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Ollin Restorative Justice Practices - Insurance Certificate (2018)CERTIFICATE OF LIABILITY INSURANCE [DATE /30/2018 THIS CERTIFICATEIS 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 NUTMEG INS AGENCY INC /PHS 210775 P: F: (888) 443 -6112 PO BOX 29611 CHARLOTTE NC 28229 CONTACT NAME: ((A//C,No,Ext): is ,Ne): (888) 443 -6112 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURERA: Sentinel Ins Co LTD 11000 INSURED OLLIN RESTORATIVE JUSTICE PRACTICES, LLC . 1005 CHERRY CT HOLLISTER CA 95023 INSURER B 76 SBU IS6163 INSURER C: 01/30/2019 INSURER D: $1, 000, 0 0 0 INSURER E: DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER F: X 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. 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,EXCLUS IONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF LVSURdNCE ADDL V SUBR POLICYNUAIBER POLICY EFF dlhl/DD/YYYY) POLICYEXP LIMITS A COMMERCIAL GENERAL LIABILITY 171 CLAIMS -MADE OCCUR General Liab 76 SBU IS6163 01/30/2018 01/30/2019 EACH OCCURRENCE $1, 000, 0 0 0 _7 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1 000, 0 0 0 X MED EXP (Any one person) $10, 000 PERSONAL & ADV INJURY $1, 000, 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � PRO � LOC JECT OTHER: GENERAL AGGREGATE s2, 0 0 0 , 000 PRODUCTS - COMP /OP AGG 52, 000, 000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY - COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ S UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ - DED I RETENTION $ $ WORKERS COMPENSA TION .LDEJfPLOYERS'LIIRILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) ❑ If yes, describe under DESCRIPTION OF OPERATIONS below WA PER I OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION © 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF G I L RO Y 7351 ROSANNA ST AUTHORIZED REPRESENTATIVE GILROY, CA 95020 © 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE FATE /30/2018 THIS CERTIFICATEIS 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 NUTMEG INS AGENCY INC /PHS 210775 P: F: (888) 443 -6112 PO BOX 29611 CHARLOTTE NC 28229 CONTACT NAME: jac °O, "J,Ezt): (ac,N�): (888) 443 -6112 E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC# INSURER A: Sentinel Ins Co LTD 11000 INSURED OLLIN RESTORATIVE JUSTICE PRACTICES, LLC . 1005 CHERRY CT HOLLISTER CA 95023 INSURER B COMMERCIAL GENERAL LIABILITY INSURER C: INSURER D: INSURER E: EACH OCCURRENCE 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. 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. INSR TYPE O£ IVSURANCE ADDL SUBR POLICY NUAIBER POLICY EFF 3L111DD1YYYY) POLICY EYP LLVITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1, 000, 0 0 0 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1 000, O O O I X MED EXP (Any one person) $10, 000 A General Liab 76 SaU IS6163 01/30/2018 01/30/2019 PERSONAL & ADV INJURY $1, 000, 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2, 0 0 0 , 000 POLICY PRO F`X] LOC JECT PRODUCTS - COMP /OP AGG $2, 000, 000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 3 UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION 5 $ WORKERS CO,iIP£NSATION ANDEtIPLOYERS'LLiBILITy PER OTH- STATUTE OR E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) F—] NIA E.L. DISEASE- EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ I L DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION © 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF G I LROY 7351 ROSANNA ST AUTHORIZED REPRESENTATIVE GILROY, CA 95020 © 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 'l LL11N RESTORATIVE JUSTICE PRACTICES Jan 26, 2018 011in Restorative Justice Practices, LLC. 1005 Cherry Ct. Hollister CA 95023 OIIinRJP @gmail.com To Whom It May Concern: 011in Restorative Justice Practices, LLC. Is under sole proprietorship of Orlando De La Cruz. The company does not employ anyone in the manner subject to the workers' compensation laws of the State of California and as a sole proprietorship company the owner chooses to remain exempt from these laws. Feel free to contact me with any questions or comments. Cor ially, Orla o &DeLa Cruz, Owner 408 - 837 -3595 GEICO", geico.=0M California Evidence of Liability Insurance 1- 800 - 841 -3000 GEICO GENERAL INSURANCE COMPANY PO BOX 509090 SAN DIEGO, CA 92150 - 9090': NAIC Code: 35882 Policy Number 4375705987 Year Make 2004 TOYOTA Insured: Effee IRISH CRYSTAL TAPIA ORLANDO DELACRUZ 1005 CHERRY CT HOLLISTER, CA 95023 -4143 12 cpiration Date 06 -12 -18 Vehicle ID No. <BR32E94Z291701 Evidence of Insurance Here are your Evidence of Liability Insurance Cards. One card must be carried in the proper insured vehicle. Proof of insurance is required to register or renew the registration of your vehicle. A law enforcement officer can ask you to prove that you have liability insurance meeting the basic requirements of California law. A violation of these requirements can result in a fine of up to: $1,000 for the first time $2,000 for additional times Also, a Judge can have your vehicle Impounded. False proof of Insurance may result in a fine up to $750 and 30 days in prison. The coverage provided by this policy meats the minimum requiremenia of secliona 16056 & 16500.5 01 the Caldomia Due to space limitations on the ID card, only the Vehicle code, minimum liabilily limiiaprescribed by law. Named Insured and the Co- insured are listed. For a full list of drivers covered under this policy, please reference the Drivers section of your Declarations Page,which is included with your insurance packet. If you would like additional ID cards you can go online to geico.com or call us at 1- 800 -841 -3000. What to do at the time of an accident. • Do not admit fault. • Do not reveal the limits of your liability coverage to anyone. • Exchange contact information; get year, make, model, plate number, insurance carrier and policy number of all involved. Also, identify witnesses and collect contact information. • Contact the police or 911 if applicable. • Contact GEICO by calling 1- 800 -841 -3000 or visit gelco.com to report the accident. U -4 -CA (11 -09)