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ACORQ CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MMIDD/YYYY) <br />09/09/2009 <br />PRODUCER 949.348. 7400 FAX 949.348.2373 <br />Insurance Solutions <br />License #0746539 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />26522 La Alameda, Suite 190 ktz%.;- +i~u_.) <br />Mission Viejo, CA 92691 I T Y OF F1IVER1L)c <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED James Duffy <br /> <br />INSURERA: Colony Insurance Company <br />39993 <br />2009 <br />S <br />DBA: O'Duffy Construction _ <br />INSURER& Mercury Casualty Company <br />11908 <br />24034 Gunther Road <br />NSURERc: Everest National <br />10120 <br />Romoland, CA 92585 RISK MANAGEMEN l <br />INSURER D: <br />INSURER E: <br />nwconrce <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />ANY REQUIREMENT <br />, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />MAY PERTAIN <br />, <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />DD' <br />NSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MM/DD/YYYY <br />POLICY EXPIRATION <br />DATE MM/DDIYYYY <br />LIMITS <br />GENERAL LIABILITY <br />GL950825 i <br />08/17/2009 <br />08/17/2010 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X <br />COMMERCIAL GENERAL LIABILITY <br />DAMAGE O NTE <br />PREMISES Ea occurrence <br />$ 100,00( <br />CLAIMS MADE I OCCUR <br />MED EXP (Any one person) <br />$ 5,00( <br />A <br />PERSONAL & HDV INJURY <br />$ 1, OUI0, 000 <br />GENERAL AGGREGATE <br />$ 2,000,00( <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG <br />$ 2,000,00 <br />POLICY X PRO LOC <br />JECT <br />AUT <br />OMOBILE LIABILITY <br />AC11040663 <br />02/15/2009 <br />02/15/2010 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1 <br />000 <br />000 <br />X <br />ANY AUTO <br />, <br />, <br />( <br />ALL OWNED AUTOS <br />`+g! <br />BODILY INJURY <br />$ <br />E <br />o <br />(Per person) <br />SCHEDULED AUTOS <br />B <br />HIRED AUTOS <br />NON-OWNED AUTOS <br />BODILY INJURY <br />(Per accident) <br />$ <br />PROPERTY DAMAGE <br />$ <br />> <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />ANY AUTO <br />OTHER THAN EA ACC <br />$ <br />AUTO ONLY: AGG <br />$ <br />EXCESS I UMBRELLA LIABILITY <br />EACH OCCURRENCE <br />$ <br />OCCUR CLAIMS MADE <br />AGGREGATE <br />$ <br />I~ <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION <br />, <br />b <br />WORKERS COMPENSATION <br />' <br />P00050286500 <br />! 09/09/2009 <br />09/09/2010 <br />X WCTORYSLIMITS ATU- O ER <br />R <br />LIABILITY <br />AND EMPLOYERS <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT <br />- $ 1 - '000, _ 00 _ <br />C <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />OTHER <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />Re. Catch Basin, Storm Drain/Chicago Ave. Improvements Subcontract #20281.04 <br />10 Da s written notice for non-payment of premium. <br />rFGTIFIrATF 41n1 nFR CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />City of Riverside <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />Street <br />3900 M <br />i <br />REPRESENTATIVES. <br />a <br />n <br />Riverside, CA 92522 <br />AUTHORIZED REPRESENTATIVE . <br />/ <br />- <br />1 <br />ony Alessandra/THERES <br />1 <br />ACORD 25 (2009/01) FAX: 951.826.5542 W Iyaa-LUUtf At-UMU %.Urcrvrval rvrv. All n911w reserveU. <br />The ACORD name and logo are registered marks of ACORD <br />