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H &HGENE -01 KGOAD <br />CERTIFICATE OF LIABILITY INSURANCE DATE JMMMoe s"' <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 License # OC36861 <br />Inland Empire - Alliant insurance Services, Inc. <br />735 Carnegie Dr Ste 200 <br />San Bernardino, CA 92408 <br />APPROVED <br />INSURED <br />H & H General Contractors Inc <br />PO Box 536 <br />Highland, CA 92346 <br />COVERAGES <br />CERTIFICATE NUMBER: <br />`' "ME"' "" <br />NA ; Christina M Mountz <br />LTR <br />PHONE o 909) 886 -9861 e�ro�No1; <br />9091 886 -2013 <br />. el <br />ADDRESS• <br />POLICY NUMBER <br />INSURER[SI AFFORDING COVERAGE _ _ _ <br />INSURERA:WeSCO Insurance Compny <br />T <br />NAIC M <br />255011 <br />INSURER a, Torus National Insurance Co <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE occuR <br />$1,000 PD dedlOee <br />AGGREGATE LIMIT APPLIES PER. <br />POLICY JECT [�] LOC <br />OTHER <br />25496 <br />INSURER C: <br />INSURER O : <br />INSURER E: <br />INSURER F : <br />f _ <br />REVISION NUMBER: <br />0712612016 <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 />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />MMIDDIYYYY <br />MMf DIYYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE occuR <br />$1,000 PD dedlOee <br />AGGREGATE LIMIT APPLIES PER. <br />POLICY JECT [�] LOC <br />OTHER <br />X <br />VifPPI04450404 <br />0712612015 <br />0712612016 <br />EACH OCCURRENCE <br />S 1,000,000 <br />pREMI5E5 Ea RENTED <br />occurrence <br />$ 100,000 <br />X <br />MED EXP (Any one person► <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />S 1,000,000 <br />GEML <br />GENERAL AGGREGATE <br />s 2,000,000 <br />PRODUCTS - COMP/OP AGG <br />S 2,000,00 <br />S <br />A <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />WNED <br />X HIRED AUTOS X NON-OWNED <br />X <br />PP104450404 <br />0712612015 <br />0712612016 <br />COMBINED SINGLE LIMIT <br />$ 11000,000 <br />BODILY INJURY (Per person) <br />S <br />BODILY INJURY (Per amidenl) <br />5 <br />PeDaEaiRde DAMAGE <br />$ <br />3 <br />UMBRELLA LIAR <br />EXCESS LIAR <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED I I RETENTIONS <br />r <br />S <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />YIN <br />ANY PROPMETORMARTNEWEXECUTIVE <br />OFFICERIMEMBEREXCLUDED? Y❑ <br />(Mandatory In NH) <br />If yse, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />10160316 <br />0110112016 <br />01/0112017 <br />X PER TH - <br />STATUTE ER <br />E EACH ACCIDENT <br />S 1,000,000 <br />E L DISEASE - EA EMPLOYE <br />$ 1,000,000 <br />E DISEASE - POLICY LIMB 1 <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS r LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required) <br />Job: Operations pertaining to named insured for cartholder. The City of Riverside is additional insured as respects to general and auto liability per <br />endorsements attached. <br />City of Riverside <br />3900 Main Street <br />Riverside, CA 92522 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />©1988 -2014 ACORD CORPORATION. All rights reserved. <br />ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD <br />