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Client #: 393205
<br />YALECHA1
<br />ACORD.,,, CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM /DD/YYYY)
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />10/19/2016
<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 />CONTACT Natalie Berend
<br />NAME:
<br />USI Insurance Services LLC -CL
<br />PHONE g18 251 -3016 FAX 610 -362 -8470
<br />A/C, No, Ext : (A/C, No):
<br />Lic # OG11911
<br />E -MAIL
<br />ADDRESS: natalie.berend @usi.biz
<br />21700 Oxnard Street, Suite 1200
<br />07101/2016
<br />07/01/2017
<br />EACH OCCURRENCE
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />Woodland Hills, CA 91367
<br />INSURER A: Zurich American Insurance Compa
<br />16535
<br />INSURED
<br />INSURER B: Travelers Property Casualty Co
<br />25674
<br />Yale /Chase Equipment and Services, Inc.
<br />PREMISESOEa..0 ence
<br />$1,000,000
<br />RCSSK Enterprises, LLC
<br />INSURER C:
<br />MED EXP (Any one person)
<br />$10,000
<br />Hawaiian Lift Truck, Inc.
<br />INSURER D
<br />Po Box 123, La Puente, CA 91749
<br />INSURER E :
<br />APPROVED
<br />INSURER F
<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
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />NSR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />(MM /DD /YYYY)
<br />POLICY EXP
<br />(MM /DD /YYYY)
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />GL0038175601
<br />07101/2016
<br />07/01/2017
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CLAIMS -MADE X OCCUR
<br />PREMISESOEa..0 ence
<br />$1,000,000
<br />X
<br />MED EXP (Any one person)
<br />$10,000
<br />Ded: $0
<br />APPROVED
<br />PERSONAL 8 ADV INJURY
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />PRO -
<br />POLICY X JECT X LOC
<br />PRODUCTS - COMP /OPAGG
<br />$2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />BAP038175701
<br />0710112016
<br />071011201
<br />(CEO MBIN SINGLELIMIT
<br />$1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />$
<br />X
<br />omp /Coll X $1,000
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />ZUP81 M4406916NF
<br />0710112016
<br />071011201
<br />EACH OCCURRENCE
<br />$10,000,000
<br />AGGREGATE
<br />$1 O OOO OOO
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I X RETENTION $0
<br />$
<br />•
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? [Y]
<br />N/A
<br />WC038175501
<br />07/0112016
<br />0710112017
<br />STATUTE EERH
<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 $1,000,000
<br />•
<br />Hired Auto
<br />BAP038175701
<br />0710112016
<br />071011201
<br />ACV
<br />Physical Damage
<br />Comp- Deductible:$1,000
<br />Coll- Dedictible:$1,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Certificate Holder is included as Additional Insured as respects operations of the Named Insured, per
<br />company form #U -GL- 1345- BCW(04 -13) and #U -GL- 1175- FCW(04 -13). Additional Insured status is valid only if a
<br />written contract is required of the insured and is in effect.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Riverside
<br />3900 Main Street
<br />Riverside, CA 92522 -0000
<br />ACORD 25 (2014/01) 1 of 1
<br />#S19127211/M18077012
<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 />© 1988 -2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />SZKJA
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