Loading...
2021/05/01 Haaker Equipment CompanyACCWI F CERTIFICATE OF GARAGE INSURANCE DATE (MM/DD/YYYY) 03/06/2021 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: It the certificate holder is an ADDITIONAL INSURED, the policy(les) must hove ADDITIONAL INSURED provisions or be endorsed. It 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 ri ghts to the certificate holder In lieu of such endorsements . PRODUCER Sentry Insurance 1800 North Point Drive Stevens Point, WI54481 CONTACT Sentry Customer Service PHONE Ex): 800-473-6879 FAX Na; 800-5147191 EMA IL businessproducts_directvsenty.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC If INSURER A: Sentry Select Insurance Company 21180 INSURED INSURER B : Haaker Equipment Company 2070 N White Ave INSURER C La Verne, CA 91750-5679 INSURER D: INSURER E : INSURER F : COVERAGES PROD / CUSTOMER ID: rFRTIFIrATF ff- 1790667 AFvlclnm H. 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 INSRD SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) Y OS/01/2021 POLICY EXP (MM/DD/YYYY) LIMITS A GARAGE LIABILITY HI HIRED AUTOS ANY AUTO ONLY X NON -OWNED OWNED AUTOS USED AUTOS ONLY IN GARAGE BUSINESS g967081005 OS/01/2022 AUTO ONLY (Ea accident) $ 500,000 OTHER THAN AUTO ONLY EA ACCIDENT $ 500,000 AGGREGATE $ 2,500,000 GARAGE KEEPERS LIABILITY X COMP / OTC LOG 1 $ 1,320,000 A LEGAL LIABILITY DIRECT BASIS 4967081005 05/01/2021 05/01/2022 SPECIFIED LOG PERILSX $ COLLISION LOG 1 $ 1,320,000 PRIMARY EXCESS _ LOC $ X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 500,000 CLAIMS -MADE �X OCCUR NI GETO R TE PREMISES Etr occurrence S 100.000 MED EXP (Any one person) $ 5.000 PERSONAL & ADV INJURY $ 500,000 A 4967061004 05/01/2021 05/01/2022 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY ❑ � CT ❑ LOG E 0 PRODUCTS -COMP/OP AGO $ 1,000,000 OTHER X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 30,000,000 A EXCESS LIAB CLAIMS -MADE 4967061006 05/01/2021 05/01/2022 DED RETENTION $ PRODUCTS - COMP/OP AGGp7}{ $ 30,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ST TATER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y/N N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) ❑ If yes, describe under E.L. DISEASE - POLICY LIMIT $ REMARKS below REMARKS (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCFI I ATInN City of Menifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 29644 Haun Rd THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE Menifee, CA 92586-6539 WITH THE POLICY PROVISIONS. -- AUT RIY ESENTA IV J ti Ha.vnU ou tzvID/us) page 1 of 2 © 2010-2015 ACORD CORPORATION. Ali rights reserved. 4967081 The ACORD name and logo are registered marks of ACORD 03/08/2021 Sentry Select Insurance Company 3 00002 0000001007 21067 N A 0 2C37E29B-4DDD-4E51-BFCO-786BFEED92CO 0027020044359988756492586653944 ACC )REy AGENCY CUSTOMER ID: =0=6064 LOC #: ADDITIONAL REMARKS SCHEDULE Page ? of ? AGENCY Dante Cipulli NAMEDINSURED Haaker Equipment Company POLICY NUMBER 4967081005 CARRIER Sentry Select Insurance Company NAIC CODE 21160 EFFECTIVE DATE: 05/01/2021 IDDITIONAL REMARKS ITHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 30 FORM TITLE: Certificate Of Garage Insurance Garagekeepers Liability Location # State Basis 2 NV Natural Disasters Legal Liability 4 AZ Natural Disasters Legal Liability Collision Limit Comp/OTC/Specified Perils Limit $ 300,000 $ 300,000 $ 200,000 $ 200,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. 4967081 The ACORD name and logo are registered marks of ACORD 03/08/2021 Sentry Select Insurance Company