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CLEEENT-01 JHOUSEI <br />ACORL7µ' CERTIFICATE OF LIABILITY INSURANCE <br />`.�•-'' <br />DATE(MM/DD/YYYY) <br />02/08/2019 <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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER License # 0757776 <br />CONTACT Jordan Bartleson <br />NAME: <br />PHONE(A/C, No):(951) 788-8502 <br />(A/C, No, Ext): (951) 788-8500 <br />Riverside, CA - HUB International Insurance Services Inc. <br />PO Box 5345 <br />Riverside, CA 92517 <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />12/11/2019 <br />INSURERA: West American Insurance Co <br />44393 <br />INSURED C Lee Enterprises DBA Tower Property Management <br />INSURER B: American Fire and Casualty Company <br />24066 <br />MED EXP (Any oneperson) <br />$ 15,000 <br />DBA Tower Realty DBA Windermere Inland Properties <br />INSURER 7 <br />APPROVED <br />INSURER D: <br />$ 1,000,000 <br />Inc. and Windermere Tower Properties <br />7197 Brockton #6 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />Riverside, CA 92506 <br />INSURER E : <br />$ <br />A <br />AUTOMOBILE <br />X <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 CONTRACT OR 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <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 />CLAIMS -MADE X OCCUR <br />BI/PD Ded: $500 <br />X <br />BKW55860395 <br />12/11/2018 <br />12/11/2019 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />500,000 <br />$ <br />X <br />GEN'L <br />MED EXP (Any oneperson) <br />$ 15,000 <br />APPROVED <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />AGGREGATE LIMIT APPLIES PER: <br />j <br />POLICY JO <br />ECT � LOC <br />OTHER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMP/OPAGG <br />$ 2,000,000 <br />$ <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIREDX NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />BKW55860395 <br />12/11/2018 <br />12/11/2019 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />1,000,000 <br />$ <br />BODILY INJURY Perperson) <br />$ <br />BODILY INJURY Per accident <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />B <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />USA55860395 <br />12/11/2018 <br />12/11/2019 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />AGGREGATE <br />$ 2,000,000 <br />DED X RETENTION $ 0 <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />City of Riverside is named as additional insured perform CG8810 04/13 when required per written contractor agreement. <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Ci of Riverside <br />City <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />3635 Market Street <br />Riverside, CA 92501 <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />