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ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 11/14/2016 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 Milestone Risk Management & Insurance Agency License No. OB72766 8 Corporate Park, Suite 130 Irvine CA 92606 CONTACT Catherine Sariana NAME: PAHic NNO Ext: (949) 852 -0909 FAX, No: (999)852 -1131 E -MAIL ADDRESS: csariana @ milestone P romise.com INSURER(S) AFFORDING COVERAGE NAIC# INSURER AAdmiral Insurance Company 24856 INSURED V.S.S. Sales DBA: Vaughan's Industrial Repair Co. 16224 Garfield Avenue Paramount CA 90723 -0000 INSURER B American Fire & Casualty Insurance 24066 INSURER C :State Compensation Ins. Fund 35076 INSURERD:Ohio Casualty Ins. Co. A INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:16 /17 Master Incl. WC 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 INSD WVD POLICY NUMBER M� DD YYYY MM /DD YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE � OCCUR DAMAGE PRE M SESOEa oNcurrDence $ 100,000 MED EXP (Any one person) $ 5,000 CA00001643505 2/23/2016 2/23/2017 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JEo El LOC POTHER PRODUCTS - COMP /OPAGG $ 2,000,000 Per Occurrence Deductible $ 5,000 APPROVED AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BAA(17)56755498 2/23/2016 2/23/2017 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS Comp. / Coll. Deductible $ 1,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED X RETENTION$ 0 $ BEX09601304 -01 2/23/2016 2/23/2017 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N X PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 C OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A 1962800 -2016 11/1/2016 11/1/2017 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Rented /Leased Equipment BKO(17)56755498 2/23/2016 2/23/2017 Limit /Deductible $50K / $1K DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is named as an additional insured, where required by written contract, per the attached endorsements. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) N S025 (201401) ©1988 -2014 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 Riverside Public Utilities THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 5901 Payton Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Riverside, CA 92501 AUTHORIZED REPRESENTATIVE Teresa Shen /TERESA�G -�— ACORD 25 (2014/01) N S025 (201401) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD