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<br />Date, 9/17!200& Time: 2,59 PM To: Ron O$tl1llm l!lI 9,1'951.3S1.t:;O'3l
<br />
<br />RECEIVED
<br />CITY OF RIVERSIDE
<br />SEP 1 r. 2COB
<br />
<br />FaO'e, O()2'003
<br />
<br />A CORD...
<br />
<br />PROOUCER (562) 493-3521 FAX: (562) 430-5300
<br />Alandale Insurance Aqency
<br />11022 Winners Circle, Ste. 100
<br />
<br />CERTIFICATE OF LIABILITY INSURA'NeE'''''''''~''I: ~Aji~7~g~~Y)
<br />THIS CERTlFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONl..Y ANt) CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT Ar.tEND, EXTEND OR
<br />AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />i
<br />I
<br />! NAIC#
<br />
<br />THE POliCIES OF INSURANCE LISTED BELOWHAVJ:BEEN ISSUED TO THEU\lSUREO NAMJ:PABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY
<br />REQi.JlREMENT, TERM OR CONDITION OF ANY CONTRACT OR. OTHER DOCUMENT WITH ReSPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
<br />THE INSURANCE AFFORDED BY THE POLICIE_S_.D~~RiBED HEREIN IS SUBJECT TO All THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
<br />AGGREGATE LIMITS SHOWN MAY HAV!' BEE ~ RFnUcED BY PAID CLAIMS
<br />INSR\AOO'L TYPE OF INSURANCE PQLICY NUMBER PJli+~~9~~~Vf P~!fir~J'h~N
<br />
<br />~NERAl L1ABtLITY
<br />~ ~ERCIAl GENERAL LiA81I.lTY
<br />-W CLAlMSMADE [!J OCCUR 35335923
<br />
<br />CA 90'720
<br />
<br />INSURERS AFFORDING COVERAG.E
<br />Ii'SURER A Ch~b Group
<br />INSURER BH~rtford Pro-oertv "
<br />INSURER C Hartford Fixe Insurance
<br />
<br />34690
<br />19682
<br />
<br />Los Alam.i. tOB
<br />INSURED
<br />G S Beckham Desiqn Associates, Inc.
<br />3199 C Airport Loop Drive
<br />
<br />Costa Mesa
<br />
<br />CA 92626
<br />
<br />INSURER O.
<br />INSURER 1::
<br />
<br />LIMITS
<br />
<br />A
<br />
<br />9/15/2008
<br />
<br />9/15/2009
<br />
<br />~:
<br />
<br />MED EXPIAnv 00",",1500\ S
<br />. AI"\! INJURY $
<br />""..<-0.. G""F'GATE S
<br />"RonU('T'" _ ("(\MP/I'\P Ar." S
<br />
<br />B
<br />
<br />-
<br />
<br />-
<br />~t AGGRf~ ,LIMIT APPliES PER:
<br />X I on. ICY I I PJ:l:,ilT n LOC
<br />
<br />~UTO"OBILE LIABILITY
<br />
<br />..!. AN Y AUTO
<br />_ ALL OWNED AurOS
<br />_ SCHEDULED AUTOS
<br />f-- HIRED AUTOS
<br />f-- NON.OWNED AUTOS
<br />
<br />aODIL Y INJURY
<br />(Per "".cidoot)
<br />
<br />APPftOVf ;'0 11.$ TO I ORM
<br />
<br />. ,'" .- . ~-...
<br />
<br />';~"V",'t IJ/J..O' ~,fo8
<br />. RISK Ml\N.4GER
<br />9/15/2008 9/15/2009
<br />
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />
<br />72UECGbf15l7
<br />
<br />aoDIL Y INJURY
<br />(POl pM.on)
<br />
<br />P/lOPERT Y DAMAGE
<br />(Pet acdd9ll1)
<br />
<br />nCE liABILITY
<br />H ANY AUTO
<br />
<br />AUTO ONLY. EA ACCIDENT' $
<br />
<br />oTHER THAN F A AI"" $
<br />AUTO oNL Y: AM S
<br />
<br />S
<br />
<br />'''''''F''AT'' $
<br />
<br />S
<br />
<br />$
<br />
<br />$
<br />X I WCSTATU.! jOJ,SI-
<br />
<br />LL EACH ACaDENT $
<br />
<br />E.L. DiSEASE. EA EMPlOYEE S
<br />
<br />E.I QlSCAS!'. POLICY t.IMIT S
<br />
<br />~ESSAJMSRELLA LIABILITY
<br />......J OCCUR 0 CLAIMS MADE
<br />
<br />
<br />A ---, DE DUCTIf:lLC
<br />
<br />-xi R~T"NT"'N $ 0
<br />C WORKERS COMPENSA TlON ANO
<br />EMPLOYERS' LIABILITY
<br />.ANY PROP/lIEIORIPARTNERIE.XECUTIVE
<br />OFFlCERIMEMBCR EXCLUDED?
<br />It yes, desaibe und<<
<br />SPCaAL PROVISIONS below
<br />OTHER
<br />
<br />9/15/2008
<br />
<br />9/15/2009
<br />
<br />79749534
<br />
<br />72WECll.Q3462
<br />
<br />10/1/2008
<br />
<br />10/1/20()9
<br />
<br />A
<br />
<br />ERRORS , OMISSIONS
<br />
<br />09/15/2008 09/15/2009
<br />
<br />$1 ,l)l)f) , 000
<br />~" A ..
<br />
<br />35335923
<br />
<br />OESCRlPTION Of OpeRATIONSILOCA"I10NSNEHIClES/EXCL!JSIClNSAOOEO BY ENOoRsflolENTi$petlAl ~I\OVls,ONs
<br />City of Riverside is named as additional insured,
<br />
<br />'"",,
<br />,..,
<br />
<br />SEP 24 2008
<br />
<br />- -- ..
<br />
<br />*10 days notice of cancellation for no,!payrnent of prtlmium
<br />
<br />CERllFICATE HOLDER
<br />(951)351-6165
<br />City of Riverside
<br />attn: Ron Ostman
<br />3900 Main Street
<br />Riverside, CA 92522
<br />
<br />CANCELLATION
<br />
<br />-.
<br />,
<br />
<br />""',,
<br />
<br />1,000,000
<br />1,000,000
<br />10,000
<br />1,000,000
<br />1,000,000
<br />1,000,000
<br />
<br />1,000,000
<br />
<br />1,000,000
<br />1,000,000
<br />
<br />1,000,000
<br />1,000,000
<br />1,000,000
<br />
<br />SHOULD ANY Of THe ABOVE OESCRlBEO POLICIES BE CANCEllED BEFORe THE
<br />EXPIRATION OATE THEREOf, THE ISSUING INSURER WILL ENOEAVOR TO MAIL
<br />
<br />30 * OAY'S WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMEO TO THE LEFT, BUT
<br />FAILURE TO DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF Am KINO UPON THE
<br />IN$V ITeAGENTS OR ReT'REfieNTA"I1VES.
<br />AUTHORIZED REPRESENTA liVE
<br />Mich.el.le Haro/MICHEL ~~cJlVtr..1l9--'
<br />
<br />ClACORD CORPORATION '1988
<br />poge 1<0
<br />
<br />ACORD 25 (2001f08)
<br />INS025 (1J108).088
<br />
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