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CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />(MM /DD /YYYY) 8/4/2016 <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 endorsements . <br />PRODUCER <br />Dealey, Renton & Associates <br />DRA License 0020739 <br />PO Box 10550 <br />CONTACT <br />NAME: <br />PHONE 714 427 -6810 FAX 714 427 -6818 <br />A/c No <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />Santa Ana CA 92711 -6810 <br />INSURER A: Security National Insurance Company <br />NA114208400 11/30/2015 11/30/2016 <br />EACH OCCURRENCE <br />INSURED MECONSTRU <br />INSURERB:State Compensation Ins. Fund of CA <br />35076 <br />M &E Construction, <br />DBA: M & E Construction <br />INSURERC:Wesco Insurance Company <br />PREMISES ETORENTED <br />PREMISES Ea occurrence <br />7938 Wood Road <br />INSURER D : <br />MED EXP (Any one person) <br />INSURER 7 <br />Riverside CA 92508 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 892310784 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 <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 />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM /DD <br />POLICY EXP <br />MWDD <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />NA114208400 11/30/2015 11/30/2016 <br />EACH OCCURRENCE <br />$1,000,000 <br />CLAIMS -MADE XI OCCUR <br />PREMISES ETORENTED <br />PREMISES Ea occurrence <br />$100,000 <br />MED EXP (Any one person) <br />$5,000 <br />PERSONAL BADVINJURY <br />$1,000,000 <br />4PPROVED <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER : <br />GENERAL AGGREGATE <br />$2,000,000 <br />POLICY PRO- <br />JECT 1:1 LOC <br />PRODUCTS - COMP /OP AGG <br />$2,000,000 <br />$ <br />OTHER: <br />C <br />AUTOMOBILE <br />LIABILITY <br />Y <br />WPP115058401 <br />8/4/2016 <br />8/4/2017 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1,000,000 <br />BODILYI INJURY (Per person) <br />$ <br />ANY AUTO <br />AUTOWNED X SCHEDULED <br />AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />HIRED AUTOS X NON -OWNED <br />AUTOS <br />X <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />91514922016 <br />1/26/2016 <br />1/26/2017 <br />X PER OTH- <br />STATUTE ER <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? ❑Y <br />N/A <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <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 />** *ALL OCIP/WRAP Projects are Excluded ** <br />Re: All Operations as pertains to named insured. <br />City of Riverside is Additional Insured as respects to General Liability coverage as required by written contract. <br />CERTIFICATE HOLDER CANCELLATION 30 Days notice /10 Days nonpay <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 />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Riverside <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Attn: Kathy Hunt <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />3900 Main Street, 4th Floor <br />Riverside CA 92522 <br />AUTHORIZED REPRESENTATIVE <br />I I <br />I (Fa4J&a44--- I <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 />