Coi Balg
Coi Balg
Coi Balg
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(ies) 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 endorsement(s).
CONTACT
PRODUCER NAME:
Andrew Chermark
DRIVE NEW JERSEY INSURANCE COMPANY PHONE FAX
(A/C, No, Ext):
(440) 461- 5000 (A/C, No):
(800) 367 - 6564
P. O. BOX 94568 E-MAIL
ADDRESS: [email protected]
INSURER(S) AFFORDING COVERAGE NAIC #
CLEVELAND OH US 44101
INSURER A : ATAIN SPECIALTY INSURANCE COMPANY 17159
INSURED INSURER B : TRAVELORS PROPERTY CASUALTY CO OF AME 25674
LOS ACOSTA TRUCKING LLC INSURER C :
53 BIDWELL AVE UNIT B INSURER D :
INSURER E :
JERSEY CITY NJ 07305
INSURER F :
OTHER: $
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY (Ea accident) $ 1,000,000
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED
A AUTOS ONLY AUTOS
CA984887883 08/05/2024 08/05/2025 BODILY INJURY (Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE
(Per accident) $
AUTOS ONLY AUTOS ONLY
$
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
STATUTE ER
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
$250,000
Motor Truck Cargo CA984887883 08/05/2024 08/05/2025
B deductible $1,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
*EXCEPT 10 DAYS WRITTEN NOTICE OF CANCELLATION FOR NONPAYMENT OF PREMIUM
2022, Volvo, VIN: 1FVACWDT3CDBF1868
2024, Wabash Dry Van, VIN: 1HTMMAAM62H506744
AUTHORIZED REPRESENTATIVE
Long Beach CA 90803