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<br />ridOSyYCERTIFICATEOF LIABILITY INSURANCE
<br />RATE (NM/DDIYYYY)
<br />4/21/2020
<br />THIS CERTIFICATE 15 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 CE'RTIFICAT'E HOLDER.
<br />IMPORTANT': If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) 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 Iholder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />NAME;
<br />IAA No, (714) 524-4:940
<br />Commercial Associates Insurance(714)524-4949
<br />1594 N. Batavia Street
<br />E-MAIL
<br />ADDRESS:
<br />_INS�URERJ§I. AFFORDING COVERAGE __.._.25682
<br />NAIL#
<br />Orange, CA 92867
<br />INSURERA;Travelers Indemnitv Go of CT
<br />_America... ..25674
<br />A
<br />CLAIMS -MADE � OCCUR
<br />INSURED
<br />INSURER.B:Travelers Prop.....Cas Cc of
<br />INSURER C:
<br />W.A. Rasic Construction Co., Inc.
<br />INSURER D : _...
<br />_.. _....
<br />4150 Long Beach Blvd.
<br />Long Beach, CA 90'80'7
<br />INSURER E:
<br />5/1/2020
<br />INSURER F'
<br />MED EXP (Any one person) $ 10,000
<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 CONTRACTOR 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 />TYPE OF (INSURANCE
<br />ADD
<br />SUSR
<br />POLICY NUMBER
<br />POLICY EFF
<br />SAM/DD/YYYY
<br />POLICY EXP
<br />IMM/DD/YYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE $ 2,000,000
<br />A
<br />CLAIMS -MADE � OCCUR
<br />DAMAGE TORI TED 300,000
<br />PREMISES (Ea pccurra �cai $
<br />X
<br />Y DT22-CO-8670X247-TCT-20
<br />5/1/2020
<br />5/1/2021
<br />MED EXP (Any one person) $ 10,000
<br />_
<br />PERSONAL & ADV INJURY $ 2,000,000
<br />GENERAL AGGREGATE $ 4,000,000
<br />GENL
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY I I JECT M LOCAPPROVED
<br />PRODUCTS - COMP/OP AGG $ ._ 4,000,000
<br />._... . _
<br />OTHER:
<br />$
<br />COMBINED SINGLE LIMIT $ 2 000 `000
<br />Ea a, dent.
<br />AUTOMOBILE
<br />LIABIL IiTY
<br />BODILY INJURY (Per person) $
<br />$
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED_.._..__..�......_..___.�,
<br />AUTOS AUTOS
<br />X
<br />Y
<br />DT -81.0 -8674X247 -TIL -20
<br />5/1/2020
<br />5/1/2021
<br />BODILY INJURY (Per accidentl $
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />PROPERTYDAMAGE $
<br />Per accident
<br />$
<br />UMBRELLA LIAR HOCCUR
<br />OCCURRENCE $
<br />_EACH -...
<br />AGGREGATE $
<br />EXCESS LIAB CLAIMS -MADE
<br />DED RETENTION $
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS" LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNERIEXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? IMN
<br />N f A
<br />ER OTH-
<br />TATUTE_
<br />7EL
<br />_-..ER _
<br />ACH ACCIDENT $
<br />(Mandatory in NH)
<br />E.L. DISEASE - EA EMPLOYE $
<br />If yes, desrribe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT' $
<br />B
<br />Installation Floater
<br />-660 -0317R186 -TIL -20
<br />5/1/2020
<br />5/x./2021
<br />POLICY LIMIT $ 2,000,000
<br />Builders Risk
<br />E1
<br />STORAGE I TRANSIT $ 2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be aMlached if more space Is required)
<br />Re: Operations usual to the named insured. Master Agreement for Electrical Utility Construction 'World for
<br />Various. City Locations on an As -Needed Basis - The City of Riverside, its City Council and all of its
<br />respective official's, officers, directors, employees, managers, commission members, representatives,
<br />agents and council members are added as additional insured including primary wording & waiver of
<br />subrogation where required by written contract as respects general liability & auto per attached CGD2.46
<br />4/19, CGT100 2/19, CGD31.6 2/19, CAT353 2/15 & CAT'499 2/1.6 and loss payee as respects installation
<br />floater. Notice, of cancellation 2er attached ILT405 3/11.
<br />�r
<br />SHO'U'LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Riverside THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />:River's'ide Public Utilities ACCORDANCE WITH THE POLICY PROVISIONS.
<br />c/o George Hanson
<br />3,900 Main Street AUTHORIZED REPRESENTATIV
<br />Riverside, CA 92522 ^w ^
<br />e 19 $-2014 ACORD CORPORATION, All rights reserved.
<br />ACORD 25 (2014/01) The ACORD name and logo are regist edpia1 of ACORD
<br />INS025 (2014011
<br />
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