The URL can be used to link to this page

Insurance - JIMNI - 2005-10-28 10/28/2005 15.59 9512770734 __ PAGE 02/03 Frvmt Linda Nn ARM At BCWermaGter&AseOCI D 5528823402 T Leslie 410a le 102812005 03 55 PM Page 2 013 JIMNSYS-D1 AILI DATE IMN,ODYIWII ACORD CERTIFICATE OF LIABILITY INSURANCE lonfin6D5 'PRSnu=ERLIconoe It CA-0079613 (562)9234831 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION BoWermaslor 8 Associates Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O.Boa 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 10631 Paramount Blvd. ' Downey,CA 90241-0100 INSURERS AFFORDING COVERAGE NAIL a L SIIREo uimnl Systems,Inc IHSUSERk Colony Insurance Company _ 25295 Cinnamon Road RNBRERa Progroselva Casualty Ins Co Lake Forest,CA 92830 INSURER c.TOPA Insurance Company _ INSURER O: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 10 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT Wail RESPECT TO WWIQI TNR CERTIFICATE MAY BE ISSUED OR MAY PE POLICIES.A0,THE INSURANCE E L MITE MAY HAYS OPOLI AFFORDED POLICIES ES DESCRIBED BY IBED HECW CLAIMS. SUBJECT 10 ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH J I PDL EFFECTWE POLICY CXMR,LTION UWT) 1R ( TYPE Of IN' '�!A11£ _ POLICY NVMen }I_nA>II.(!AA9nm1 nnTJMMIC ryp EACH OOGURPENOE y 1,000,000 nrRmuERCIm DANwE1D,-tNrtV 100,000 A X COMUERCIALGEMERALUAaLITY GL163409 4/112005 4]112006 F!O!MISES(Ea DAUFncel b MED Expos),ens tenon/ 9 iRCIUdeC cm/48 MADE © OCCUR PERSONAL LAW INJURY 6 1,000,90E – GENERAL AGGREGATE E 2,000,00E PROOUGrs-COMPIOP AGO a 1,000,09[ GENT AGGREGATE UNR IPR�LI-E9 PER —1 POLICY r I P I T LOC NITOMOBLLE mammy co.oI Eo INGLE LINE s 1,000000 B ANY AUTO 020973584 1011412005 4/1412008 oT X ALL OWNED AUros BODILY PUSSY 3 _ (Pa person) X SCHEDULED AUTO ( X HIRED AUTOS �NPLY INJURY S X NONAwNEDAUT08 PROPERTY DAMAGE I (Pa!edtlenI) AIJr00NLY-EA ACCIDENT 9 _ GABAOY LIABILITY UTO OTHER NLYN EA AGO I _ ANY AUTO AUTO ONLY AGO 9 EACH OCCURRENCE. 1 2,000,011 EXC OCCUR RELLA LIABIL!T'f 4/112005 4)1(2006 AGGREGATE t 2,000,00 C OCCUR n OVUM MADE X[1623101 9 S OEOUCTIBLE $ ( RETENION $ 10,000 wG aTAn- o*H- WORKEReCOMPENSAT10NAND (TORY LIMIT,E Fl! EMPLOYERS'UASILITY E .EACH ATCIO011 S ANY OOFFFICCEERIMMBEREACLUEOEDT CUTNE EL DIGOLCE-EA EMPLOYEE,$ S.Et 1dAtA 0e eolox EL DISEASE•POLICY LINY S OTHER PEG GRIP TION OF OPERATIONS I LOCATIONS l VEHICLES/EXCLUSIONS AODEO BY tAm0A6EMENTI SPECIAL PROVISIONS If this palsy cancels for non-payment the company will IsSUG 10 day notice of cancelled" INSURANCE VERIFICATION ONLY. CERTIFICATE HOLDER . CANCELLATION SHOULD ANY OF THE ABOVE O5SCRIB ED PEW CIB$BE CANCELLED BEFORE THE EI➢IMTION INSURANCE VERIFICATION ONLY DATE THEREOF.TMEISSL!NG INSURFA WILL ENDEAVORIt MAIL 10 DAY VRrITTEN NOTICE TO THE CERTIFICATE HOLDER HAMAD To n4 LEFT.EUT FAILURE TO CO 80 SHALL IMPOSE NO OBLIOATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR UNLADE NTATIVEs. AUn{ORIZEOREPREBENTATNE . t c" it CORPORATION 1986 ACORD 25 p001103) _ 10/28/2005 15:59 9512770734 PAGE 03/03 From Linde Nnewarm Al:eowenneste 8 Aeso.ID 5628823482 To'Legs •Date:10/28/2005 0355 PM Page'3 o13 SG POLICYHOLDER COPY STATE P.O. BOX 420807 SAN FRANCISCO.CA 84142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OP WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-25-2005 GROUP. 000018 POLICY NUMBER: 00004EE-3005 CERTIFICATE l0: 109 CERTIFICATE EXPIRES:04-01-2005 04-01-2009/04-01-2005 CM OF COSTA MESA 50 77 FAIR DRIVE COSTA MESA CA 92026 This Is to artily that we have issued a valid VVOntere Corryensstion insurance policy in a term approved by the California In urine Commissioner to the employer named below for Me policy period ndlcned. This policy is not subject to cancellation by the fund except upon30 drys .dvmce written notice to MO employer. We will als give you 90 drys advance notice should this policy be noelled prior to its normal expiration. This ottlfioate df infuranoe is not en insurance policy and do not amend. extend or alter the overage afforded by the policy listed herein Notwmlletending any odulrement term condition of any convect or other doWment with respect to which this corndi ate of insurance may be Is ved or to which It may pertain the Mw al forded by ttie policy de teed heroin It subject to all the forma, exclusions. and conditions, of such policy, AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE EDORSEMENT glow EMRARA PLEASANTS SEC EXCLUDED. ENDORSEMENT #1000 JAMES N. PLEASANTS PRES,TRES EXCLUDED. ANZRS6D TO AND s EN9 ENTITLED OFITN 9TPOLazzERS' NOTICE EPPECTIVE 04-01-2000 IS EMPLOYER JINNI SYSTEMS. INC SG 25295 CINNAMON RD LAKE FOREST CA 12010 11316.SC) PRINTED 10-211-2EmbE, r0fV.2-051