Laserfiche WebLink
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />12/01/2025 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />NAME:K T L Business Insurance Services, Inc.K T L Business Insurance Services, Inc. <br /> 322 8th Street Suite # 101 <br /> Del Mar CA 92014 <br />PHONE <br />(A/C, No. Ext):(858) 350-0555 FAX <br />(A/C, No):(858) 350-0556 <br />E-MAIL <br />ADDRESS kevin@ktlinsurance.com <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURED <br />Agency Lic#: CA # 0D86601 INSURER A: <br />INSURER B: Hartford Casualty Insurance Company <br />Valley Forge Insurance Company <br />29424 <br />20508 <br />NHA ADVISORS, LLC <br />4040 CIVIC CENTER DR STE 200 <br />SAN RAFAEL CA 94903 <br />INSURER C:Underwriters at Lloyd's, London 15642 <br />INSURER D: <br />INSURER E: <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 104717 REVISION NUMBER:1 SUPERCEDES PREVIOUS REVISIONS <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR TYPE OF INSURANCE ADDL <br />INSRD <br />SUBR <br />WVD <br />POLICY EFF <br />DATE (MM/DD/YY) <br />POLICY EXP <br />DATE (MM/DD/YY) <br />X <br />POLICY NUMBER <br />EACH OCCURRENCE <br />LIMITS <br />$2,000,000 <br />A <br />COMMERCIAL GENERAL LIABILITY 6025083654 01/23/25 01/23/26 DAMAGE TO RENTED <br />PREMISES (Ea occurence)$1,000,000CLAIMS MADE X OCCUR <br />10,000MED EXP (Any one person)$ <br />2,000,000PERSONAL & ADV INJURY $ <br />4,000,000GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO- <br />JECT <br />GENERAL AGGREGATE $ <br />4,000,000POLICYLOCPRODUCTS-COMP/OP AGG $ <br />OTHER: <br />6025083654 01/23/26 COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />A AUTOMOBILE LIABILITY 01/23/25 $1,000,000 <br />ANY AUTO BODILY INJURY (Per person)$ <br />OWNED <br />AUTOS ONLY <br />SCHEDULED <br />AUTOS BODILY INJURY (Per accident)$ <br />X HIRED <br />AUTOS ONLY X NON-OWNED <br />AUTOS ONLY <br />PROPERTY DAMAGE $(Per accident) <br />$ <br />UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br />EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br />DED RETENTION $$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY 72WECBL6J57 11/08/25 11/08/26 X PER <br />STATUTE <br />OTH- <br />ER <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />Y/N N/A E.L. EACH ACCIDENT $1,000,000 <br />E.L. DISEASE-EA EMPLOYEE $1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $1,000,000 <br />C Procfessional Liability MPL43740025 02/06/25 02/06/26 Ea Occurrence/Aggregate 2,000,000 <br />EACH CLAIM 1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />Attention: Kevin Levine Lic # 0834847 <br />ACORD 25 (2016/03)Certificate #104717 Revision #1 © 1988-2015 ACORD CORPORATION. All right reserved. <br />The ACORD name and logo are registered marks of ACORD <br />Docusign Envelope ID: BB80A86F-2853-4F40-B02D-18F5B9DD615F