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PROCCEL -01 HZ559e CERTIFICATE OF LI ABILITY INSU RANCE DAr3/8/2013 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 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 License # OC77485 CO Spectrum Risk Management & Insurance Services, LLC PHONE -5730 756 -5730 FAX ( 949)___ 756 -5740 74 Discove W_C Ext)_( ) No ): E-MAIL Irvine, CA 9 618 ADDRESS'_ I � i DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) City of Riverside - Risk Management is named as additional insured as required by written contract per attached policy forms. Cancellation notice of 30 days applies. CERTIFICATE HOLDER City of Riverside - Risk Management 3900 Main Street Riverside, CA 92522 CANCELLATION 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 REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. INSURER(S) AFFORD C OVERAGE NAIC # _ IN A: Peerless Insurance Co 24198 INSURED INSURER B: Gol den Ea Ins Corp 10836 INSURER C Lib erty Insurance Corporation 42404 Process Cellular, Inc. DBA: ProCell 3020 W. Harvard St. INSURER D C ypress Insurance Company 10855 Santa Ana, CA 92704 -3914 INS URER E: i INSURER F: COVERAGE CERTIFIC NUMBER: R EVISION NUM 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 R EDUCED BY PAID CLAIMS. INSR DOCSUE R POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE SR WD POLICY NUMBER MMIDD/YYYY)_ (MM /DDIrrrY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X CBP8780429 DA Abut G15TOIR5 6/28/2012 612812013 PREMISES Ea occurrence $ 100,00 CLAIMS -MADE X OCCUR AP ROVE A AS FO MED EXP (Any one person) $ 10,00 P ERSONAL & ADV INJURY $ 1,000,00 G ENERAL AGGREGATE $ 2 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AG $ 2,000,00 POLICY X PR LOC $ r + AUTOMOBILE LIABILITY I _ Usk M 8 COMBINED SINGLE LIMIT ident Ea acc S 1,000,0C B X ANY AUTO X iBA8780029 6/26/2012 6/28/2013 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTO X X NON -OWNED PROPERTY DAMAGE $ AUTOS (PER ACCIDENT) X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,00 C EXCESS LIAB CLAIMS -MADE 'TH7- 661 - 065866 -022 6/26/2012 6/28/2013 AGG REGATE m T $ 10,000,00 DIED X I RETENTION $ 10,000 $ WORKERS COMPENSATION I X I WC STATU- OTH- TORY LIMIT FIR AND EMPLOYERS' LIABILITY D ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 3300057570 -121 . 9/17/2012 9/17/2013 E.L. EACH AC CIDENT $ 1,000,0C OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1,000,0C If es, describe under I DESCRIPTION OF OPERATIONS below 1 E.L. DISEASE - POLICY LIMIT $ 1 ,000,0( I � i DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) City of Riverside - Risk Management is named as additional insured as required by written contract per attached policy forms. Cancellation notice of 30 days applies. CERTIFICATE HOLDER City of Riverside - Risk Management 3900 Main Street Riverside, CA 92522 CANCELLATION 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 REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved.