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2018/12/31 DSRM Cable Construction, Inc. Certificate of Liability InsuranceACCPRU CERTIFICATE OF LIABILITY INSURANCE kk.� DATE(MMIDD/YYYY) 12/13/2018 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 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 UUNTACT NAME: Elizabeth Michel, CISR Robert Bell Insurance Brokers, Inc. PHONE t: (760)451-8556 203 FAX LJAIC.N0: (760)451-8613 605 East Alvarado Street City of Menifee E­MAIL emichel@robertbellinsurance.com ADDRESS: Suite 200 city clerk INSURER(S) AFFORDING COVERAGE NAIC # Fallbrook CA 92028 INSURERA:OhiO Casualtx Insurance Cc 24074 INSURED JAN 0 7 2019 INSURER B:America Fire and Casualty Co 24066 DSRM Cable Construction, Inc INSURERC: 4 San Raphael Place Received INSURER D : INSURER E: Phillips Ranch CA 91766 INSURER F: COVERAGES CERTIFICATE NUMBER:2018 Master REVISION NLIMRER- 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. IN.SR LTR TYPE OF INSURANCE ADDL t UBR yyyD POLICY NUMBER POLICY EFF MMIDDIYYYY) POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1XI OCCUR EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 15,000 X BK055878322 12/31/2018 12/31/2019 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO JECT LOC GENERAL AGGREGATE $ 2,000,000 - PRODUCTS COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMaimED SIN7ML-1hrir—$ Ea acddenl 1,000,000 B X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BAA,55878322 12/31/2018 12/31/2019 BODILY INJURY (Per accident) $ X X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X *HA Phys Dmg 'HA -ACV Less Deductible $ $1, 000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 B4DED EXCESS LIAB CLAIMS -MADE I X I RETENTION $ 10,000 $ ESA55B78322 12/31/2018 12/31/2019 WORKERS COMPENSATION PER TH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A STATUTE ER E L. EACH ACCIDENT $ E L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under E L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Installation Floater BKOSS878322 12/32/2018 12/31/2019 Installation Lim Jobsile/Catastrophe $250,000 Rented, Leased Equipment Deductible $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is an additional insured per the attached CG 88 10 04 13 and CG 85 83 04 13 CER 1 iFiCA 1 E HOLDER CANCELLATION City of Menifee 29714 Haun Rd 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 Bell/EM • , "`,> ©1988-2014 ACORD CORPORATION. All riahts reserved ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)