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Insurance - Wester AV Inc - 2023-02-15ACC CERTIFICATE RT I F I DATE (MM/DDNYYY) CATE OF LIABILITY INSURANCE 02/15/2023 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 CONTANAME: Melanie Duarte StateFarm Javier Misiego LaCPHONE EXt1: 714-772 3838 FAX Nola 714-808-6431 1661 N. Raymond Ave Suite 102 E-MAIL C ADDRESS: Melanie.a.duarte.vadk7j@statefarm.com INSURER(S) AFFORDING COVERAGE NAIC # Anaheim CA 92801 INSURERA : State Farm Mutual Automobile Insurance Compan 25178 INSURED INSURER B : State Farm Fire and Casualty Company t 25143 WESTERN A/V INC INSURER C : State Farm General Insurance Company r{P 25151 1592 N BATAVIA ST STE 2 INSURER D ORANGE, CA 92867 INSURER E COVFRAnFS r'P0TIG1r`ATC Ai110A01=110• v.c+.�■. ....■.•.e—r._ 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. IN R ADDL $UBRPOLICY LTR TYPE OF INSURANCE I INSD WVD POLICY NUMBER EFF POLICY EXP MM/DD/YYYY l I MM DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE /� OCCUR DAMAGE TO RENTED - PREMISES (Ea occu_rrence� $ 300,000 MED EXP (Any one person) $ 5,000 C Y 92-GY-D812-0 10/31/2022 10/31/2023 PERSONAL & ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRO POLICY JECT LOC -. - PRODUCTS - COMP/OP AGG $ 4,000,000 OTHER: s 248,400 _ AuroMOBILE LIABILITY Y Y 675 9458-F02-751 12/02/2022 06/02/2023 COMBINED SINGLE LIMIT ! $ 1,000,000 (Ea_accidentl__- X ANY AUTO - BODILY INJURY (Per person) $ A . OWNED X!SCHEDULED AUTOS ONLY _a AUTOS i BODILY INJURY (Per accident) t $ XHIRED NON -OWNED AUTOS ONLY X j AUTOS ONLY :; PROPERTY DAMAGE $ (Per_accidentl X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAR CLAIMS -MADE, N/A N/A; 92-XC-0351-6 12/14/2022 12/14/2023 AGGREGATE $ E DED i RETENTION $ $ WORKERS COMPENSATION PER OTH- X ' AND EMPLOYERS' LIABILITY Y / N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A:; Y 92-MW-G260-4 E L EACH ACCIDENT $ 1,000,000 01/01/2023 01/01/2024 (Mandatory in NH) E L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under _...... - - - DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 SURETY BOND B 92-W6-8753-3 11/17/2022 11/17/2023 $15,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUDIO VISUAL SYSTEMS INTEGRATION Business Location 1592 N Batavia St., Ste 2, Orange, CA 92867 It is agreed that is is the intention of the Company to provide 30 days written notice prior to the cancellation of the policy designated in this certificate. However, the Company assumes no liability for failure to do so. %.crx r rri%.m 1 C nvLUCIM CANCFI I ATInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District ACCORDANCE WITH THE POLICY PROVISIONS. 290 Paularino Avenue AUTHORIZED REPRESENTATIVE Costa Mesa, CA. 92626 1 i` ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 1001486 132849.13 04-22-2020