F S CONSTRUCTION - Laserfiche WebLink

Home

FSCON -2 OP ID: TC CERTIFICATE OF LIABILITY INSURANCE 7OTE ( MMIDDIY 1 10512015 6 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 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 Sierra Oak Insurance Services Lic# OC97528 CONTACT NAME: Dan Brock PHONE FAX AIC No Ext :916- 364 -7380 arc No): 916- 364 -7381 Certs@einsurancespecialist.com E-MAIL Sacramento, 9700 Business Park Dr. Ste 105 CA 95827 _ADDRESS: Daniel E. Brock INSURER(S) AFFORDING COVERAGE NAIC p wsURERA:Golden Eagle Insurance Corp. 10836 X INSURED Jose Angel Rojo Fierros DBA wsURERB: Landmark American 33138 F S Construction 14838 Bledsoe Street Sylmar, CA 91342 INSURER C: RSUI Indemnity Company 22314 INSURER D: Insurance Company of the West INSURER E : MED EXP (Any one person) $ EX luded INSURER F: $ 1,000,000 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS 3900 Main St. GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 B X COMMERCIAL GENERAL LIABILITY X LHA137360 0111312014 0111312015 DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 CLAIMS -MADE 7XI OCCUR MED EXP (Any one person) $ EX luded PERSONAL & ADV INJURY $ 1,000,000 GENERAL GATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER PRODUCTS -CO PRODUCTS- COMPfOP AGG $ 2,000,000 APPROVED POLICY X PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1'000'000 BODILY INJURY (Per person) $ A ANY AUTO X BA1093270 08/2612014 08/26/2015 ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE PER ACCIDENT $ X HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 X AGGREGATE $ 3,000,000 C EXCESS LIAR CLAIMS -MADE NHA234715 01/1312014 01/13/2015 DED RETENTION$ GL $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERfEXECUTIVE WSA 5026584 00 05/2812014 05/28/2015 X WC STATU- OTH- TORY LIMITS ER E L EACH ACCIDENT $ 1,000,000 OFFICERfMEMBER EXCLUDED? ❑ (Mandatory in NH) NIA E . DISEASE- EA EMPLOYEE $ 1,000,000 fyes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE- POLICY LIMIT $ 1,000,000 A Equipment Floater IM1093269 08/2612014 08/26/2015 Scheduled 45,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Job: Reid Park / 701 Orange Street, Riverside CA, 92501 City of Riverside, its officers, employees and agents are named additional insured in regards to General Liability and Auto. CERTIFICATE HOLDER CANCELLATION CITYORR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Riverside J Cortez AUTHORIZED REPRESENTATIVE 3900 Main St. Riverside, CA 92522 ACORD 25 (2010105) © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD