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Commercial Certificate of Insurance <br />Agency Wendy Miller <br />Name 1911 Commercenter East #1 15 <br />& San Bernardino, CA 92408 <br />Address 909 -388 -9266 <br />St. 97 Dist. 46 Agent 367 <br />iAAMENS <br />.mac °uvl► FARMERS <br />Issue Date (MM /DD /YY) <br />This certificate is issued as a matter of information only and confers no rights <br />upon the certificate holder. This certificate does not amend, extend or alter the <br />coverage afforded by the policies shown below. <br />Companies Providing Coverage: <br />1 rlsured Company I Y A ']'ruck Insurance I�.xchankc <br />. Habitat for Humanity Leiter <br />Name 2180 Iowa Avenue Company B Farmers Insurance Exchange <br />& Riverside, CA 92507 Le11C1 <br />mpany C Mid- Century Insurance Cornpany <br />Address LeCona <br />Company I� <br />Leuei <br />Coverages <br />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 <br />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 <br />-- 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 <br />paid claims. <br />Cry. Policy Effective Policy Expiration <br />I.u'. q�YPr' of Insurance I olicy Number Date (MM /DD /YY) Date (MM /DD/Y'�) Policy L,irnils <br />1 General Liability General Aggregate g <br />Commercial ommercial General <br />Liability Aggregate $ <br />- Occurrence Version <br />Contractual Inridental APPROVED <br />Only <br />Owners & Contractors Prot. <br />A X Automobile Liability 01498 -08 -84 04/12/14 04/12/15 <br />A X All Owned Commercial <br />Autos <br />A X Scheduled Autos <br />A X I tired Autos <br />Nun -Owned Autos <br />Garage Liability <br />Umbrella Liability <br />Workers' Compensation <br />and <br />Employers' Liability <br />Description of Ulrerat ions /Vehicles /Restrictions /Spu:ial items: <br />Personal & <br />Advertising Injury $ <br />Each Occurrence $ <br />Fire Damage <br />(Any one fire) $ <br />Medical Expense <br />(Any one person) $ <br />Combined Single <br />Lrmrt <br />$ 1,000,0oo <br />Bodily In ury <br />(Per person <br />$ N/A <br />Bodily Injury <br />(Per accident) <br />$ N/A <br />Property Damage <br />$ 1,000,000 <br />Garage Aggregate <br />1 $ <br />Lmut <br />$ <br />Statutory <br />Each Accident <br />$ <br />Disease - T.ach Ltnpioyee $ <br />Disease - Policy Limit I % <br />- - - - -- - - -- - -1 <br />It is agreed that City of Riverside and its officers, employees and agents are added as additional insured's Linder this policy, solely for <br />work done by and on behalf ol' the named insured for the City of Riverside. City of Riverside shall be given (30) days written notice <br />prior to cancellation. <br />Certificate Holder Cancellation <br />City of Riverside, City Hall Should any of the above described policies be cancelled before the expiration date <br />Name Attn: Community Development Dept. thereof, the issuing company will endeavor to mail 30 days written notice to the <br />& 3900 Main Street, 3rd Floor certificate holder named to the left, but failure to mail such notice shall impose no <br />Address Riverside, CA 92522 obligation or liability of any kind upon the company, its agents or representatives. <br />Wendy Gallagher, Agent <br />Authorized Representative <br />5G 2492 4 -94 Copy Distribution: Service Center Copy and Agent's. Copy <br />