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Adobe Scan Dec 28, 2023

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0% found this document useful (0 votes)
41 views1 page

Adobe Scan Dec 28, 2023

Uploaded by

Brian Albarracin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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ACORD DATE (MM/DOrYYYY)

CERTIFICATE OF LIABILITY INSURANCE 12/28/2023


THIS CERTIHICATE 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 ACONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
MPORTANT: Kthe certficate holder Is an ADDITIONAL INSURED, the policyles) must be endorsed. HSUBROGATION IS WAVED, Subject to the
tems andholder
certtficate conditions
In lleuofofthe policy,
such certaln pollcles
endorsement(s). may requlre an ondorsement. Astatement on this certificate does not confer rights to the
PRODUCER CONTACT
NAME: Angel Moreno
|Angel Moreno PHONE FAX
NG, No, Ext): 210-775-1242 (WC, No):
401ESonterra Blvd 375 È-MAIL
ADDRES8: infoaeastaragents.com
San Antonio TX 78258
INSURER(S) AFFORDING COVERAGE NAIC #

INSURED
INSURER A: Eastar Insurance Group 55280
Juan Jose Calleja and Danny Caldera INSURERB:
10102 Ingram Road INSURER C:
San Antonio TX 78245 INSURER D :
INSURER E:

INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERIFY THAT THE POLICIES OF INSURANCE LISTED BELOW
HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER D0CUMENT WITH PERIOD
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY RESPECT TO WHICH THIS
THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN TERMS,
NSR REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE TADDL SUBRI POLICY EFF POLICY EXP
GENERAL LIARUTY
INSRWwp POLICY NUMBER
(MMDDYYYY(MWDDYY LIMITS
EACH OCCURRENCE
COMMERCIAL GENERAL LABILITY DAMAGE TO RENTED
PREMISES (Ea OcCurrence)
CLAJMS-MADE OCCUR
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
GENL AGGREGATE LIMIT APPLIES PER:
POUCY
PRO PRODUCTS - COMP/OP AGG $
JECT LOC
AUTOMOBILE UABILTY
COMBINED SINGLE LIMIT
ANY AUTO Ea accident) $60,000
ALL OWNED |Y SOCHEDULED BODILY INJURY (Per person) $ 30,000
A AUTOS AUTOS
NON-OWNED P3249744442524 BODILY INJURY (Per accldent) $ 60.000
HRED AUTOS
AUTOS 10/23/202304/23/2023 PROPERTY DAMAGE
(Per accident) $25.000
UMBRELA LIAB
OCCUR
XCESS LIAB EACH OCCURRENCE
CLAIMS-MADE
DED RETENTION $ AGGREGATE
WORIERS COMPENSATION
AND EMPLOYERSUABILTY OPTATu.
ANY PROPRIETORPARTNEREXECUTIVE YIN
O

YLIMITS
|OTH
ER
OFFICENEMBEREXCLUDED?
(Mandatory in NH)
NIA
E.L. EACH ACCIDENT
f ves Cescrbe under
DESCRPTON OF OPERATIONS below. E.L. DISEASE-EA EMPLOYEE S
E.L. DISEASE - POLICY LIMIT

OPERAIONS /LOCATIONS / VEHICLES (Attach ACORD 101,


DESWACAMPY VIN 4T1811HK5KU226186
2019 Additlonal Remarks Schedule, Hmore space Is requlred)
Comp arnd Coll500 deductibles

CERTIFCATE HOLDER
CANCELLATION
Tricolor Aulo Group
SHOULD ANY OF THE ABOVE
DESCRIBED POLICIES
2751 SW Militapry Dr THE EXPIRATION DATE
THEREOF, NOTICE
BE CANCELLED BEFORE
ACCORDANCE WITH THE POLICY WNILL BE DELIVERED IN
San Antonio TX 78224 PROVISIONS.
AUTHORZED REPRESENTATIVE

ACORD25 (2010/05) The ACORD name and logo are


©
1988-2010 ACORD
reglstered marks of ACORD CORPORATION. AIl rights reserved.

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