2010/11/08 Dennis Janda, Inc. BAN
A �.1
R054 oATE IM5-201
CERTIFICATE OF LIABILITY INSURANCE o7-os-toll
THIS CERTIFICATEIS 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 I NSURERIS),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL IN SU RED,the policylies)must 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 CeNficate does not confer rights to the
certificate holder in III of such endorsement sl.
PRODUCER CONTACT
NAME:
i4ELLIS. FARGO INS INC/PAC NEP PAHONEaxak-
715725 P: O - F: O A
PO BOX 33015 ODREss:
RODUCER
SAN ANTONIO TX 78265
NIaU11ERW AFFOflOINO COVERAGE NA1Ctl
ENSURE, RMURERA: Hartford Casualty Ins Co
xsuR R a:
DENNIS I ; INC
42164 REMEMINGNGTON AVE INSURER L:
TEMECULA CA 92590 INSURER D:
INSURER E:
NSUS ER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORME 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.
CSX1B TIME OF A. PCUCV DM1B9r IMMAWYYYYU (MM2OiYYVV1 CIS
eaMB ,16A ETV EACH OCCURRENCE 8
COMMERCIAL GENERAL.LIABILITY PREMISES lEa as vrwo 4
CWMSMADE OCCUR M ED.1 Ary one MHzwl. 6
PERSONAL a ADV INJURY 6
GENERAL AG ... F
L AGGOy8 TEUMITAffr PER PRODUCTS-COMPAPAGE I
POLICY U PECT
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AUTOMOaRE{/RBILDY COMBINED SINGLE LIMIT B
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ANYAUTO BODILY INJURY(Par M,.,l 8
ALL OWNED A.. BODILY INJURY Per AmIlen[) Y
SCHEDULED AUTOS
PROPERTY DAMAGE E
HIRED AUTOS IPer a[citlmtl
NON-CANNED AUTOS t
4
4W(RFLLA LIAR OCCUR EACH OCCURRENCE S
EXCEYS aA9 CLAIMS MADE AGGREGATE
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rMUWsNI 41 WEG J16051 11/0e/2010 11/08/2011 EL.DISEASE-EA EMPLOYE a1, 000, 000
oi"'vnONo OPERATIONS l.Mw E�DsusE-PDUOY LIMIT I 11, 000, 000
OESCN.O SBASSAIRYS11C.00NBUYD/DESUANmASDIe ror,MOpwrN Rwm ll.sMaluk.n—M,Ar.q Hvd,
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
City Of Menifee DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
29714 HAUN RD ABINONREVKYRESENTATWE
SUN CITY, CA 92586 7e`-
1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 /2009/091 The ADDED name and logo are registered marks Of ACORD