Loading...
2018/03/01 Hemet Fence Corp Certificate of Liability Insurance (3) Phone:(951)723-3716 Direct Line ® DATE IMMIDDIYYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE `� 1 01/15/2019 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 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 NAME, Ginger Greeb Speake Insurance Services,Inc. PHONE g5i 547 6779 N,:(951 648-0925 1791 Third Street E-MAILgo Ertl: I ) i 2860 ADDRESS: ginger@speakeinsurance.com Norco, CA 9 INSURER(S)AFFORDING COVERAGE NA1C R License#. 92860 INSURERA: {Colony Ins Co _39993 INSURED INSURERS: National Union Fire Pittsburgh PA .19445 HEMET FENCE CORP INSURERc_National Liability and Fire 20052 25959 JUNIPER FLATS ROAD INSURERD: _ HOMELAND, CA 92548 INSURERE. INSURER F'- COVERAGES CERTIFICATE NUMBER: 00000000-0 REVISION NUMBER: 101 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 IN811 I ADDL SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY Y Y 103GL002529200 09/0112018 09/01/2019 EACH OCCURRENCE S 1,000,000 DAMA E TO REN EO _ CLAIMS-MADE X OCCUR _PREMI$ESt-aoowrtenca� $ 100,000 _ME_D EXP(Any one perean) S 5,000 -� PERSONAL 8 ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY X JECT LOC PRODUCTS-COMNOPAG_G S 2,000,000 OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S (Ea acmdenU__ ANY AUTO BODILY INJURY(Per person) 8 OWNED SCHEDULED BODILY INJURY{Per axlaeni) S AUTOS ONLY AUTOS - -- HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY {Per awdentl S B UMBRELLAUAB X OCCUR EBU016838985 0910172018 09101/2019 EACH OCCURRENCE $ 2,000,000 kx EXCESS LIARCLAIMS-MADE AGGREGATE S 2,000,000DED RETENTIONS 3 WORKERS COMPENSATION PER OTH- C Y V9WC921640 03/01/2018 G310112019 X STATUTE ER- . AND EMPLOYERS'LIABILITY - ANYPROPRIETOR/PARTNERIEXFCUTIVE YIN N!A EL EACH ACCIDENT_ $ 1,000,000 OFFICER/MEMBER EXCLUDED? � - (Mandatory In NHI Et DISEASE-EA EMPLOYE S 1,000,000 If yes.deacnbe under 1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached it mare space is required) 30 Day cancellation provision reverts to 10 days notice in the event of non-payment of Premium. RE: Fire Station#68 Fencing Improvements City of Menuifee, its elected and appointed officers,employees,agents,and authorized volunteers are included as Additional Insured,on a Primary/Non-Contributory basis,including Waiver of Subrogation for Ongoing and Completed Operations General Liability per CG2017 04113;CG2037 04113; CG2001 04113;and CG2404 05109 attached. Waiver of Subrogation applies to Workers'Compenstion per WC040306 4-84 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Cityof Menifee Attn:Margarita Cornejo,Contract 8 Procurement Administrator ACCORDANCE WITH THE POLICY PROVISIONS - 29714 Haun Road MENIFEE,CA 92586 AUTHORIZ REPRESENTATIVE GIN (D1988-2015 ORE)CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Printed by GIN on January 15,2019 at 01 45PM 103 GL 0025292-00 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY --- OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and i i li CG 20 0104 13 5 Insurance Services Office, Inc.,2012 Page 1 of 1 i 103 GL 0025292-00 POLICY NUMBER: 103 GL 0025292-00 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART f SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations All persons or organizations as required by written As designated in written contract with the Named contract with the Named Insured Insured Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II -- Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to"bodily injury" or damage" or "personal and advertising injury" "property damage"occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2, That portion of "your worts" out of which the 1. The insurance afforded to such additional injury or damage arises has been put to its intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 113 0 Insurance Services Office, Inc., 2012 Page 1 of 2 103 GL 0025292-00 I C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: i 1. Required by the contract or agreement; or' E Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 10 04 13 103 GL 0025292-00 POLICY NUMBER: 103 GL 0025292-00 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) location And Description Of Completed Operations All persons or organizations as required by written As designated in written contract with the Named Insured contract with the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A, Section II—Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s)or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage"caused, in whole or in part, by required by a contract or agreement, the most we your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement;or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 2 7 0 3 04 13 O lnsurance Services Office, Inc., 2012 Page 1 of 1 i 103 GL 0025292-00 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following? COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: All persons or organizations as requested by written contract with the Named Insured, Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 O Insurance Services Office, Inc., 2008 Page 1 of 1 I WORKERS COMPENSATION AM13 L.alPLOYCRS LIABILITY INSURANCE POLICI WC 04 03 OB (Ed. 4-84) WAIVER OF OUR RIG[IT TO RECOVER FROM OTHERS CNDORSI=MENT-CAt_IFORMIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be ?_03_% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Blanket Waiver-Any person or organization for whom the A I CA Operations Named Insured has agreed by written contract to furnish this waiver. This endorsement changes the policy to which it is attached and is effective on the date Issued unless otherwise staled_ (The Information below Is required only when this endorsement Is issued subsequent to preparation of the pollcy.) Endorsement Effective Hemet fence Corp Policy No. V9WC921640 Endorsement No. G Insured Insurance Company Countersigned By G7998 by the Workers'compensation Insurance Rating Bureau of California.All rights reservers.