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GHURTAD-01 FADST1 ACORO°° CERTIFICATE OF LIABILITY INSURANCE ll►� DATE(MMIDD/YYYY) 10/31/2019 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). PRODUCER CONTACT Stephanie Fader NAME: PHONE FAX (A/C, No, Ext): (949 ) 583-0300 (A/C, No): Solomon & Solomon Insurance Brokers 24411 Ridge Route Dr Ste 135 Laguna Hills, CA 92653 ADDARESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Continental Insurance Co 35289 INSURED INSURER B: Continental Casualty Company 20443 INSURER C: Insurance Co. of The West 27847 G. Hurtado Construction Inc. INSURER D : 9/6/2019 16130 Reiner Cr. Riverside, CA 92504 INSURER E DAMAGE TO RENTED PREMISES Ea occurrence INSURER F: MED EXP (Any one person) COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE FArl OCCUR 6015875040 9/6/2019 9/6/2020 DAMAGE TO RENTED PREMISES Ea occurrence 100,000 $ MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:APPROVE-Dj GENERAL AGGREGATE $ 2,000,000 POLICY �X JECT LOC PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ X BODILY INJURY (Per person) $ ANY AUTO 6083410530 6/14/2019 9/6/2020 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ AUTOS ONLY X AUUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS -MADE 6057025395 9/6/2019 9/6/2020 AGGREGATE $ 2,000,000 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE WSA504866700 6/1/2019 6/1/2020 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ OFFICER/MEMBEREXCLUDED? ❑ (Mandatory in NH) N /A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ A Equipment Floater 6020259822 7/29/2019 7/29/2020 Limit 600,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: Dry utility installation/Riverside, CA; Enchroachment Permit City of Riverside is hereby named as additional insured with Primary Non-contributory per blanket additional insured forms CNA75079XX (10-16) & CNA74879XX(1-15). Policy provides 30 days written notice of cancellation for other than non-payment of premium CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Ci of Riverside THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Dep. 3900 Main St. AUTT/H;ORIZED REPRESENTATIVE Riverside, CA 92522 A" ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD