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A 9 ' CERTIFICATE OF LIABILITY INSURANCE oATp t8� lzala ' 05t0 THIS CERTIFICATE 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), AUTHOR}ZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is art ADDmONAL INSURED, the poflcptie!) must be endorsed- If SUBROGATION IS WAIVED, subject to the tenant and casein:We of the potti y, certaM polities may require an endorsement. *statement on MI5 certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PR>PL E l Phone: t3138.574 -WOO F BCD --921-550E CONSTRUCTION SPECIALTIES INSURANCE SERVICES 100 HOWE AVENUE SUITE 200 NORTH SACRAMENTO CA 95825 Agency Lid/. 0826752 =M -ACT Construction Specialties Insurance Services NAW: 1 IC No ten: 888-874-3800 NO 800-921-5506 E-MA+L Info@csisIns.com aonRr ss: INSURER(S) AFFORDING COVERAGE J NAIL F INSURER : U.S. Specialty Insurance Company 29599 INSURED J B C DESIGN $ BUILD CO 5249 MITCHELL AVENUE RIVERSIDE CA 92505 IrasuRsss INSURER : 12101117 INSURER 6: IP/St/REA E - 3 1,000,000 INSURER F - D DA.rttaIs AISETOREe�,omuaNT re PREca) COVERAGES CERTIFICATE NUMBER: 84816 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 CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POt1CIES. LIMPS SHOWN t.SAY HAVE BEEN REDUCED BY PAID CLAIMS, HSR: LTR TYPE OF INSURANCE mon? sueR POLICY NUMBER POLICY POLICY IMIarOOrrYwn Pouf [MMIOnnrnm MITTS A GENERAL uAelLITY COMMERCIAL GENERAL LIABILITY x U17AC84901-03 12101117 12/01/18 EACH °CCURRENCE 3 1,000,000 X D DA.rttaIs AISETOREe�,omuaNT re PREca) $ 100,000 CLAIMS -MADE , X.1OCCUR MED. EXP (Any one parson) 5 5,000 PERSONAL & ADV INJURY 5 1,000,000 APPROVED GENERALAGGREGATE- 5 2,000,000 GENL AGGREGATE LIMIT APPLIES PER- X1 POL3CYIr PRC• �1 LOC JSCr P PRODUCTS COMPfOP AGG S 2,000,000 5 AUTOMOBILE - _ ..._.. LIABILITY ANYAUTO ALL OWNED AUTOS HfRED AUTOS SCHEDULED AUTOS OWNED AUTOS J C0U.SsNE.-0 E++GLE Limn IEA =Wen* 8 EMILY tNJURY (Per person) $ .NON BODILY INJURY (Per accident) 5 oAAu DROPERWsa [per bcciderel S S UMBRELLA UAB EXCESS LIAR OCCUR CLAMS -MADE, EACH OCCURRENCE 5 AGGREGATE 5 0E0 I IREvecTiav 5 5 WORXERB COMPENSATION An, ENTLOYEA6' IJABILnY ANY PI EDP CFFCERIMEmBER EXCLUDED? IIII0MItlaryIn NN} IF yu, desert(' undo, DESCRIPTION OF OPERATIONS below NIA - I I "WORKERS rrll TORTY u* rrs I I cER S E.L.E+1CHP.CCIDEHT 5 rY�N 1 I E L DISEASE -EA EMPLOYEE 5 E.L DISEASE-FOUCY LIMIT S OEBCRIPTiON OF OPERATIONS f LOCAT10N$ I veN L€S (Attach AGORD 101, Atdditlanal Remarks Schedure, If mono apace 1s requires) "10 DAYS NOTICE FOR NON-PAYMENT, 30 DAYS FOR ALL OTHER THE CITY OF RIVERSIDE AND ITS OFFICERS, EMPLOYEES, AND AGENTS ARE NAMED ADDITIONAL INSURED ONLY AS THEIR INTERESTS MAY APPEAR PER FORM CG 20 33 07 04 ATTACHED. RE: EZEQUIEL L GUZMAN - 3058 LUCERNE PL, RIVERSIDE, CA 92506 CERTIFICATE HOLDER CANCELLATION. THE CITY OF RIVERSIDE RISK MANAGEMENT 3900 MAIN STREET RIVERSIDE, CA 92622 Attention: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TI -IE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPREBENTATLVE Brett Webster ACORD 25 (2010105) ID1988-2010 ACORD CORPORATION. All rigts*S reserved The ACORD name and logo are registered marks of ACORD