V.S.S. Sales, Inc. Vaughan's Industrial Repair, Inc

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DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 2/20/2019 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 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). CONTACT PRODUCER Catherine Montoya NAME: FAX PHONE (949)852-1131 (949)852-0909 Milestone Risk Management & Insurance Services (A/C, No): (A/C, No, Ext): E-MAIL cmontoya@milestonepromise.com License No. 0B72766 ADDRESS: 8 Corporate Park, Suite 130 INSURER(S)AFFORDINGCOVERAGENAIC# IrvineCA92606 Liberty Surplus Insurance Corp10725 INSURER A : INSURED American Fire & Casualty Insurance24066 INSURER B : V.S.S. Sales, Inc. Vaughan's Industrial Repair, Inc. Underwriters at Lloyds15792 INSURER C : 16224 Garfield Avenue Insurance Company of the West027847 INSURER D : Ohio Casualty Insurance Co.24074 INSURER E : ParamountCA90723-0000 INSURER F : 19/20 Master COVERAGESCERTIFICATENUMBER:REVISIONNUMBER: 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY X 1,000,000 EACHOCCURRENCE$ DAMAGE TO RENTED 100,000 CLAIMS-MADEOCCUR$ AX PREMISES(Eaoccurrence) XY 1000330673012/23/20192/23/2020 5,000 MEDEXP(Anyoneperson)$ 1,000,000 PERSONAL&ADVINJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- X 2,000,000 POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY$ 1,000,000 (Eaaccident) BODILYINJURY(Perperson)$ X ANY AUTO B ALLOWNEDSCHEDULED BODILYINJURY(Peraccident)$ BAA(20)567554982/23/20192/23/2020 XY AUTOSAUTOS NON-OWNED PROPERTY DAMAGE $ XX HIRED AUTOS (Peraccident) AUTOS $ $1000/$1000 Comp/Coll Deductibles UMBRELLA LIAB x EACHOCCURRENCE$ 5,000,000 OCCUR EXCESS LIAB CLAIMS-MADEAGGREGATE$ X 5,000,000 C x CAS0000406012/23/20192/23/2020 $ DEDRETENTION$0 PEROTH- WORKERS COMPENSATION x STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACHACCIDENT$ 1,000,000 N / A OFFICER/MEMBER EXCLUDED? D WSA50441080011/1/201811/1/2019 (Mandatory in NH) Y E.L. DISEASE - EA EMPLOYEE$ 1,000,000 Ifyes,describeunder E.L. DISEASE - POLICY LIMIT$ 1,000,000 DESCRIPTION OF OPERATIONS below Limit/Ded Leased/Rented Equipment$50k/$1k E BKO(19)567554982/23/20192/23/2020 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Where required by written contract and solely as respects work done by and on behalf of the named insured for the City of Riverside it is agreed that the City of Riverside, its officers, employees and agents are included as additional insureds as respects General Liability & Auto Liability with Waiver of Subrogation to apply as respects General Liability, Auto Liability & Workers' Compensation per the attached endorsements. CERTIFICATE HOLDERCANCELLATION (951)826-5622 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Riverside ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Dept. 3900 Main Street AUTHORIZED REPRESENTATIVE Riverside, CA 92522 Catherine Montoya/CAM ©1988-2014ACORDCORPORATION.Allrightsreserved. ACORD25(2014/01)TheACORDnameandlogoareregisteredmarksofACORD INS025 (201401)