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ACC)R " CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDDIYYYY) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />06/17/2020 <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 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 CONTACT Administrator <br />NAME: <br />PYA Insurance Brokerage AICNNo Ext: 877-446-2071 AIS No: 877-841-1246 <br />2151 S Haven Ave E-MAIL COI@PYAIB.COM <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />Ontario CA 91761-0742 INSURERA: Hiscox Business Insurance 10200 <br />INSURED ..., ,� ercial Auto <br />20260 <br />Ybanag Realty & Development Corp.I' eferred Insurance Company <br />10346 <br />DBA: D'Ybanag Construction Company DYCC APPROVED' <br />4293 N Webster AV <br />Perris CA 92571-7456 INsuRERF: <br />COVERAGES CERTIFICATE NUMBER: 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 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />AVD <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD/YYYY <br />POLICY EXP <br />MMIDD/YYYY <br />LIMITS <br />K <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1.000.000 <br />CLAIMS -MADE L OCCUR <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$ 100 ��� <br />MED EXP (Any one person) <br />$ 5.000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />A <br />Y <br />Y <br />UDC4071704CGL-20 <br />02/15/2020 <br />02/15/2021 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2.000.000 <br />iC <br />POLICYEl PROJECT � LOC <br />PRODUCTS - COMP/OP AGG <br />$ 1.000.000 <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />B <br />OWNED KSCHEDULED <br />AUTOS ONLY AUTOS <br />Y <br />Y <br />504610131062001 <br />11/08/2019 <br />11/08/2020 <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED RETENTION $ <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? Y❑ <br />(Mandatory in NH) <br />NIA <br />Y <br />EIG2649745-00 <br />05/23/2020 <br />05/23/2021 <br />K PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1.000.000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 000 000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Re: Description of work performed for the city of Riverside, reference to event or description of operations. <br />The City of Riverside and its officers, employees, and agents shall be named as additional insured as respects to the operations of the named insured per attached General <br />Liability Form CA 20 4810 13 and Automobile liability form Workers Compensation waiver of subrogation applies in favor of City of Riverside per attached form CA 04 44 <br />1013 <br />CERTIFICATE HOLDER CANCELLATION <br />City of Riverside <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Risk Management <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />3900 Main Street <br />Riverside CA 92522 <br />AUTHORIZED REPRESENTATIVE <br />III' <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />