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2018/08/15 Taber Drilling Certificate of Liability Insurance
TABECON-01 TGALART ACd� Q CERTIFICATE OF LIABILITY INSURANCE DATEYYYY) 718/2018/2019 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 POLICIES BEE_OW. 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 License # OB50501 CONTACT Teresa Galart 239W ongCourt t Associates PHON(A/C, No, EXt, (530) 668-2777 f jvC, No):(530) 668-2779 239 W COUrt St, Bldg A Woodland, CA 95695 E-MAIL INSURED INSURER B : Wesco Insurance Taber Drilling INSURERC:State Com ensati 536 Galveston St INSURERD: West Sacramento, CA 95691 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. TIN TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICIDDY EXPLTR 8/15/2019 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR Pollution X FEIECC1719505 8/15/2018 EACH OCCURRENCE 1,000,000 $ pR I jGE TO RISES ENTED � n $ 50,000 X MED EXP An one person)$ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMITAP LIES PER: POLICY AI JERK LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: Boat liability $ 1,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY PerDerson) $ ANY AUTO WPP115051303 8/15/2018 8/15/2019 OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident) $ X PROPERTY DAMAGE Peraccdent 5 HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 9,000,000 EXCESS LIAB I CLAIMS -MADE FEIEXS1719605 8/15/2018 8/15/2019 DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNER/EXECU I IVE ❑ OFFICERlMEMVR EXCLUDED? (Mandatary In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 1972433 7/13/2019 8/15/2018 7/13/2020 8/15/2019 X PER OTH- TATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E-L DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 000,000 $ 5,00000 A Pollution FEIECC1719505 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re Project #2014-0038 Bradley Road Bridge over Salt Creek. The City of Menifee is named as additionally insured as per the attached endorsement. 'flease is a nrnewcerli f ic;3te Picafor Workcrs' COmnensaiion on Iv: sc c previOLrs certiricale for tYie�tfaniorla] Insured E'ndarscalenl referenced. City Clerk City of Menifee Engineering Department 29714 Haun Road Sun City, CA 92586 RBCCivef,i, 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD