2017/07/01 County of Riverside Certificate of Insurance or Self-Insurance
P.O. Box 1210, Riverside, CA 92502 (951) 955-3540 (951) 955-4027 riskmgmt.rc-hr.com
BRENDA DIEDERICHS,
Asst. County Executive Officer/
Human Resources Director
CERTIFICATE OF INSURANCE OR SELF-INSURANCE
Date: September 20, 2018 Jeffrey L. Hunter
cc: Teresa Diaz, Contracts and Grants Analyst @ RUHS – PH Procurement
THIS IS TO CERTIFY THAT THE SELF-INSURED COVERAGE LISTED BELOW IS CURRENTLY IN EFFECT 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 COVERAGE AFFORDED BY THIS CERTIFICATE DESCRIBED HEREIN IS SUBJECT TO ALL THE
TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH CERTIFICATE.
COVERAGE PROVIDED IS SUBJECT TO THE TERMS AND CONDITIONS OF THE EXCESS POLICY.
Type of Coverage Company and
Policy Number
Policy Period Limits of Liability
Bodily Injury/Property Damage
Commercial
General Liability
Including Vehicle
Liability
Self-Insured
07/01/2018
to
07/01/2019
$1,000,000 Combined
Single Limit Per
Occurrence with No
Aggregate Limit
Workers’
Compensation
& Employers’
Liability
Permissibly
Self-Insured
07/01/2018
to
07/01/2019
$2,000,000 Combined Single
Limit Per Occurrence with
No Aggregate Limit
Medical Malpractice
(Professional
Liability)
Self-Insured
10/01/2017
to
10/01/2018
The County of Riverside certifies that the above self-insured program is in effect as respect to: City of Menifee is
working on setting up a Active Transportation Program (ATP) agreement with Riverside County.
Certificate Holder Cancellation
City of Menifee
Attn: Margarita Cornejo
29714 Haun Road
Menifee, CA 92586
In the event of cancellation of the self-insurance program or policy
designated below, it is the intent of the County of Riverside to mail
30 days’ prior notice thereof.
X
X
This certificate is not valid unless signed by an authorized representative of the County of Riverside, Risk Management Divis ion