NAGCO GLASS OF POMONA AND UPLAND

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Client #: 317008 GMIGLASS ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 2/28/2014 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 CONTACT Laurie Mumford, Account Mgr Kevin Gigler, Account Executive PHONE 858- 768 -7325 FAX 619- 342 -7544 A/C, No, Ext : (A/C, No): HUB Int'I Insurance Serv. Inc. E-MAIL laurie .mumford @hubinternational.com 5405 Morehouse Dr., #340 $1,000,000 X COMMERCIAL GENERAL LIABILITY INSURER(S) AFFORDING COVERAGE NAIC # San Diego, CA 92121 INSURERA: Praetorian Insurance Company 37257 INSURED INSURER B: State Comp Insurance Fund of CA 35076 GMI Glass Corporation MED EXP (Any one person) dba Nagco Glass of Pomona and Upland INSURER C: $1,000,000 X PD Ded $500 /occur 243 E Holt Avenue INSURER D Pomona, CA 91767 INSURER E APPROVED INSURER F PRODUCTS - COMP /OP AGG COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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. LTR TYPE OF INSURANCE ADDLSUBR NSR WVD POLICY NUMBER POLICY EFF /Y (MM /DDYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL LIABILITY H01000187901 01/27/2014 01/27/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TOERENTED ence $100,000 CLAIMS -MADE � OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 X PD Ded $500 /occur GENERAL AGGREGATE $2,000,000 APPROVED GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $1,000,000 X POLICY PRO- JECT LOC $ A AUTOMOBILE LIABILITY H01000187901 01/27/2014 01/27/201 MD (CEO, accciden SINGLE LIMIT $1'000'000 X BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPccERTY DAMAGE Per aident $ HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LAB EACH OCCURRENCE $ HOCCUR AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? [y] N/A 908525514 01/01/2014 01/01/201 X TORYIMITS EORH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Riverside is additional insured in regard to general liability per attached form CG2010 07/04. Additional insured in regard to the Auto Liability applies per attached form PICA0592 09/07. City of Riverside Risk Management 3900 Main Street Riverside, CA 92522 ACORD 25 (2010/05) 1 of 1 #S2723538/M2635865 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. The ACORD name and logo are registered marks of ACORD IT41