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ACCOR" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />1
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />1/17/2020
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />NAME: Dani Schulze
<br />Dealey, Renton & Associates
<br />PHONE
<br />License #0020739
<br />(FAX,
<br />/C_ -427-6810 /C -427-6818
<br />(A No, Ext): 714 A No): 714
<br />E-MAIL
<br />ADDRESS: certificates@dealeyrenton.com
<br />600 Anton Blvd., #100
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />Costa Mesa CA 92626
<br />INSURERA: State Compensation Ins. Fund of CA
<br />35076
<br />INSURED MECONSTRU
<br />INSURERB: Wesco Insurance Company
<br />25011
<br />M&E Construction,
<br />DAMAGE TO RENTED
<br />DBA: M & E Construction
<br />INSURERC: Allied World Surplus Lines Insurance Company
<br />24319
<br />INSURER D
<br />7938 Wood Road
<br />Riverside CA 92508
<br />INSURER E:
<br />INSURER F:
<br />$100, 000
<br />COVERAGES CERTIFICATE NUMBER: 1865866016 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AE30VE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE 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 />INSIR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />INSD
<br />BIR
<br />WVD
<br />D
<br />POLICYNUMBER
<br />PC
<br />POLICY EFF
<br />(MM/DD/YYYY)
<br />POLICY EXP
<br />(MM/DD/YYYY)
<br />LIMITS
<br />C
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />0250573124
<br />0250573124
<br />11/30/2019
<br />11/30/2020
<br />EACH OCCURRENCE
<br />$1,000,000
<br />F7�vl
<br />DAMAGE TO RENTED
<br />CLAIMS -MADE Ln -1 OCCUR
<br />PREMISES (E. occurrence)
<br />$100, 000
<br />MED EXP (Any one person)
<br />$5,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />AGGREGATE LIMIT APPLIES PER
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GEN'L
<br />PP,
<br />APPROVE�D]
<br />Fy] PRO -
<br />POLICY F-1 LOC
<br />PRODUCTS - COMP/OP AGG
<br />$2,000,000
<br />$
<br />OTHER
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />WPP1803021
<br />10/22/2019
<br />10/22/2020
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$
<br />BODILY INJURY (Per person)
<br />$1,000,000
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$1,000,000
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />$
<br />X
<br />HIRED AUTOS NON -OWNED
<br />X AUTOS
<br />UMBRELLA LAB
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION$
<br />$
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y/N
<br />915149219
<br />9/22/2019
<br />9/22/2020
<br />ER JOTH-
<br />X SPTATUTE I ER
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />OFFICER/MEMBER EXCLUDED? F—]
<br />N/A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />***ALL OCIPAA/RAP Projects are Excluded—
<br />Re: All Operations as pertains to named insured.
<br />Additional InsuredAA/aiver of Subrogation Endorsement is granted as to Automobile Liability policy, naming City of Riverside, its officers, employees and agents
<br />as additional insured, per attached endorsement #ILPISCH0414, Waiver of Subrogation Endorsement as to Commercial General Liability policy is granted as
<br />against City of Riverside, per attached endorsement #CG 24 04 10 93. Waiver of Subrogation Endorsement as to Worker's Compensation policy is granted in
<br />favor of City of Riverside, per attached endorsement SCIF FORM 10217 {REV.4- 2018).
<br />CERTIFICATE HOLDER CANCELLATION 30 Days Notice of Cancellation
<br />@ 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) 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 />Attn: Robert Wise
<br />AUTHORIZED REPRESENTATIVE
<br />3900 Main Street, 4th Floor
<br />Riverside CA 92522
<br />@ 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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