2017/06/18 A Q Engineering Consultants, Inc. Certificate of Liability Insurance (3)ACORD CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/YYYY)
6/12/2017
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
CONTACT Stephanie Ortiz
NAME: P
James G Parker Insurance Associates
PHONE (559)222-7722 FAX
A/C o El: A/C No;(559)222-1724
License #0554959
E-MAIL sortiz@J' arker.com
ADDRESS: 9P
P O BOX 3947
INSURERS AFFORDING COVERAGE
NAIC #
Fresno CA 93650
INSURERA:State Compensation Ins Fund
35076.
INSURED
INSURER B :
A Q Engineering Consultants Inc
INSURERC:
26759 Chamomile St
INSURERD:
INSURER E :
Murrieta CA 92562
INSURERF:
COVERAGES CERTIFICATE NUMBER:17-18 WC RFVl-glr)Al NI IMRFR•
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
I TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
MMIDDIYYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
S
DAMAGERENTED
PREMISES Ea occurrence
S
MED EXP (Any one person)
S
PERSONAL & ADV INJURY
S
GEN'L
AGGREGATE LIMIT APPLIES PER
PRO -
POLICY JECT LOC
I GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
S
S
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
S
BODILY INJURY (Per person)
S
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY Per accident
( )
S
NON -OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
Per accident
S
S
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
S
AGGREGATE
S
EXCESS LIAB
CLAIMS -MADE
DED I I RE
S
I
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? Fy I
(Mandatory in NH)
If yes, describe under
NIA
9061672-2017
6/18/2017
6/18/2018
PER OTH-
% STATUTE ER
E.L. EACH ACCIDENT
S 1,000,000
E.L. DISEASE - EA EMPLOYEE
S 1,000,000
E.L. DISEASE - POLICY LIMIT
S 1,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: FY 17/18 on —call engineering services (recoverable)
Vendor No. 00811
111 IVA I L I IVLI-ILR
City of Menifee
29714 Haun Road
Menifee, CA 92586
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 REPRESENTATIVE
J Parker III/STEORT ��.,
U 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
INS025 (201401)
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