2021/05/01 Haaker Equipment Company (3)A41CQRO DATE (MM/DD/YYYY)
lh._� CERTIFICATE OF GARAGE INSURANCE 03108/2021
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(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 endorsements .
PRODUCER
Sentry Insurance
1800 North Point Diive
Stevens Point, WI54481
CONTACT Sentry Customer Service
HONENo, Ext; 800-473-6879 FA No: Boo-514-7191
EMAIL business roducts_diract�sen4 com
ADDRESS: P y
INSURER(S) AFFORDING COVERAGE
NAIC N
INSURER A: Sentry Select Insurance Company
21180
INSURED
INSURER B:
Haaker Equipment Company
2070 N White Ave
INSURER C
La Veme, CA 01750-5679
INSURER ID:
INSURER E :
INSURER F :
COVERAGES PROD / CUSTOMER ID: CERTIFICATE rf: 1790667 REVISION N:
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)
POLICY EXP
(MM/DD/YYYY)
LIMITS
A
GARAGE LIABILITY H1 HIRED AUTOS
ANY AUTO ONLY
X NON -OWNED
OWNED AUTOS USED
AUTOS ONLY IN GARAGE
4967081005
05/01/2021
05/01/2022
AUTO ONLY (Ea accident)
$ 600,000
OTHER THAN
EA ACCIDENT
$ 500,000
AGGREGATE
$ 2,500,000
BUSINESS
AUTO ONLY
GARAGE KEEPERS LIABILITY
X
COMP /
OTC LOC
1
$ 1,320,000
A
LEGAL LIABILITY
DIRECT BASIS
4967081005
05/01/2021
05/01/2022
SPECIFIED LOC
PERILSX
$
COLLISION LOC
1
$ 1,320,000
PRIMARY EXCESS
LOC
$
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 500,000
CLAIMS -MADE � OCCUR
DAMAG O RENTED
PREMISES Ea occurrence
$ 100.000
MED IXP (Any one person)
$ 5,000
A
4967081004
05/01/2021
05/01/2022
PERSONAL & ADV INJURY
$ 500,000
_
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 1,000,000
POLICY ❑PRO- LOC
JECT
X
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
4967081006
05/01/2021
05/01/2022
DED I J RETENTION $
PRODUCTS - COMP/OP AGGp7}{
$ 30,000,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
STATUTE ER
ANY PROPRIETOR/PARTNER/D(ECUTIVE N / A
OFFICERIMEMBEREXCLUDED? Y/N
E.L EACH ACCIDENT
$
(Mandatory in NH) ❑
E.L. DISEASE - EA EMPLOYEE
$
If yes, describe under
REMARKS below
E.L. DISEASE - POLICY LIMIT
$
REMARKS (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
CERTIFICATE HOLDER
City of Menifee
29844 Haun Rd
Menifee, CA 92586-6539
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE POLICY PROVISIONS.
El
ACORD 30 (2016/03)
4967081
Sentry Select Insurance Company
3 00002 0000001007 21067 N A 0
Page 1 of 2 0 2010-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD 03/08/2021
2C37E2913-4DDD-4E51-BFCO-7969FEED92CO 0027020044359988756492586653944