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SW HOCHSTETLER EQUIPMENT RENTAL
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Last modified
6/7/2019 11:36:57 PM
Creation date
11/26/2018 12:54:31 PM
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General
Department
City Clerk
General - Type
Agendas
General 2 - Date
11/26/2018
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FU <br />CITY OF RIVERSIDE SP <br />4268 LIME STREET <br />3900 MAIN ST RIVERSIDE <br />RIVERSIDE CA 92522-0001 CA 92501 <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the <br />California Insurance Commissioner to the employer named below for the policy period indicated. <br />This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. <br />We will also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. <br />This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded <br />by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document <br />with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance <br />afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. <br />ze--,egel W,,el <br />Authorized Representative President and CEO <br />EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. <br />ENDORSEMENT #0015 ENTITLED ADDITIONAL INSURED EMPLOYER EFFECTIVE 2018-11-19 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. NAME OF ADDITIONAL INSURED: <br />CITY OF RIVERSIDE <br />ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 08-01-2006 IS <br />ATTACHED TO AND FORMS A PART OF THIS POLICY. <br />ENDORSEMENT #1651 - SCOT W HOCHSTETLER PRESIDENT - EXCLUDED. <br />ENDORSEMENT #1651 - ROBYN HOCHSTETLER VP,SEC - EXCLUDED. <br />SCOT HOCHSTETLER CONTRACTING INC AND/OR SP <br />HOCHSTETLER,SCOT W AND/OR HOCHSTETLER, ROBYN <br />41396 COLLEGIAN WAY <br />HEMET CA 92544 <br />[SITY,CN] <br />(REV.7-2014) PRINTED : 11-19-2018 <br />
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