2019/07/01 Riverside Transit Agency Certificate of Liability Insurance— 1 £ DATE {MM7D67YYYT]
ArnRQ CERTIFICATE OF LIABILITY INSURANCE 07/15/2019
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 POLIC: .C, BELOW. THIS CERTIFICATE OF INSURANCE
DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE r 'RODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. "JJBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require an endorsement. A statement on thli certificate does not confer rights to the
certificate holder in lieu of such enclorsement(s).
PRODUCER corTTAct JENNIFER C. RODRIGUEZ
ALLIANT INSURANCE SERVICES, INC. PH NEE: PAX
P.O. Box 6450 _�AlC, Na.� 949-660-5987 N� I
Newport Beach, CA 92658-6450 E-MAIL
JCRODRIGUEZ@ALLIANT.COM
Ph 949 756-0271 • Fax 949 756-2713 • License No. OC36861 PRODUCER:
� ) � ) ,.,,n..�e,,,,, COURTNEY RAMIREZ
INSURER(S) AFFORDING COVERAGE NAIC #
RIVERSIDE TRANSIT AGENCY INSURER A: LLOYDS BRIT SYNDICATE 2987
ATTN: RICK MAJORS INSURER B:
1825 THIRD STREET
RIVERSIDE, CA 92517 INSURER C:
INSURER D:
INSURER E:
INSURER F:
COVFRAGFS- CFRTIFICATF NIIMRFR• RFVIRIAN NI IIIMRFG•
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 TYPE OF INSURANCE
LTR
ADDL
INSR
SUER
WVD
POLICY NUMBER
POLICY EFF
MWDD
POLICYEXPLIMITS
MM/DD
A
GENERAL LIABILITY
X
PK1031919
07/01/19
07/01/20
EACH OCCURRENCE
$ 2,100,000
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE I OCCUR
DAMAGE TO RENTED
PREMISES�Es..__Oxvmence
MED EXP (Any One person)
PERSONAL 8 ADV INJURY
ANNUAL AGGREGATE LIMIT APPLIES PER:
ANNUAL AGGREGATE
$ 2,100,000
)( I POLICY 1 I PE F7 LOC
CT
PRODUCTS-COMP/OP AGG.
SELF -INSURED RETENTION
$ 400,000
OTHER
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea Acexient
BODILY INJURY ( Per person)
i
ANY AUTO
BODILY INJURY (Per accident)
ALL OWNED AUTOS
SCHEDULED AUTOS
PROPERTY DAMAGE
(Per AccideaU
HIRED AUTOS
NON -OWNED AUTOS
UMBRELLA LWB
OCCUR
EACH OCCURRENCE
EXCESS LIAB
CLAIMS
MADE
ANNUAL AGGREGATE
DEDUCTIBLE
PER OCCURRENCE/AGG
RETENTION:
PER OCCLIRRENCE/AGG
PER OTH
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY YIN
STATUTE
ANY PROPRIETORY/PARTNER/ EXECUTIVE j
OFFICER / MEMBER EXCLUDED, I I NIA
E.L. EACH ACCIDENT
(MANDATORY IN NH(
IF YES DESCRIBE UNDER
E.L. DISEASE — EA
E.L. DISEASE— POLICY LIMIT
UNDER DESCRIPTION OF OPERATIONS BELOW
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach Acord 101, Additional Remarks Schedules, if more space is required)
AS RESPECTS INSTALL AND MAINTAIN 17 BUS STOPS ON THE EXISTING SIDE WALK AT 1825 THIRD STREET, RIVERSIDE, CA 92507.
CITY OF MENIFEE IS NAMED AS ADDITIONAL INSURED PER ATTACHED ENDORSEMENT.
SUBJECT TO POLICY TERMS CONDITIONS AND EXCLUSIONS
GLKIIFIGAIL HOLDER CANCFI I ATIf1N
CITY OF MENIFEE
29714 HAUN ROAD City of Mlenifee
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
MENIFEE, CA 92586
City C i
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
e a s
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE — ---_ -
z^r -0 . l V l UUO-LU14 RL.UKUI GO}SYLJKA44i w. Pii ngnTis reservea.
ACORD 25 (2014-01) f Y u thbSWARD name and logo are registered marks of ACORD
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NAMED ASSURED: Riverside Transit Agency
Policy Number: PK1031919
Effective Date: July 1, 2019
Authority Ref. No: 130356JA281N18
Endorsement No. 16
ADDITIONAL ASSURED ENDORSEMENT
It is hereby understood and agreed that under Coverage Section II General Liability with respect to
liability for BODILY INJURY, PROPERTY DAMAGE and PERSONAL INJURY, the City of Menifee is
added as an additional ASSURED as respects the installation and maintenance of 17 bus stops on the
existing side walk located at the following location(s):
Project Location: 1825 Third Street
Riverside, CA 92507
Bus Stop Locations:
1. south side of McCall Blvd. approx. 80ft far side east of Hillpointe Drive
2. south side of McCall Blvd. approx. 200ft far side east of Heritage Lake Dr.
inside of the bus turn out.
3. west side of Heritage Lake Dr. approx. 100ft. far side south of Grand Ave. with
100ft red curb 'Bus Zone"
4. north side of Heritage Lake Dr. approx. 100ft far side west of Calm Horizon Dr.
5. west side of Lindenberger Rd. approx. 100ft south of Simpson Rd.
6. Trailhead Dr. approx. 35ft near side north of Amarante St.
7. west side Menifee Rd. approx. 100ft far side south of Aldergate Dr. with 100ft
red curb 'Bus Zone"
8. west side Menifee Rd. approx. 100ft far side south of Camino Cristal
9. east side of Merafee Rd. approx. 100ft far side north of Camino Cristal
10. east side of Menefee Rd. approx. 100ft far side north of Carnelian Way. with
100ft red curb 'Bus -Dre"
11. east side of Menifee Rd. approx. 250ft far side north of Trailhead Dr. inside
Bus Turn Out
12. south side of Simpson Rd. approx. 230ft far side east of Menifee Rd. inside
Bus Turn Out
13. east side of Lindenberger Rd. approx. 100ft far side north of Simpson Rd.
14. south side of Heritage Lake Dr. approx. 100ft far side east of Boardwalk Ct.
15. east side of Heritage Lake Dr. approx. 150ft near side south of Grand Ave.
with 100ft red curb 'Bus Zone"
16. north side of McCall Blvd. approx. 90ft far side west of Heritage Lake Dr.
17. north side of McCall Blvd. approx. 30ft near side east of Via Entrada
Additional ASSURED: City of Menifee
29714 Haum Road
Menifee, CA 92586
Any claim arising out of the sole negligence of the additional ASSURED is excluded under this Policy.
Except as amended in this Endorsement, this insurance is subject to all coverage terms, clauses and
conditions in the policy to which this Endorsement is attached.