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MBWAT -2 <br />OP ID: AH <br />'4�� CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMI °DIYYYY) <br />05/06/2016 <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 <br />Curtis & Harris Insurance Sery <br />CA Box # OF30715 <br />PO Mesa, 3129 APRDV <br />La Mesa, CA 91944 <br />Lucy Harris,MLIS,CPCU,RPLU <br />POLICY NUMBER <br />CONTACT Lucy Harris,MLIS,CPCU,RPLU <br />PHONE 858 -450 -9988 FAX <br />INC. No. Eat): !arc, No): 619- 303 -8994 <br />ADDRES S: Iuc curtisharrisinsurance.com <br />y� <br />INSURER(S) AFFORDING COVERAGE <br />NAIL # <br />INSURER A : James River Insurance Co. <br />12203 <br />INSURED M & B Water Trucks, Inc. <br />5868 Ingvaldsen Place <br />Rancho Cucamonga, CA 91739 <br />INSURER B: Torus National Ins. Co. <br />44776 <br />INSURER C <br />S 1,000,000 <br />INSURER 0 : <br />INSURER E : <br />DAMAGE <br />PREMISES fTO Ea RENTED ence ocwrri <br />INSURER F : <br />COVERAGES <br />CERTIFICATE 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 <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 />MR <br />TYPE OF INSURANCE <br />INSD <br />I <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />PO <br />POLICY EXP <br />(MMIODlYYYYi <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />X <br />000622743 <br />05/02/2016 <br />05/02/2017 <br />EACH <br />EACH OCCURRENCE <br />S 1,000,000 <br />CLAIMS -MADE © OCCUR <br />DAMAGE <br />PREMISES fTO Ea RENTED ence ocwrri <br />$ 50,000 <br />MED EXP (Any one person) <br />$ Excluded <br />PERSONAL 8 ADV INJURY <br />S 1,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY X JEC LOC <br />OTHER. <br />GENERAL AGGREGATE <br />S 2,000,000 <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,000 <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED <br />AUTOS <br />HIRED AUTOS <br />^ <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS <br />COMBINED SINGLE LIMIT <br />IEa eccidenii <br />BODILY INJURY (Per person) <br />5 <br />BODILY INJURY {Par accident) <br />S <br />PROPERTY <br />$ <br />S <br />B <br />X <br />UMBRELLA LIAS <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />78507J151ALI <br />05/02/2016 <br />05/02/2017 <br />EACH OCCURRENCE <br />5 5,000,000 <br />AGGREGATE <br />$ 5,000,000 <br />DED I <br />RETENTION S <br />$ <br />WORKERS COMPENSATION <br />AM] EMPLOYERS LIABILITY Y! N <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N I A <br />I PERTUTE I I WH- <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />5 <br />E.L. DISEASE - POLICY LIMIT <br />S <br />DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) <br />The City of Riverside is named as additional insured per attached <br />form CG2010 07/04 and CG2037 07104 when required by a written contract. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />CITYOF7 <br />City of Riverside <br />ty <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 />AUTHORIZEDREPRESENTATiVE <br />ACORD 25 (2014/01) <br />© 1988.2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />