2017/08/01 TKE Engineering, Inc. Certificate of Liability Insurance (3)Page 1 of 1
ACORO CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
07/27/2017
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 endorsement(s).
PRODUCER
CONTACT
Willis of Illinois, Inc.
NAME:
PHONE FAX
c/o 26 Century Blvd
1-877-945-7378 1-888-467-2378
A/ No Ext: A/C No
E-MAIL cbmr'
ADDRESS: certificates@willi5�:
P.O. Box 305191
Nashville, TN 372305191 USA
INSURERS AFFORDING COVERAGE
NAIC#
INSURER A: Liberty InsailY!nce Underw;l'ters Inc,' �i
19917
INSURED1
- -
TKE Engineering, Inc.
INSURER B:
INSURER C :
2305 Chicago Avenue
Riverside, CA 92507
INSURERD: Vt' „_�y `I,
INSURER E : �� I
INSURER F :
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
LTR
TYPE OF INSURANCEINSD
ADDL
SUBR
WVDPOLICY
NUMBER
I POLICY EFF
MM/OD/YYYY
POLICY EXP
MM/DD
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
S
DAMAGE TO RENTED
PREMISES Ea occurrence
S
CLAIMS -MADE OCCUR
MED EXP (Any one person)
S
PERSONAL & ADV INJURY
S
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
S
POLICY ❑
JECOT- LOC
PRODUCTS -COMP/OPAGG
S
S
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
S
BODILY INJURY (Per person)
S
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
S
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
S
S
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
S
AGGREGATE
S
EXCESS LIAB
CLAIMS -MADE
DED RETENTIONS
S
WORKERS COMPENSATION
PER OTH-
AND EMPLOYERS' LIABILITY Y / N
STATUTE ER
E.L. EACH ACCIDENT
S
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
N/A
E.L. DISEASE - EA EMPLOYEE
S
(Mandatory In NH)
If yes, describe under
E.L. DISEASE - POLICY LIMIT
S
DESCRIPTION OF OPERATIONS below
A
Professional Liability
N
N
AEXNYABCETE001
08/01/2017
08/01/2018
Per Claim
$1,000,000
Annual Aggregate
$2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
Project: On Call Services
City of Menifee
Attn: Jonathan Smith, Contracts Administrator
29714 Baun Road
Menifee, CA 92586
l.Ml\IiGLLH 1 guild
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
4, �. x).
v IUd6-ZU9b ACORD CORPORATION- All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SR ID: 14882060 SATCR: 395798