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DATE (MWDD/YYYY) <br />AC" °® CERTIFICATE OF LIABILITY INSURANCE 12/4/2014 <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 NAME: CONTACT Erika Mora <br />NAME: <br />AHTKY Insurance Agency, LLC PHONE (310) 516 -0110 FAC o. (310)516 -0381 <br />1451 W Artesia Blvd, Suite A ADDRIESS:erikam @ahtky.com <br />INSURERS AFFORDING COVE <br />Gardena CA 90248 INSURERA:State Comp Ins Fund <br />INSURED INSURER B: <br />Valley Green Construction, Inc., DBA: Valley INSURER C: <br />2 64 8 Fair Oaks Ave. INSURER D: <br />J Alta Dena CA 91001 1 INSURER F: I I <br />nrw0nAf%00 rrcortctrrAre M1IMAQC17.1 A -1 5 WC R1=V1RInN IJI!MRFR- <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 <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MM /DDYYYY <br />POLICY EXP <br />MM /DDYYYY <br />LIMITS <br />GENERAL LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE r_1 OCCUR <br />I <br />EACH OCCURRENCE <br />$ <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <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 />POLICY PRO LOC <br />PRODUCTS - COMPIOP AGG <br />$ <br />$ <br />AUTOMOBILE LIABILITY <br />A <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />COMBINED SINGLE LIMIT <br />Ea accident <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />POP RTY DAMAGE <br />$ <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />HOCCUR <br />AGGREGATE <br />$ <br />DED I I RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNER/EXECUTIVE Y/ N <br />OFFICER /MEMBER EXCLUDED? � <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />9034751 -14 <br />11/28/2014 <br />11/28/2015 <br />X WC STATU- OTH- <br />FR <br />E.I. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYE <br />$ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) <br />CERTIFICATE HULUhK <br />(951) 826 -5542 <br />City of Riverside <br />Risk Management <br />3900 Main Street <br />Riverside, CA 92522 <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 />Kaoru Anegawa /ELM <br />ACORD 25 (2010/05) V 1Vk$t1 -ZU1U AUUKU CUKFUKA I IUN. An rignis reservea. <br />INS025 - 201005) 01 The ACORD name and logo are registered marks of ACORD <br />