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• rCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 02/22/2019 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), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). CONT PRODUCER NAMEA T Ali Hussain Hawk's Bay Auto Insurance PHONE Qy�M<,; 951-588 0757 a� Nel; 951-588-0761 5800 Van Buren Blvd Ste 108 E-MAIL ApDREss: hawksbay2C yahoo com ------- Riverside CA 92503 — INSURER(S) AFFORDING COVERAGE INSURED Ortiz , Yolanda 6449 Rutland Avenue Riverside , CA 92503 INSURER D F: The American Insurance nnvcoAn_co rcorrnrArc KIH"01=0• RFVICICIN NIIMRFR, 21857 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ACCORDANCE WITH THE POLICY PROVISIONS. ADDL SUBR------------- AUTHORIZED REPRESENTATIVE POLICY EFF POLICY EXP Robert V. Nuccio C G. G c1 /fes LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY XXC80514929 4/13/2019 04/15/2019 EACHOCCURRENCE $ _1,000,000 bArv��°rb ti�Jr YT"15__ PREMISES (Ea occurrence $ 50,000 50,00 _ -- Z .� CLAIMS -MADE OCCUR NAEP086155 MED EXP Any one person) $ 0 OSt �.jquor LlaiJlllty PERSONAL & ADV INJURY -- - $ 1,000,000 ...._. .... GEN'L AGGREGATE LIMIT APPLIES PER: AGGREGATE .._ —.. ___ $ 2 000 000 _ -- '--. ._... PRO- POLICY [.. —� JECT LOC APPROVEDGENERAL PRODUCTS-COMP/OP AGO $ 1,000,000_ . . ..... $ OTHER COMBINED SINGLE LIMIT _{Ea accident) $ AUTOMOBILE LIABILITY ANY AUTO BODILY INJURY (Per person) $ OWNED _ SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED PROPERTY DAMAGE --------------- AUTOS ONLY AUTOS ONLY UMBRELLA LIAB -- OCCUR EACH OCCURRENCE —.._._ .. . RENCE-_.,,, $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION STATUTE ERH AND EMPLOYERS' LIABILITY Y / N _ _ ANYPROPRIETOR/PARTNER/EXECUTIVEEl E.L. EACH OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E LDISEASE -„EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Additional Insured: Additional Insured - General Liability is included as per form CG 20 26 07 04 as required by written contract. Additional Insured - General Liability: City of Riverside The City of Riverside, Its Officers, Employees, And Agents rAAIr CI I ArInN City of Riverside Risk Management SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3900 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Riverside , CA 92522 AUTHORIZED REPRESENTATIVE Robert V. Nuccio C G. G c1 /fes IJIU00-AVl0AkdVRLl VVI[rVRHIIVIV. M1I IKUIRZO IWTWIVC.N. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD