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ACORV CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
09/27/2021
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 CA LIC OB29370 1-925-244-7700
Edgewood Partners Insurance Centers (EPIC)
[San Ramon - Branch ID 143941
P. O. Box 5003
CONTACT Certificates Department
NAME:
PHONE FAX
.925-244-7700 AIC No:925-901-0671
E-MAIL
ADDRESS: EPICcertsQepicbrokere.com
INSURERS AFFORDING COVERAGE
NAIC #
INSURERA:ALASRA NAIL INS CO
38733
San Ramon, CA 94583
INSURED
Pacific Coast Container, Inc.
INSURER B :
dba PCC Logistics
INSURERC:
432 Estudillo Avenue
INSURERD:
INSURER E :
INSURER F:
San Leandro, CA 94577
COVERAGES CERTIFICATE NUMBER: 63344765 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
ADDLSUBR
POLICY NUMBER
POLICY EFF
POLICY EXP
IMMIDDANM
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
$
DAMAGE TO RER%T_
PREMISES Me occurrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO- ❑ LOC
JECT
OTHER:
GENERAL AGGREGATE
$
PRODUCTS - COMPIOP AGG
i
$
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)
S
BODILY INJURY (Per accident)
S
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEO I I RETENTIONS
$
A
AND EMPLOYERS' LIABILnY WORKERS COMPENSATION
ANYPROPRIETORIPARTNER/EXECUTIVE a
OFFICERIMEMSEREXCLUDED4
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N 1 A
21JW312326
10/O1/21
10/O1/22
R STATUTE I ERA
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
E 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is requlrod)
Confirmation of Coverage
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Gilroy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
7351 Rosanna St. AUTHORIZED REPRESENTATIVE
Gilroy, CA 95020
USA
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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63344765
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