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L7► 4CERTIFICATE OF LIABILITY INSURANCE, RANCE, ETE15� � 9 i�'I
<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 />BELOK THIS CERTIFICATE OF INSURANCE DOZES NOT CONSTITUTE A CONTRACT BETWEEN THE IISSUIINO INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the p olicy(Ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to, the terms and conditions of the policy, certain policiesmay require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate hinder in lieu of such endorsement(s),
<br />PRODUCER COIA NTACT "Thomas PlOuffe / Mlllctlael Plouaffe
<br />_ m,...".
<br />Reciall lnSUrance, LTL. wauowE� 903-951-7095 &q e� 203-43"1--016,62
<br />�_. _...____.._.. _ _I�=, ,1�-
<br />P,> , Box 19901 ADOR S& tomjiCtspeciah.yu usLuranceit'd.co m /mploufte rnai .ccr
<br />West Haven, CT 0951
<br />.._-.. .-.__.— ..._."... ,INSURE�OR INOERAGE ..a..".LAIC
<br />„
<br />-----
<br />--_ IlC.............._ .......
<br />"declal Insurauceltdccm SURACain UdrvntersLqqLda152
<br />"........ ®............ ....
<br />INSURED.........
<br />INSURE
<br />N,MWsaImTSRs CRUMI ANIS FOSTER
<br />mMN�IdRsc; ro lesslve: United .
<br />hrl3porraeuclal Cas Inc 1117711
<br />12842 Valley ' '1ew St # 103 INSURER a,
<br />" - -
<br />Garden Greve, A 92845
<br />���.�.m�.�.... _..... � ...".... ..... �.. .._...
<br />COVERAGE'S CERTIFICATE NUMBER.
<br />REVISION NUMBER:
<br />THIS IIS 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
<br />DOCUME"1NT' WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIf+I„ THE IINSURANCE AFFORDED BY THE POLICIES DESCRIIBPD HERON IS SUBJECT TO AL,I. THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMII"S SHOWN NAY RAVE BEEN REDUCED BY PAAD CLAIMS.
<br />w.U�..,
<br />POLICY
<br />OSESE" M D IJ ExP
<br />(LTR 'rime IIP IIM#SURAN'p�CE� � s ,. ' POLICY WUiN+Aa,E�R�
<br />........ . . ....� .. . .--......
<br />... LIMITS
<br />COMMERCIAL GFEMtlE,'RAL LIABI L,IYY
<br />A IC M8, 193' 4/17N19 4/17/21)
<br />1 1 00 i11�C�7
<br />S
<br />�
<br />1-
<br />.. �
<br />I1��mT B��
<br />300
<br />.. ... CLAIMS -MADE T,.1 OCCUR
<br />Fi�l�'E.MItl%� Pau rarc„aBtttns, � $ ,00,0
<br />� ._
<br />..----......---
<br />MF FXP (Any �aneapapsM. crnl `' 5 10,000....
<br />f
<br />PSR Lm6A6 SACMIIVIImIR/1 00,00
<br />iir'RI AL"GREY"AT'h f IM'IrAPPI) E—SPERAPPROVED
<br />GFNERAt AGGREGATE 1 ,$ 5 X0'0,000
<br />POLICY 1:�..w..� J T �........� L i
<br />.. ..... ...,......
<br />......
<br />0,000 ..
<br />PR�ii��t.7�o.-LLBIh+VPP�",J�PAP.�R., � $.-...-._ 5 0----
<br />I_... OTIHER
<br />.
<br />AUTOMOBILE
<br />ARl"rC8 �43a�LE�VAR'IILITi
<br />CCY59 687-11 4/18/19 4118J20
<br />acs d a LE LIMMT 1,000,000
<br />...... ...."...
<br />8.drPIL"r'" pra„14.YRi` Rine Perun $�.�"
<br />OWNED Sr, 9EQULEL
<br />AUTOS ONLY X AUTOS
<br />--.,
<br />0DILY, �NJURY (Per Pr6danklS
<br />RFD .NONND
<br />X
<br />.............�m..m..".�
<br />PROPERTY OAMAGE $
<br />AI-O;NLr
<br />II �.m......
<br />uimaRELLALIAa OCCUR
<br />A( 71 1 a�C I S 4117/"i 9 4/17JC
<br />X,
<br />FAP E L L RRr6JCB' 1,000,000
<br />EXCESS LIAS CLAIMS -MADE
<br />_. .
<br />AGGREGATE $ 1,O110i 00011
<br />I)FD 1 RETENTION S
<br />WORKERS COMIPENWSATIONR
<br />Y�" H-
<br />STAT9TE
<br />AND EMPLOYERS" LIVABILITY ''r d qW
<br />_ .m._...... ......".�.,.�_
<br />JaNYPROPRUE-TORYPARTNE�RAEXF,V-,1.!'TI''�r"E ��""
<br />, 14NA
<br />OPP3C:ERXm.NPMBrf'ri6.CL'11CIECN" r
<br />",.L IEAtt H AGGIC7EIv1 S
<br />E,.. ...". �,.” .... ........__......_
<br />(Mandatory on Noi$
<br />F'.L kYIS ASP rAE�MPLI1YEE S
<br />DIf etiIPI.Noisrl&,r
<br />CPS'GRIf�1"Va'VMI ChF OF,,RATICkhJ,a Yaelerw
<br />�. ......... , ,.....
<br />E.L. DISEASE -POLICY OMIT S
<br />EXCESS X SEi -11042, 9 1 411711 4/17/20
<br />3 millIionener N Aggregate
<br />3' Killian Per C urrenee 1
<br />OESO'RIIF MON OF OPERATIONS d LOCATIONS I VEHICLES (ACORD 101, AdIINIanal R'amaees SC.$'4 Jule, may be anarlhed If more space Is raquIrad)
<br />Citi" of riverside Parks and Rec. and City, of Riverside ide rare added as an eddiitluenal insured per the attached
<br />endorsementCC_GL- LAI (101117) as respects "airm nt Perk Celebration, located at 2601 Fairmont. Blvd.,
<br />Riverside,CA 02501 from Sept. 117 -24, 201 �
<br />City of Riverside Parks and Rec. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE;
<br />EXPIRATION DATE THEREOF„ NOTICE WILL BE DELIVERED IIN
<br />26011 Fairmont Blvd. A ACCORDANCE WITH THE POLICY PROVISIONS,
<br />Riverside, CSI 925101
<br />AUTHOPmRREO REPRESENT ATII E
<br />umow.,
<br />1985-20(15 ACORO CORPORATION. Ally rights (reserved.
<br />ACORD 25 (2 i1 EV83) The ACORD name and logo are registered marks of ACORD
<br />
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