AUTOS ONLY AUTOS ONLY
hk
(Per 1cri�SpnR1 .....
....... ....
'
X Crum $1,000 Coll S1,000
UMBRELLA LIAB OCCUR----..
EACH OCCURREN CE
....
EXCESS LIAB CLAIMS -MADE
AGGREGATE
., .... .
$ _ _ ..... ......
_.j--.
RETENTION
DED N S
B
WORKERS COMPENSATION
WC 7879629 02
7/1/2023
7/1/2024
X .PSTA LITE ( EOTRH
A
AND EMPLOYERS' LIABILITY y Y N
WC 7879624 02
7/1/2023
7/1/2024
$ 1,000 000
ANYPROFFICE /MEMB R/PARTNE EEXECUTIVE
OFFICER/MEMBEREXCLUDED? N
N/A
D SCH
"""
(Mandatory in NH)""'
E.L. EASECIDENTEA EMPLOYEE
_
$1,000,000
If yes, describe under
DISEASE POLICY LIMIT
' $ 1,000,000
DESCRIPTION OF OPERATIONS below
E.L. -
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Evidence of Insurance.
I.AIY IiCLLA I IVIY
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
TO Whom It May Concern AUTHORIZED REPRESENTATIVE
V I Vt55-ZUI0 AUUKU !L UK1-UKA I IVIY. All rign►5 rezieuvCu.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD