2017/09/17 Statewide Towing & Recovery, Inc. Certificate of Liability InsuranceSTATE-1
D 0 06/2525//2018Y)
018
CERTIFICATE OF LIABILITY INSURANCE
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 endorsements .
PRODUCER 858-457-5720
Rubin Insurance Agency Inc.
CA Lic 0645355
CONTACT Michael Rubin
PHONE FAX
(A/C, No, EXt): 858-457-5720 (A/c. No):858-457-5729
5075 Shoreham Place, Suite 100 City of Menifee
E-MAIL
D RESS: mlChael@rubininSUranCe.COm
San Diego, CA 92122
Michael Rubin City Clerk
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: American States Ins Co
19704
INSURED Statewide Towing & Recovery JUL 0 2018
INSURER B : Evanston Insurance Company
35378
Inc
190 N Main St
INSURERC:
INSURER D :
Riverside, CA 92501 Receive,
INSURER E :
INSURER F :
rnVFRAnFC r_FRTIFIr_ATF NIIMRFR• DC\/ICIrIAI AIt1MRCD-
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.
ILT R
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
01-CI-854585-3
07/01/2018
07/01/2019
EACH OCCURRENCE
$ 1,000,000
DAMAGE TORENTEDREMISESncel
$ 1,000,000
B
X
Pollution Liab
MKLV5ENV100347
09/17/2017
09/1712018
MED EXP (Any oneperson)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY ❑PRO ❑ LOC
JECT
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS
2,000,000
$
Pollution
1,000,000
OTHER:
A
AUTOMOBILE
LIABILITY
EOMBINED SINGLE LIMIT
$ 1,000,000
BODILY INJURY Perperson)
$
ANY AUTO
01-CI-854585-3
07/01/2018
07/01/2019
BODILY INJURY Per accident
$
OWNED SCHEDULED
AUTOS ONLY X AUTOS
X
PROPERTYDAMAGE
Per accident
$
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
I $
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
N / A
PER OTH-
ISTATUTE I ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
A
GKLL
01-CI-854585-3
07/01/2018
07/01/2019
Ded $500
600,000
A
On-Hook/Cargo
01-CI-854585-3
07/01/2018
07101/2019
Ded $500
600,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Proof of Insurance
CITY075
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
" — `-'C
ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD