|
H &BEQUII -01 EFLORES
<br />AFRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM:DD/YYYY)
<br />12/31 /2014
<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 policy(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 License # OE02096 C NTACT
<br />NAME:
<br />DiBuduo & DeFendis Insurance Brokers, LLC AH/cON1J Ext , (661) 322 -9993 FAX Nd ; 661 322 -9714
<br />P.O. Box 9548 ( )
<br />Bakersfield, CA 93389.9548 E -MAIL
<br />AnnRFRC-
<br />INSURED
<br />H & B Equipment Co., Inc.
<br />P.O. Box 404
<br />Bakersfield, CA 93302
<br />COVFRAGFS
<br />r;=PTIFIr ATF All IMRFR-
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A:Ironshore Indemnity, Inc.
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSURER B: American Alternative Insurance Corp
<br />19720
<br />INSURER C: Ironshore Specialty Insurance Co.
<br />25445
<br />INSURER D: State Compensation Insurance Fund
<br />35076
<br />INSURER E: New Hampshire Insurance Company
<br />23841
<br />INSURER F:
<br />$ 1,000,000
<br />oovlmnnl nu lnncoo.
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR TYPE OF INSURANCE ADDUSUBR POLICY EFF POLICY EXP
<br />LTR I POLICY NUMBER MM /DDNYYY I JMM?DDffYYYJ LIMITS
<br />A
<br />X
<br />I COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE F _x] OCCUR
<br />X
<br />NBG0060700
<br />09/01/2014 09/01/2015
<br />PREMISES Eaoccurbence
<br />$ 50+000
<br />X
<br />MED EXP (Any one person)
<br />$ Excluded
<br />Hook Liability
<br />X
<br />Mobile Equip Over Rd
<br />PERSONAL R.ADVINJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY X] PRO- LOC
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />,,
<br />q
<br />PRODUCTS - COMP /OPAGG
<br />$ 2,000,000
<br />Em IO ee benefi
<br />p y
<br />$ 1,000,00
<br />OTHER
<br />�
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident)
<br />$ 1,000,000
<br />X
<br />$
<br />B
<br />ANY AUTO
<br />X
<br />2LA2CA000013500
<br />09/01/2014
<br />09/01/2015 BODILY INJURY (Per person)
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />HIRED AUTOS NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />$
<br />X
<br />UMBRELLA LIAR X OCCUR
<br />EACH OCCURRENCE
<br />$ 5,000,00
<br />AGGREGATE
<br />$
<br />C
<br />EXCESS LIAR CLAIMS -MADE
<br />NXS0000103
<br />09/01/2014
<br />09/01/2015
<br />. DED I X RETENTION $ 10+000
<br />Aggregate
<br />$ 5,000,000
<br />WORKERS COMPENSATION
<br />X PER OTH-
<br />AND EMPLOYERS' LIABILITY Y / N
<br />STATUTE ER
<br />D
<br />ANY PROPRIETOR /PARTNER /EXECUTIVE
<br />912138014
<br />12131/2014 12/31/2015 E.L. EACH ACCIDENT $ 1,000,00
<br />OFFICER /MEMBER EXCLUDED? ❑
<br />N/A
<br />(Mandatory in NH)
<br />E.L. DISEASE - EA EMPLOYEE $ 1,000,00
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000
<br />09/01/2014 09/01/2015 Ded $5000 per occ 1,000,000
<br />E
<br />Cargo Insurance
<br />01LX0670424180
<br />E
<br />Riggers Liability
<br />01LX0670424180
<br />09/01/2014 09/01/2015 Ded $5000 per occ 1,000,000
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />As required by written contract the certificate holder is added as an additional insured under the general liability and automobile liability and as required by
<br />written contract the certificate holder is favored with a Waiver of Subrogation under the general liability and automobile liability. Endorsements for each are
<br />attached.
<br />t,r-M 1 IrItA I t MULUMM GANL;tLLA I IUN
<br />City of Riverside
<br />Public Works Dept
<br />8095 Lincoln
<br />Riverside, CA 92504
<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 />A425
<br />C 1988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
|