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ACORD~ CERTIFICATE OF LIABILITY INSURANCE OP 10 SDL I DATE (MMlDDIYYYY) CACON-l 01/26/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Orr and Associates Ins. Servo ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CA License #OE63493 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 28780 Single Oak Drive #255 0 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Temecula CA 92590 RECEIVE Phone:951-506-5859 Fax: 951-50f6t-~9.'f RIVERSIDE INSURERS AFFORDING COVERAGE NAIC# INSURED IAN ~~ ~i, 2.009 INSURER A: INOIlIN IIAABOR INSURANCE COMPlIN INSURER B: CENTURY-NATIONAL INS. COMPlINY AVI-CON, Inc. dba: A HISK MANAGEMENl INSURER C: ROCKHILL INSURANCE COMPANY 28053 C A Construction 981 Iowa Avenue Suite INSURER 0: NATIONAL UNION FIRE OF PIT. 19445 Riverside CA 92507 INSURER E: 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I POLICY NUMBER P~';!~~:~~~~IE Pgk!fl(~~~~N LIMITS LTR NSRC TYPE OF INSURANCE ~NERAL LIABILITY EACH OCCURRENCE $ 2,000.000 A X X COMMERCIAL GENERAL LIABILITY ESG0027692 11/21/08 11/21/09 PREMISES (Ea occu,encel $ 100,000 l CLAIMS MADE ~ OCCUR MED EXP (Anyone pe'son) $ 5,000 Ji- DED 5,000 PERSONAL & ADV INJURY $2,000,000 f-- GENERAL AGGREGATE $ 2,000,000 !il'L AGG~EnE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 X PRO- ~ POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 I-- ANY AUTO (Ea accident) f-- y''2fJ/08 B ~ ALL OWNED AUTOS BAP 1615:/) ('/20/09 BODILY INJURY ~ (Pe, pa,son) $ SCHEDULED AUTOS ~~ - ~ HIRED AUTOS r\1 BODILY INJURY ~'1. \..) $ Ji- NON-OWNED AUTOS '~ .. fA1ff (Pa, accident) ~S' . - \ PROPERTY DAMAGE $ (Pe, accident) GARAGE LIABILITY /' Jr AUTO ONLY - EA ACCIDENT $ - ==l ANY AUTO // OTHER THAN EAACC $ \/ AUTO ONLY: AGG $ EXCESs/UMBRELLA LIABILITY EBU023Bl'~ V EACH OCCURRENCE $1.000.000 D IiJ OCCUR 0 CLAIMS MADE 12/12/08 11/21/09 AGGREGATE $1,000,000 Prod/Ops $1,000,000 R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND I T~WyS~~WS I J~lt ----- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $ If yes. describB under E.L. DISEASE - POLICY LIMIT $ SPECiAl PROVISIONS below OTHER C POLLUTION LIAB RCPLEOO084200 10/30/08 10/30/09 Aggregate $1,000,000 CLAIMS MADE Pollution $1.000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS THE CITY OF RIVERAIDE AND ITS OFFICERS AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED PER ATTACHED ENDORSEMENT FORMS CG2037 0704; CG2033 0704; CG2404 1093 (WAIVER) ; ESL 471 0107. *10 DAYS NON-PAY; 30 DAYS ALL OTHER. CERTIFICATE HOLDER COVERAGES CITY OF RIVERSIDE C/O CITY ATTORNEY CITY HALL 3900 MAIN STREET RIVERSIDE CA 92522 JAN 28 2009 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL * 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AU$:E~~IVE @ACORD CORPORATION 1988 Finance/Risk Mgmt ACORD 25 (2001108)