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AcioR °® CERTIFICATE OF LIABILITY INSURANCE �0 /2i2" ""' 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 Pedigo Lessenberry Ins. Agency, Inc. 103 Pin Oak Lane P. O. BOX 1899 Glasgow KY 42142 -1899 NAME Mik McCandless PHONE (270) 651 -8837 1 FAX. No: (270)651 -8127 .mmccandless @plinsurance.com INSURERS AFFORDING COVERAGE NAIC 9 INSURER A:Liberty Mutual Fire Ins. Co. 23035 INSURED I.C.E. Builders, Inc. AKA Gray- I.C.E. Builders, Inc 421 E. Cerritos Ave. Anaheim CA 92805 INSURER B Mutual Insurance Compa 23043 INSURER c:Liberty Insurance Corporation 42404 INSURER D: INSURER E: S 1,000,000 INSURER F: X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE a OCCUR COVERAGES CERTIFICATE NUMBER:ICE -WC GL Auto Umb 12/13 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADD S BR POLICY BER POLICY EFF MMID POLICY EXP MMlDD/YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE a OCCUR 2- 0/1/2012 0/1/2013 "0 RURTED_ =511 Ea occurrence) S 1,000,000 MEDEXP(Anyoneperson) S 5,000 PERSONAL 8 ADV INJURY S 1,000,000 J�;/� O F GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2,000,000 POLICY X PRO- LOC S AUTOMOBILE LIABILITY COM81 acc ident ) E 51NGLE LIMIT S 1,000 B ALL OWNED SCHEDULED AUTOS AUTOS Ix ANY AUTO 2- 651 - 289605 -042 Risk Ma 10/1/2012 agar 10/1/2013 BODILY INJURY (Per person) S 130DILYINJURY(Peraccident) S PROPERTY DAMAGE (Per accident S HIRED AUTOS X NON -OWNED AUTOS PIP -Basic S X UMBRELLA LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE S 10,000,000 AGGREGATE S 10,000,000 A EXCESS LIAR DIED I X I RETENTION 10,000 S H2- 641 - 439001 -012 0/1/2012 10/1/2013 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERtEXECUTIVE r OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N /A A7 -65D- 289605 -012 10/1/2012 0/1/2013 X WCSTATU- OTH- TORY LIMITS E.L. EACH ACCIDENT S 1 000,000 E.L. DISEASE- EA EMPLOY S 1 : 000,000 If yes, es dcribe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT I S 1, 000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) SEE CANCELLATION ATTACHMENT The City of Riverside is an Additional Insured for General Liability as per CG2012 (05/09) attached. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010105) INS025 (mioo5).ol ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Riverside ACCORDANCE WITH THE POLICY PROVISIONS. 3900 Main Street AUTHORIZED REPRESENT `S Riverside, CA 92522 r, P DKiO -L SENBERRY IMURAtM ACORD 25 (2010105) INS025 (mioo5).ol ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD