2012/12/01 Chrisp Company Certificate of Liability Insurance7 0
ACORO CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
F6/2/2014
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 endorsements .
PRODUCER
Arthur J. Gallagher & Co.
Insurance Brokers of CA, Inc. LIC #0726293
3697 Mt. Diablo Blvd., Suite 300
Lafayette CA 94549'
01
CONTA T
NAME:Certificates Team
PHONE _ - Fvc qo):925-953-6270
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A:N VI t I t Insurance
INSURED hi .) 092014
Chrlsp Company
INSURERB:
INSURERC:
INSURER D :
43650 Osgood Road
Fremont, CA 94539 P- r� `1! 81 0
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 17_17Rfi1 FR7 REVISION NUMBER:
vTHIS 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 I
LTR
TYPE OF INSURANCE
ADDL
INSR
SUER
WVD
POLICY NUMBER
POLICY EFF
MMIDD
POLICY EXP
MM/DD/YYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES Ea occurrence
$
MMERCIAL GENERAL LIABILITY
MED EXP (Any one person)
$
CLAIMS -MADE OCCUR
PERSONAL & ADV INJURY
$
rGENV1
GENERAL AGGREGATE
$
GGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
$
ICY PROJEC LOC
COM13INED SINGLE LIMIT
AUTOMOBILE LIABILITY
Ea accident
BODILY INJURY (Per person)
$
ANY AUTO
BODILY INJURY (Per accident)
$
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
WC STATU- OTH-
T RY LIMI
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory In NH)
N / A`
E.L. DISEASE -POLICY LIMIT
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
A
POLLUTION LIABILITY
(OCCURRENCE)
F12ECPOA3R20NC
12/1/2012
2/1/2014
EACH OCC. 1,000,000
AGGREGATE 2,000,000
Deductible 10,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Chrisp Job #: 2M.4555 I RE: Newport Road and Menifee Road Project, Menifee, CA.
NOTE: Liability certificate to follow under seperate cover.
tIGA I t
City of Menifee
29714 Haun Road
Menifee CA 92586 USA
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
L•'yt�s, Qk,�rri�...�. �i,,.,T c
Q9 7J88-AU I NVVrcU a.vrcrWr J w1.. r uUK . .--.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
005878