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H&HGENE -01 CMOUNTZ .4COR0 k....__-- CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DDIYYYY) 7/21/2017 THIS CER11FICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CER11FICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 0C36861 Alliant Insurance Services, Inc. 735 Carnegie Dr Ste 200 San Bernardino, CA 92408 NAME: CT Christina M Mountz PHONE g09 886 -9861 Fax 909 886 -2013 INC No Ext):� ) (Arc, No): ( ) E-MAIL SS: cmountz@alliant.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : I ndia n Harbor Insurance Company 36940 INSURED H & H General Contractors Inc PO Box 536 Highland, CA 92346 INSURER B :West American Insurance Company 44393 INSURER C :StarStone National Insurance Company 25496 INSURERD: $ 1,000,000 INSURERS: INSURER F : X COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR R TYPE OF INSURANCE IA INSD WVD POLICY NUMBER POLICY EFF (MM1DDlYYYY) POLICY EXP (MM1DD /YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X ESG004796801 07/26/2017 07/26/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE= 10 REN I ED PREMISES (Ea occurrence) $ 50,000 X BIIPD Ded $5,000 MED EXP An one y person) 5,000 $ 5 000 APPROVED L PERSONAL &ADVINJURY $ 1,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES jE PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OPAGG $ 2,000,000 $ B AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS Comp Ded $1,000 X X SCHEDULED AUTOS ISTO-OSVVN ED Coll Ded $1,000 X BAW (18) 57 45 66 09 07/26/2017 07/26/2018 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Pea accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER /ME MBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y 1 N Y N I A 710170316 01/01/2017 01/01/2018 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Encroachment permit for Project #1 -0- 00071 -04; Monroe MDP - Monroe Channel, Stage 4. City of Riverside and their officers, employees and agents are additional insureds as respects general liability and business auto per endorsements attached. CERTIFICATE HOLDER CANCELLATION City of Riverside Risk Management 3900 Main St Riverside, CA 92522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) © 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD