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2018/06/01 Guy F. Atkinson Construction, LLC Certificate of Liability Insurance
ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 11/29/2018 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 have ADDITIONAL INSURED provisions or 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 Alliant Insurance Services, Inc. 7108 Fairway Drive Suite 225 City of Menifee Palm Beach Gardens, FL 33418 City Clerk CONTACT NAME: PHONE FAX AIc No Ext: 561.214.6366 AIC No: ADE-MADRESS: clarkcerts@alliant.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Zurich American Insurance Company 16535 INSURED DEC 042018 Guy F. Atkinson Construction, LLC 18201 Von Karman Avenue INSURERB: American Guarantee and Liability Ins CO 26247 INSURERC: INSURERD: Suite 800 Received Irvine CA 92612 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1084524965 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. INSR LTR TYPE OF INSURANCE ADDL 1 D SUBR D I POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y GLO926578008 6/1/2018 6/1/2019 EACH OCCURRENCE $2,000,000 CLAIMS -MADE � OCCUR DAMAGES(RENTED PREMISES Ea occurrence) $300,000 X MED EXP (Any one person) $ 10.000 Contractual Liab X X.C.0 Cov PERSONAL & ADV INJURY $ 2,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 GEN'L FTI POLICY PEA Ex] LOC PRODUCTS - COMP/OP AGG $4,000,000 1 $ OTHER: A AUTOMOBILE LIABILITY Y Y BAP926578108 6/1/2018 6/1/2019 COMBINED SINGLE LIMIT Ea accident $2000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS Ix BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY 8 UMBRELLA LIAB X OCCUR Y Y SXS654268309 6/1/2018 6/1/2019 EACH OCCURRENCE $ 8,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $ 8,000,000 DED I I RE Is A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETORfPARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? F N/A Y WC926578208 (AOS -Stop Gap only for ND, OH, WY) EWS489553813 (WA) 6/1/2018 6/1/2018 6/1/2019 6/1/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 A Inland Marine/CE Leased/Rented/Borrowed Equip. CPP532198713 12/1/20111 12/1/2019 Any One Item Per Occurrence $2,500,000 $2,500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) Re: 150348, Scott Road 1-215 - Menifee and Murrieta, CA. The County of Riverside, its Agencies, Districts, Special Districts and Departments, their respective directors, officers, Board of Supervisors, elected and appointed officials, employees, agents, and representatives, State of California, Department of Transportation, its elected and appointed officials, officers, directors, employees, agents, and representatives, The City of Menifee, its elected and appointed officials, officers, directors, employees, agents, and representatives, The City of Murrieta, its elected and appointed officials, officers, directors, employees, agents, and representatives, Eastern Municipal Water District (EMWD), its officers, directors, employees, agents, and representatives, Frontier Communications, its officers, directors, employees, agents, and representatives are included as an Additional Insured on a Primary/Non-Contributory basis with respect to the above General Liability and Automobile Policies as required by a written contract. Waiver of Subrogation Applies to both General Liability and Workers Compensation. No policy will permit cancellation or modification without thirty (30) days prior written notice. t.:tK I Wit -A I t MULUtK GAN(:tLLA I IUN 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD