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,a►coRO� CERTIFICATE OF LIABILITY INSURANCE <br />L <br />DATE (MM /DD/YYYY) <br />11126/2014 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE <br />AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br />ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGRATION IS WAIVED, <br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does <br />not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER OnPoint Underwriting Inc. <br />8390 E Crescent Pkwy, Suite 200 <br />Greenwood Village, CO 80111. <br />CONTACT NAME: Steven McComb <br />PHONE (A/C, No Ext): (360) 828 -0644 FAX (A/C, NO): (360) 828 -0699 <br />EMAIL ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A: <br />ACE American Insurance Company <br />22667 <br />INSURED <br />Barrett Business Services, Inc. <br />LCF W.H. JEWETT, INC. <br />8400 MAPLE PLACE ,SUITE 105 <br />RANCHO CUCAMONGA, CA 91730 <br />INSURER B: <br />LTR <br />INSURER C: <br />WVD <br />INSURER D: <br />(MM /DD/YYYY) <br />INSURER E: <br />GENERAL LIABILITY <br />INSURER F: <br />EACH OCCURRENCE <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION <br />OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE <br />ISSUES OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />LTR <br />INSR <br />WVD <br />(MM /DD/YYYY) <br />(MM /DD/YYYY) <br />GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />DAMAGE TO RENTED PREMISES (Ea <br />COMMERCIAL GENERAL LIABILITY <br />7-7CLAIMS-MADE OCCUR <br />occun:nce) <br />$ <br />MED EXP (Any one person) <br />$ <br />PERSONAL & ADV INJURY <br />$ <br />GENERAL AGGREGATE <br />$ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP /OP AGG <br />$ <br />POLICY PROJ- LOC <br />$ <br />ECT <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY (Per person) <br />$ <br />ALL OWNED AUTOS SCHEDULED AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />HIRED AUTOS NON -OWNED AUTOS <br />PROPERTY DAMAGE <br />$ <br />$ <br />UMBRELLA LIAB OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAB OCCUR <br />AGGREGATE <br />$ <br />DED RETENTION $ <br />$ <br />$ <br />A <br />WORKERS COMPENSATION AND EMPLOYERS' <br />RWC <br />11/22/14 <br />11/01/2015 <br />WC STATU- <br />I <br />OTH- <br />LIABILITY Y/N <br />C48092883 <br />TORY LIMITS <br />ER <br />E.L. EACH ACCIDENT <br />$2,000,000 <br />ANY PROPRIETOR/PARTNER/ EXECUTIVE Y <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />Covered states: <br />CA <br />E.L. DISEASE - EA EMPLOYEE <br />$2,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$2,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATA THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />The City of Riverside Risk Management <br />POLICY PROVISIONS. <br />3900 Main Street <br />AUTHORIZED REPRESENTATIVE <br />Riverside CA 92522,15 <br />Richard Poling <br />ACORD 25 (2010/05) <br />c) 1988 -2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD. <br />