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/DATE <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />A� " CERTIFICATE OF LIABILITY INSURANCE <br />(MM/DD/YYYY) <br />INSR <br />LTR <br />05/29/2019 <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 <br />CONTACT Sue Lusk <br />NAME: <br />Cornerstone Specialty Insurance Services, Inc. <br />(714) 731-7750 <br />pAH/CONIJ <br />(714) 731-7700 a/c, <br />EACH OCCURRENCE $ 2'000'000 <br />Ext: No: <br />14252 Culver Drive, A299 <br />E-MAIL sue@cornerstonespecialty.com <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURERA: Travelers Property Casualty Co 25674 <br />Irvine CA 92604 <br />INSURED <br />INSURER B: Travelers Indemnity Co of Conn 25682 <br />C BELOW, INC. <br />INSURER C: Continental Casualty Company 20443 <br />14280 Euclid Avenue <br />INSURER D: <br />INSURER E: <br />PERSONAL &ADV INJURY $ 2,000,000 <br />Chino CA 91710 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 18/19 COVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE 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 INSURANCEAUULbUbK <br />INSD <br />WVD POLICY NUMBER <br />POLICY EFF <br />MM/DD/YYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE $ 2'000'000 <br />CLAIMS -MADE FX OCCUR <br />PREM SDA AGES Ea oNcurDrence $ 100,000 <br />MED EXP (Any one person) $ 5,000 <br />X ADDTL INSRD/PRIMARY <br />X BLNKT WVR OF SUBRO <br />PERSONAL &ADV INJURY $ 2,000,000 <br />A <br />Y <br />Y 680-5H559891 <br />12/18/2018 <br />12/18/2019 <br />LAGGREGATE LIMITAPPLIES PER: <br />GENERAL AGGREGATE $ 4'000'000 <br />''. <br />POLICY ❑X jE�❑LOCfAPPROVED <br />MOTHER <br />PRODUCTS-COMP/OP AGG $4'000'000 <br />$ <br />: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />Ea accident <br />BODILY INJURY (Per person) $ <br />X <br />ANYAUTO <br />B <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />Y <br />Y <br />BA -7D687122 <br />12/18/2018 <br />12/18/2019 <br />BODILY INJURY (Pe r accide nt) $ <br />PROPERTY DAMAGE $ <br />Per accident <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE $ 10'000'000 <br />AGGREGATE $ 10'000'000 <br />A <br />EXCESS LAB <br />CLAIMS -MADE <br />Y <br />Y <br />CUP -4181T634 <br />12/18/2018 <br />12/18/2019 <br />X1 <br />DED I I RETENTION $ 0 <br />$ <br />P` <br />WORKERS COMPENSATION/� <br />AND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />N /A <br />Y <br />XJUB-8J675252 <br />12/18/2018 <br />12/18/2019 <br />STATUTE EORH <br />1 ,000,000 <br />E.L. EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYEE $ 1 ,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />1000000 <br />E.L. DISEASE - POLICY LIMIT $ , , <br />Each Claim $2,000,000 <br />C <br />Professional Liability <br />Claims Made <br />MCH288306745 <br />12/18/2018 <br />12/18/2019 <br />Annual Aggregate $2,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />The City of Riverside and its officers, employees and agents, are Additional Insured for General & Auto Liability including Primary and Non -Contributory <br />Wording and Waiver of Subrogation applies per attached <br />endorsements, but only if required by written contract with the Named Insured prior to an occurrence. Coverage is subject to all policy terms and conditions. <br />"30 days notice of cancellation, except for 10 days notice for non-payment of premium. For Professional Liability, the aggregate limit is the total insurance for <br />all covered claims reported within the policy period. <br />CERTIFICATE HOLDER CANCELLATION <br />@ 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />City of Riverside <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />3900 Main Street <br />Riverside CA 92522 <br />@ 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />