AVITUS GROUP LABOR CONTRACTOR FOR CO EMPLOYEES OF NEHEMIAH REBAR SERVICES INC

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AWROJ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 06/02/2016 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 pollcy(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 endorsementtsl. PRODUCER Doug Jones c/o Artex Risk Solutions, Inc. 8840 E. Chaparral Rd.; Suite 275 Scottsdale, AZ 85250 INSURED Avitus, Inc. dba: Avitus Group Labor Contractor, for co- employees of: Nehemlah Rebar Services, Inc 175 N. 27th Street, Suite 800 PO Box 2506 Billings, MT 59103 CONTACT NAME: PHONE Li . Exuz _ 480 951 -4177 ADDRESS: FAx a: 480 951 -4266 INSURERISI AFFORDING COVERAGE NAIC INSURER A: American Zurich Insurance Company INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : 40142 COVERAGES CERTIFICATE NUMBER: 16MT901883876 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. ILIR TYPE OF INSURANCE INSD SWVD POLICY NUMBER IM POLICY YYYI IMMI�/WYYI LMT COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS -MADE I I OCCUR RENTED 5 REMISES fEa MED EXP (Any one person) 5 PERSONAL 6 ADV NJURY 5 GEN'L AGGREGATE LIMIT APPLIES PER POLICY ❑ JECT ❑ LOC ll OTHER: GENERAL AGGREGATE 5 PRODUCTS - COMP/OP AGG 5 S AUTOMOBILE — L ABILITY ANY AUTO AUTOSNED H RED AUTOS , AUTOSEO NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea aeddent) S BODILY INJURY (Per person) 5 BODILY INJURY (Peraodden) 5 PROPERTY DAMAGE (Per accIdent) S 5 — UMBRELLA UAB EXCESS LJAB _ OCCUR CIA,MS -MAvc EACH OCCURRENCE S AGGREGATE S DER 1 RETENTIONS S A WORKERS COMPENSATION AND EMPLOYERS' LJABIL TY ANY PROPRIETORIPARTNERIEXECUTIVE Y❑ (Mandatory InaRIMEMNH) E%CLUDED7 If yes, describe under DESCR PTION OF OPERATIONS below NIA X WC 91.73- 612 -02 04/01/2016 04/01/2017 I PER `OTH- X STATUTE 1 ER E.L- EACH ACCIDENT s 1,000,000 E.L. DISEASE • EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 Location Coverage Period: 04/01/2016 04/01/2017 Client# C10-CA DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H mons space Is rsqulnd) Nehemiah Rebar Services, Inc. Waiver of subrogation issued in favor of the certificate holder for the following project Coverage is provided for 9 p 3932 Ponderosa Rd Ste 204 Risk Management only those co- employees 8095 Lincoln Ave of, but not subcontractors Shingle Springs, CA 95682 to: Endorsements: Waiver of Subrogation CERTIFICATE HOLDER CANCELLATION I City of Riverside 3900 Main Street Riverside. CA 92522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRE NTATIVE ACORD 2512014/01! 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD