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a <br />ACC>R" CERTIFICATE OF LIABILITY INSURANCE <br />111.� <br />DATE (MM/DD/YYYY) <br />r <br />DOCUMENT WITH RESPECT TO WHICH THIS <br />3/2/2018 <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(les) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). <br />PRODUCER Risk Strate Has Company <br />�treet, <br />CONTACT <br />-NAR <br />2040 Main Suite 450 <br />Irvine, CA 92614 <br />PHONE �FAX <br />C No): 949-251-0347 <br />MED EXP (Anyone person) 1 S $5,000 <br />----- ---- — - -- ---- <br />E-MAIL <br />A RIESS: AD b <br />Do ___ ............... . ..... — ------ 4 ..iy�_@_(t��k-.§��at@gies.,c-o-m <br />PERSONAL & ADV INJURY $ 1 000 <br />____IN��q!!_kR.(§)_��FFORD,IN,GC_OVER_AGE <br />www.risk-strategies.com CA DOI License No. OF06675 <br />. ....... . . . . ...... .... .. . . <br />INSURER A: Starr ur�lus Lines Insurance Comp <br />...-111.11,111 s____ <br />INSURED <br />2 R Drilling Inc. <br />--- --------- - -, ____ - __any <br />JNSURER B: Starr Indemnity & Liability Company 38318 <br />3968 Chino Avenue <br />INSURER C: Stat _Compensation Insurance Fund 35076 <br />. ­ - - Re <br />Chino CA 91710 <br />. . . ..... .. <br />IN S RER D <br />---- - --------- ... .... - - - — __ <br />-!,,$1 <br />I <br />INSURER E: <br />I <br />INSURER F <br />-------- .......... <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 <br />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 />-- ------- -- illuah� <br />iNSR �%fflyc S <br />S <br />LTR I TYPE OF INSURANCE iNqn wvn I POLICY NUMBER (MWDDNYYY) I <br />LIMITS <br />A COMMERCIAL GENERAL LIABILITY 11000066831181 1/28/2018 1/28/2019 <br />EACH OCCURRENCE $1 <br />$ <br />CLAIMS -MADE OCCUR <br />- � - --I- . _'_i;lQ0_,000 <br />XCU <br />1 PRE_M__SEs1Eaxc®rraRqq)_ __$$�5_0' 0-0-0. <br />MED EXP (Anyone person) 1 S $5,000 <br />----- ---- — - -- ---- <br />-G-E-N"LAG--GR-E,GATE--L-IM-,I-TA-- APPROVED <br />PPLIES PER- <br />PERSONAL & ADV INJURY $ 1 000 <br />r­-­ r I—— <br />PRO- i i <br />I GENERAL AGGREGATE s$2,000,000 <br />_' - - - -_ <br />POLICY jECT LOC <br />F�R AGG S$2,000,000 <br />OTHER: <br />_9DUCTS,-_99MP/OP <br />B AUTOMOBILE LIABILITY !SISIPCA08320518 -7 <br />/28/2018 1/28/2019 <br />COMBINED SiNGLE LIMIT <br />000,000 <br />ANY AUTO <br />-!,,$1 <br />I <br />BODILY INJURY (Per person) I <br />OWNED SCHEDULED <br />AUTOS ONLY L_ AUTOS <br />BODILY INJURY (Per accident) <br />HIRED NON -OWNED <br />i <br />AUTOS ONLY AUTOS ONLY <br />�P .. R . OF . E I R I T I Y .. D - AMAGE ..... . ... . . . . ........ <br />$ <br />(__CeqC aqcidep�_ <br />1$ <br />UMBRELLA LIAB i <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />EXCESS LIAB CLAIMS -MADE <br />.. ........ <br />;AGG REGATE <br />DIED RETENTION$ <br />$ <br />C WORKERS COMPENSATION �9224957-2018 "11/28 <br />AND EMPLOYERS'LIABILITY 1/28/2018 /2019 <br />-,-F—? ] OTIi <br />_ER_ <br />V�-[Xnn ER <br />ANYPROPRIETORIPARTNERJEXECUTIVE Y/N <br />OFFICERIMEMBER EXCLUDED? F N/A <br />E.L. EACH ACCIDENT <br />$$1,000,000 <br />(Mandatory In NH) <br />Ues, describe under <br />E.L. DISEASE - EA E 0 E <br />Y E <br />$Sj�(�QD <br />D SCRIPTION OF OPERATIONS below I <br />E.L. DISEASE - POLICY LIMIT <br />$$1,000,000__ <br />DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />The City of Riverside is named as additional insured on the general liability and auto liability policy -see attached endorsement, <br />The above policies contain a 30 -day notice provision for non -renewal and cancellation, 1 0 -day notice for non-payment of premium. <br />City of Riverside <br />Public Works Department <br />3900 Main Stree <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 />Michael Christian <br />(V 1Vt5t$-ZU1 5 AGORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />4066�954 1 18 19 ri, AL-Up.�-WC,Cp_l I AXi Odebiy� � 3/2/2018 3:29:39 Pll� (PST) I P-ge I Of 4 <br />