CENTCOA-19
DOMI
ACORDTV CERTIFICATE QF LIABILI
RODUCER
(80S) 593-1400
iBuduo & DeFendis Insurance Brokers, LLC - SLO
icense #OE02096
00 Cross Street, Suite 203
an Luis Obispo, CA 93401
JSURED
Central Coast Synthetic Waterproofing (dba)
PO Box 14438
San Luis Obispo, CA 93406-
TY INSURANCE
DATE (MIWDD/YYYY)
4/13/2010
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURER A USF Insurance Company
INSURER B: American States Insurance Company
INSURER c: Southern Insurance Company
INSURER D:
NAIC#
INSURERS:
I
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
bk
TR
k
3
•\
-*
UDD'L,
NSRD
TYPE OF INSURANC E
GENERAL LIABILITY
~vH
A | COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE | X | OCCUR
GEN'L AGGREGATE LIMIT APPLES PER:
X i POLICY n^ FiLOC
AUTOMOBILE LIABILITY
! ANY AUTO
I ALL OWNED AUTOS
X SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
GARAGE LIABILITY
ANY AUTO
EXCESS/UMBRELLA LIABILITY
J OCCUR
J CLAIMS MADE
DEDUCTIBLE
RtTENT ON
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER
POLICY NUMBER
LGBGL83308
01CI2129892
WSI0041 37801
POLICY EFFECTIVE i POLICY EXPIRATION
DATE IMM/DD/YY1
DATE (MM/DO/YY1
4/10/2010
4/10/2010
4/11/2010
4/10/2011
4/10/2011
4/11/2011
LIMITS
EACH OCCURRENCE
DAMAGE 1 0 KbN 1 tLl
PREMISES |Ea occurence)
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
$
1,