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<br />MEADHU1OPID:MRH
<br />DATE(MM/DD/YYYY)
<br />CERTIFICATEOFLIABILITYINSURANCE
<br />11/19/2018
<br />THISCERTIFICATEISISSUEDASAMATTEROFINFORMATIONONLYANDCONFERSNORIGHTSUPONTHECERTIFICATEHOLDER.THIS
<br />CERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYTHEPOLICIES
<br />BELOW.THISCERTIFICATEOFINSURANCEDOESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER(S),AUTHORIZED
<br />REPRESENTATIVEORPRODUCER,ANDTHECERTIFICATEHOLDER.
<br />IMPORTANT:IfthecertificateholderisanADDITIONALINSURED,thepolicy(ies)musthaveADDITIONALINSUREDprovisionsorbeendorsed.
<br />IfSUBROGATIONISWAIVED,subjecttothetermsandconditionsofthepolicy,certainpoliciesmayrequireanendorsement.Astatementon
<br />thiscertificatedoesnotconferrightstothecertificateholderinlieuofsuchendorsement(s).
<br />CONTACT
<br />608-257-3795PhilHausmann,CIC
<br />PRODUCER
<br />NAME:
<br />Hausmann-JohnsonInsuranceInc
<br />PHONEFAX
<br />608-257-3795608-257-4324
<br />(A/C,No,Ext):(A/C,No):
<br />700RegentSt.,POBox259408
<br />E-MAIL
<br />Madison,WI53725-9408
<br />ADDRESS:
<br />PhilHausmann
<br />INSURER(S)AFFORDINGCOVERAGENAIC#
<br />TravelersCasualty&Surety19038
<br />INSURERA:
<br />Mead&Hunt,Inc.
<br />INSURED
<br />INSURERB:
<br />M&HArchitecture,Inc.
<br />INSURERC:
<br />Mead&HuntCompanies,Inc.
<br />Mead&HuntInternational,Inc
<br />INSURERD:
<br />2440DemingWay
<br />INSURERE:
<br />Middleton,WI53562-1562
<br />INSURERF:
<br />2016-1
<br />COVERAGESCERTIFICATENUMBER:REVISIONNUMBER:
<br />THISISTOCERTIFYTHATTHEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIOD
<br />INDICATED.NOTWITHSTANDINGANYREQUIREMENT,TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS
<br />CERTIFICATEMAYBEISSUEDORMAYPERTAIN,THEINSURANCEAFFORDEDBYTHEPOLICIESDESCRIBEDHEREINISSUBJECTTOALLTHETERMS,
<br />EXCLUSIONSANDCONDITIONSOFSUCHPOLICIES.LIMITSSHOWNMAYHAVEBEENREDUCEDBYPAIDCLAIMS.
<br />INSRADDLSUBRPOLICYEFFPOLICYEXP
<br />TYPEOFINSURANCEPOLICYNUMBERLIMITS
<br />(MM/DD/YYYY)(MM/DD/YYYY)
<br />LTRINSDWVD
<br />1,000,000
<br />A
<br />COMMERCIALGENERALLIABILITY
<br />X
<br />EACHOCCURRENCE$
<br />DAMAGETORENTED
<br />300,000
<br />CLAIMS-MADEOCCUR
<br />X
<br />P6305C656013TIL1812/01/201812/01/2019
<br />$
<br />PREMISES(Eaoccurrence)
<br />10,000
<br />MEDEXP(Anyoneperson)$
<br />1,000,000
<br />PERSONAL&ADVINJURY$
<br />2,000,000
<br />GEN'LAGGREGATELIMITAPPLIESPER:GENERALAGGREGATE$
<br />PRO-
<br />2,000,000
<br />XX
<br />POLICYLOC
<br />PRODUCTS-COMP/OPAGG$
<br />JECT
<br />OTHER:$
<br />COMBINEDSINGLELIMIT
<br />1,000,000
<br />A
<br />AUTOMOBILELIABILITY
<br />$
<br />(Eaaccident)
<br />X
<br />ANYAUTO P8106C161444IND1812/01/201812/01/2019
<br />BODILYINJURY(Perperson)$
<br />OWNEDSCHEDULED
<br />AUTOSONLYAUTOSBODILYINJURY(Peraccident)$
<br />PROPERTYDAMAGE
<br />HIREDNON-OWNED
<br />XX
<br />(Peraccident)$
<br />AUTOSONLYAUTOSONLY
<br />$
<br />9,000,000
<br />A
<br />XX UMBRELLALIAB
<br />OCCUR
<br />EACHOCCURRENCE$
<br />CUP0K301101174312/01/201812/01/2019
<br />9,000,000
<br />EXCESSLIABCLAIMS-MADE
<br />AGGREGATE$
<br />0
<br />X
<br />DEDRETENTION$
<br />$
<br />PEROTH-
<br />WORKERSCOMPENSATION
<br />A
<br />X
<br />STATUTEER
<br />ANDEMPLOYERS'LIABILITY
<br />Y/N
<br />UB8J3173931743VWI12/01/201812/01/2019
<br />1,000,000
<br />A
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />E.L.EACHACCIDENT$
<br />N/A
<br />OFFICER/MEMBEREXCLUDED?
<br />UB8J2154321743E-OTHSTAT12/01/201812/01/2019
<br />1,000,000
<br />(MandatoryinNH)
<br />E.L.DISEASE-EAEMPLOYEE$
<br />Ifyes,describeunder
<br />1,000,000
<br />DESCRIPTIONOFOPERATIONSbelowE.L.DISEASE-POLICYLIMIT$
<br />DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES(ACORD101,AdditionalRemarksSchedule,maybeattachedifmorespaceisrequired)
<br />RE:RiversideMunicipalAirport-Whenspecifiedinwrittencontractthe
<br />CityofRiverside,anditsofficers,employees,andagentsarelistedas
<br />AdditionalInsuredonaPrimary&Non-Contributorybasiswithrespectto
<br />CommercialGeneralLiabilityandCommercialAutoLiability.Waiversof
<br />SubrogationapplyinfavoroftheAdditionalInsuredwithrespecttoNEXT
<br />CERTIFICATEHOLDERCANCELLATION
<br />CITYRIV
<br />SHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDBEFORE
<br />THEEXPIRATIONDATETHEREOF,NOTICEWILLBEDELIVEREDIN
<br />CityofRiverside
<br />ACCORDANCEWITHTHEPOLICYPROVISIONS.
<br />3900MainStreet
<br />Riverside,CA92522
<br />AUTHORIZEDREPRESENTATIVE
<br />ACORD25(2016/03)©1988-2015ACORDCORPORATION.Allrightsreserved.
<br />TheACORDnameandlogoareregisteredmarksofACORD
<br />
<br />
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