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M <br />WIN <br />ME <br />no <br />ACC>RVDATE (MINIVI <br />CERTIFICATE OF LIABILITY INSURANCE 4/20/2018 <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 poficy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER IVII-11 <br />NAME: <br />commercial Associates insurance 1NQ -4949 PAX 940 (714) 524 ' (Air <br />(714) 524-4 <br />1594 N. Batavia Street C -MAIL <br />Orange, CA 92867 INSURERS AFFORDING COVERAGE I <br />INSURER A:Travelers Indemnitv Cc of CT 2568. <br />1NSURED INSURER 8 <br />W.A. Rasic Construction Co., Inc. i INSURERC. <br />4150 Long Reach Blvd, INSURERD: <br />Long Beach, CA 90807 rINSURER E <br />COVERAGES <br />CERTIFICATE <br />NUMBER: <br />REVISION NUMBER: <br />7'i <br />IPS 15 TO CERTIFY THAT THE POLICIES <br />OF INSURANCE <br />LISTED BELOW HAVE BEEN ISSUED TO <br />THE INSURED <br />NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, <br />TERM OR CONDITION OF ANY CONTRACT <br />OR OTHER <br />DOCUMENT VATH RESPECT TO WH1(>I THIS <br />CERTIFICATE <br />MAY BE ISSUED OR MAY <br />PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES <br />DESCRIBED <br />HEREIN IS SUBJECT TO ALL I -HE TERMS, <br />EXCLUSIONS <br />AND CONDITIONS OF SUCH <br />POLICIES, <br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY <br />PAID CLAIMS, <br />INSR <br />LTR <br />"A13I3L <br />TYPE OF INSURANCE <br />POLICY EFF <br />POLICY NUMBER _(MM0=yyYJiJMM/0DfYYyy) <br />POQCY EXP <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE S 2,000,000 <br />X OMMERCIALGENERAL LiAmu'ry <br />C <br />bAMA - NTE <br />PREMISES fEa occulS <br />I_ <br />300, 000 <br />A <br />CLAIMS -MADE [i] OCCUR <br />X <br />DT22-CO-867OX247--TCT-18 5/1/2018 <br />5/1/2019 <br />MED EXP (Aam Le_r_S0nL_ <br />S 10, 00'0 <br />PttLSILNAL.SLADV INJU_FY <br />S 2,000,000 <br />GENERAL AGGREGATE_ <br />S 4,000,000 <br />GEN'L AGGREGATE LIMTAP <br />IPLIES PER <br />PRODUCTS - COMPIOP AG�G <br />S 4,000,000 <br />POLICY 7 PRO- 0 Loc <br />APPROVED <br />S <br />AUTOMOBILE LIABILITY <br />COMBINED <br />_�9AA - <br />L2 {)00 0"00 <br />A <br />I ANY AU70 <br />BODILY INJURY (Per Person) <br />S <br />ALL O"NED SCHEDULED_.,..T-810-8670X247-TCT-18 <br />5/1/2018 <br />5/1/2019 <br />BCDRYJNJURY�PeralcidertY <br />AUTOS AUTOS <br />S <br />NON -OWNED <br />PROPERTY DAMAGE <br />S <br />HIRED AUTOS AUTO$6�f <br />_IJP �4 -Ot q W <br />UnlnSLred rrotorist co=ined <br />S <br />UMBRELLA LIAB OCCUR <br />EACH OCCURRENCE <br />S <br />EXCESS LAB <br />AGGREGATE$ <br />D7DERETENTION$ <br />WORKERS COMPENSATION <br />WC STATU'....GTH <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPR�FTOR)F'�,R"TNERIEXru'CU'T�VE r--'-1 <br />EA, EACH ACCIDENT <br />(11FICCRW�MSER EXCLUDEI L <br />NIA <br />(Mandatory in Hit) -i <br />E L. DISEASE - EA EMPLOYEE <br />$ <br />Ul d' escrIbe ,ruder <br />D <br />DESCRIPTION OF OPERATIONS below <br />I <br />E.L DISEASE -POLICY LIMIT <br />S <br />DESCRIPTION OF OPERATIONS d LOCATIONS / VEHICLE$ (Aftach ACORD 101, Additional Rernarks Schedule, if more spate Is required) <br />(WAR#17PC25) Re: Operations usual to the named insured - Street Opening Permit <br />City of Riverside is added as additional insured where required by written contract as respects general <br />liability per attached CGD316 11/11, <br />30 days notice of cancellation except 10 days for non-payment. <br />City of Riverside <br />Risk Management <br />3900 Main Street <br />Riverside, CA 92522 <br />ACORD 25 (2010105) <br />1 NS025 (201005) 01 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />01 <br />9198 -2 10 ACORICORPORATION. All rights reserved. <br />The ACORD name and logo are registeredazark§ of <br />