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1 0 AC"R" CERTIFICATE OF LIABILITY INSURANCE 11..� (MMIDDIYYYY) 70 9/20/18 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). PRODUCER CONTACT Dan Peterson NAME: LIMITS FAX PHONE (AIC No): IAIC�,o, Ext): 916-361-9585 x266 916-361-9821 E-MAIL dpeterson@skylesinsurance.com ADDRESS: Skyles Insurance Agency INSURER(S) AFFORDING COVERAGE NAIC 9840 Business Park Drive INSURER A: Amtrust International Underwriters DAC AA1780074 Sacramento CA 95827 INSURED INSURER B: INSURER C: N L TAVAGLIONE DEVELOPMENT INSURER D: NICK TAVAGLIONE INSURER E: 210 CLEARWOOD AVE INSURER F: RIVERSIDE CA 92506 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY TPAT 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. INSR LTR TYP E OF INSURANCE ADDLSUBR INSD WVD POLICYNUMBER POLICY EFF IMMIDDIYYYY) POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 _7 PERSONAL & ADV INJURY $ 1,000,000 A Y Y XN 108361100 08/28/2018 08/28/2019 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICYF—] JECT [—] LOC PRODUCTS - COMP/OP AGG $ 2,000,000 MBINED SINGLE LIMIT $ (CEO, .cd.nl)- $ OTHER: APPROVED — AUTOMOBILE LIABILITY BODILY INJURY (Per person) $ ANY AUTO OWNED L SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPEcR7Z�DAMAGE Par c id I $ $ UMBRELLA LIA13 HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED I ENTION $ $ WORKERS DOM ENSATION AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE F__1 I OTH- I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N/A E.L. DISEASE - POLICY LIMIT $ if yes, d ascribe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) CERTIFICATE HOLDER IS ADDED AS ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT AND AS RESPECT TO GENERAL LIABILITY PER THE CONDITIONS OF THE ATTACHED FORM: NX GL 189 0511 rF=PTH=lrATFz wni n;=p rANCIFILLATION CITY OF RIVERSIDE RISK MANAGEMENT 3900 MAIN STREET RIVERSIDE CA 92522 ACORD 25 (2016103) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED 1988-201 The ACORD name and logo are registered marks of ACORD TION. All rights reserved.