White Nelson Diehl Evans - Insurance Certificate (2019)ACOR 1 0
�...► -� CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYYY)
05/09/2018
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 poliLy(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 NAME STEVE SCHNEIDER
Silver Creek Insurance Agency, Inc
HONE
AIC No. Ext) (714) 838 -0693 aC No (714) 838 -9438
ADDRESS steve @sllvercreekagency com
17742 Irvine Blvd
INSURERS AFFORDING COVERAGE
NAIC #
Suite 203
INSURER SENTINEL INS CO LTD
11000
Tustin CA 92780
INSURED
INSURER B
MED EXP (Any one person)
INSURER C
White Nelson Diehl Evans LLP
INSURER D
L AGGREGATE LIMIT APPLIES PER
PRO -
POLICY 1-1 PRO ❑ LOC
OTHER
2875 Michelle Ste 300
INSURER E
PRODUCTS - COMP /OP AGG
$ 2,000,000
INSURER F
$
Irvine CA 92606
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
LTR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
MM /DDIYYYY
POUCY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE " i OCCUR
57SBABH5586
06/01/2018
06101/2019
EACH OCCURRENCE
$ 1,000,000
PRAEM SES ( a occu RENTED
$ 1,000,000
GEN
X
MED EXP (Any one person)
$ 10,000
PERSONAL BADV INJURY
$ 1,000,000
L AGGREGATE LIMIT APPLIES PER
PRO -
POLICY 1-1 PRO ❑ LOC
OTHER
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP /OP AGG
$ 2,000,000
$
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
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
57SBABH5586
06/01/2018
06/01/2019
EACH OCCURRENCE
$ 4 000 000
AGGREGATE
$ 4,000 000
DED X RETENTION $ 10000
PR/COMP OPS AGG
$ 4000,000
A
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N
OFFICER/MEMBEREXCLUDED9 �Y
(Mandatory In NH)
If yes describe under
D:3CRIPTiON OF OPLRATIONS ualo.
NIA
I
57WECDX4233
06/01/2018
06/01/2019
-
7PSTEA R OTH-
TUTE ER
ACH A CCIDENT
$ 1,000,000
EL DISEASE - EA EMPLOYEE
$ 1,000,000
E' D�SEnSF P�ILICY LIMIT
$ 1,000 000
_
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 Additional Remarks Schedule, maybe attached If more space is required)
Those usual to the insured's operations
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Gilroy ACCORDANCE WI rH THE POLICY PROVISIONS
AUTHORIZED REPRESENTATIVE
7351 Rosanna Street
Gilroy CA 95020
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