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2017/12/12 Blanca A Yanes and John I De Gange Certificate of Liability Insurance AoC R DATE(MM/DD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 11/30/2018 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 BYTHE 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(les)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: Crisma Padilla(9965P6J) PHONE FAX 27412 Enterprise Cir W Ste 202 (A/C,NO,EXT):951-972-3377 WC,NO):951-977-4109 E-MAIL Temecula CA 92590-4876 ADDRESS: cpa6illa@farmersagent.com INSURER(S)AFFORDING COVERAGE NAIC N INSURED INSURERA: Truck Insurance Exchange 21709 INSURERB: Farmers Insurance Exchange 21652 DBA"De Gange BLANCA A AND JOHN I DE GANGE INSURERC: Mid Century Insurance Company 21687 ge Consulting PO BOX 1494 INSURERD: TEMECULA CA 92593 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHATTHE POLICIES OFINSURANCE LISTED BELOW HAVE BEEN ISSUEDTOTHE INSURED NAMEABOVE FORTHE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONSAND CONDITIONSOF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDTL SUER POLICYNUMBER POLICYEFF POLICYEXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE '$ 1,000,000 CLAIMS-MADE I J� OCCUR DAMAGE TO RENTED PREMISES(Ea Occurrence) $ 75,000 MED EXP(Anyone person) S 5.000 A Y N 504701461 12/12/2017 12/12/2018 PERSONAL&ADV INJURY 13 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE 13 2000000 POLICY ❑ PROJECT ❑ LOC PRODUCTS-COMP/OPAGG 13 1.000.00 OTHER: J 13 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 (Ea accident) ANYAUTO BODILY INJURY(Per person) $ A ONLY AUTOS SCHESCHEDULED BODILY INJURY(Per accident)$ 604701461 12/12/2017 12/12/2018 HIREDAUTOS X NON-OWNED PROPERTY DAMAGE X ONLY AUTOSONLY (Peraccldent) $ :$ UMBRELLALIAB OCCUR EACH OCCURRENCE �$ EXCESS LIAB CLAIMS-MADE AGGREGATE '$ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTHER :$ AND EMPLOYERS'LIABILITY STATUTE ANY PROPRIETOR/PARTNER/ YIN N/A E.L.EACH ACCIDENT 'S EXECUTIVE OFFICER/MEMBER EXCLUDED?(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 43275 CALLE CAPISTRANO,TEMECULA,CA 92590 CERTIFICATE HOLDER CANCELLATION CITY OF MENIFEE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION 29714 HAUN ROAD DATE THEREOF,Nfn"CE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPkESENTATIVE CRISMA PADILLA C-A_Z258 — ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION.All Rights Reserved 31-1769 11-15 The ACORD name and logo are registered marks ofACORD ACaRL> CERTIFICATE OF LIABILITY INSURANCE DATE 11/30/2018 ' 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,ANDTHE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the pol icy(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: Crisma Padilla(9965P6J) PHONE FAX 27412 Enterprise Cir W Ste 202 (A/C,NO,EXT):951-972-3377 (A/C,NO):951-977-4109 E-MAIL Temecula CA 92590-4876 ADDRESS: cpadilla@farmersagent.com INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: Truck Insurance Exchange 21709 INSURERS: Farmers Insurance Exchange 21652 BLANCA A YANES AND JOHN I DE GANGE INSURER c: Mid fLentury Insurance Company 21687 DBA"De Gange Consulting — PO BOX 1494 INSURER D: TEMECULA CA 92593 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTOTHE INSURED NAME ABOVE FORTHE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT W ITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHETERMS,EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDTL SUBR POLICY EFF POLICY EXP LTR TVPEOFINSURANCE INSD WVD POLICY NUMBER LIMITS (MM/DD/VYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000.00 DAMAGETO RENTED CLAIMS-MADE [XI OCCUR PREMISES(Ea Occurrence) $ 75,00 MED EXP(Anyone person) $ 5,00 A Y N 604701461 12/12/2018 12/12/2019 PERSONAL&ADV INJURY :$ 1,000,00 GENT AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE '$ 2000,00 X POLICY ❑ PROJECT ❑ LOC PRODUCTS-COMP/OPAGG '$ 1.000,000 OTHER: - $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ,$ 1,000,00 (Ea accident) ANYAUTO BODILY INJURY(Per person) $ 4 OWNEDAUTOS SCHEDULED BODILY INJURY(Per accident):$ 604701461 12/12/2018 12/12/2019 HIREDAUTOS X NON-OWNED PROPERTY DAMAGE X ONLY AUTOSONLY (Per accident) $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTHER $ AND EMPLOYERS'LIABILITY STATUTE ANY PROPRIETOR/PARTNER/ Y/N N/A E L.EACH ACCIDENT $ EXECUTIVE OFFICER/MEMBER EXCLUDED?(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATI ONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 43275 CALL CAPISTRANO,TEMECULA,CA 92590 CERTIFICATE HOLDER CANCELLATION CITY OF MENIFEE SHOULD ANY OFTiF.ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 29714 HAUN ROAD DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 AUTHORIZED REPRESENTATIVE CRISMA PADILLA MEMIEEF CA 92586 . ACORD 25(2016/03) ©l988-2015 ACORD CORPORATION.All Rights Reserved 31-1769 11-15 The ACORD name and logo are registered ma is ofACORD