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HomeMy WebLinkAboutattachments - mergedSecretary of State Certificate of Status I, SHIRLEY N. WEBER, PH.D., California Secretary of State, hereby certify: Entity Name:JB & LEON CORP Entity No.:3464566 Registration Date:04/26/2012 Entity Type:Stock Corporation - CA - General Formed In:CALIFORNIA Status:Active The above referenced entity is active on the Secretary of State's records and is authorized to exercise all its powers, rights and privileges in California. This certificate relates to the status of the entity on the Secretary of State ’s records as of the date of this certificate and does not reflect documents that are pending review or other events that may impact status. No information is available from this office regarding the financial condition, status of licenses, if any, business activities or practices of the entity. IN WITNESS WHEREOF, I execute this certificate and affix the Great Seal of the State of California this day of January 15, 2023. SHIRLEY N. WEBER, PH.D. Secretary of State Certificate No.: To verify the issuance of this Certificate, use the Certificate No. above with the Secretary of State Certification Verification Search available at biz fileOnline.sos.ca.gov. 073833529 State of California Department of Industrial Relations Division of Labor Standards Enforcement Licensing & Registration Unit 1515 Clay Street, Ste. 1902 Oakland, CA 94612 Janitorial Services Registration REGISTRANT WITH EMPLOYEES Effective Date 10/31/2023 Expiration Date 10/31/2024 JB & Leon, Corp. 1128 E. Chestnut Ave Santa Ana, CA 92701 Workers Compensation Insurance Expiration Date: October 16, 2024 Having paid to the Labor Commissioner of the State of California the required Registration Fee is hereby granted a registration to conduct the business of Janitorial Services in the State of California at the location(s) listed above and effective for the period designated above in conformity with the provisions of Chapter 4, Part 4.2, Division 2 of the Labor Code and the rules and regulations issued thereunder by the Labor Commissioner. THIS REGISTRATION IS NOT TRANSFERABLE AND IS VALID ONLY AT THE REGISTERED OPERATING LOCATION INDICATED ABOVE POST IN A CONSPICUOUS PLACE ALTERATIONS WILL VOID THIS REGISTRATION Registration Number: JS-LR-1000983388 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 2/12/2024 Olivier-VanDyk Insurance Agency,Inc. 2780 44th St SW Wyoming MI 49519 Certificates 616-454-0800 616-454-7100 certificates@ovdinsurance.com Travelers Casualty and Surety Company of America 31194 JB&LEON-01 ICW National Insurance Company 24635JB&Leon Corp DBA Juniper Cleaning 1128 E Chestnut Ave Santa Ana CA 92701 1409091513 A X 1,000,000 X 300,000 5,000 1,000,000 2,000,000 X 630-6X316122 1/1/2024 1/1/2025 2,000,000 A X X 1,000,000CUP-6X417559 1/1/2024 1/1/2025 X 0 B Y WMI 5067968 1/1/2024 1/1/2025 1,000,000 1,000,000 1,000,000 **FOR INSURANCE PURPOSES ONLY**