2020/04/01 Becker Pipeline Co Certificate of Liability Insurance (5) AC40RE0 CERTIFICATE OF LIABILITY INSURANCE DATE g/22/2020 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 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: Vanessa Gilbert The Empire Company PHONEMo. t (909)476-0600 PAX N0, (111)116-0601 l. 10201 Trademark St. , Suite D E-MAIL vgilbert@empire-co.com ADDRESS: P.O. Box 5400 INSURERS AFFORDING COVERAGE NAIC# Rancho Cucamonga CA 91729 INSURERA:Berkley Assurance Company 39462 INSURED INSURER B:California Auto Insurance Company 38342 Becker Pipeline Co INSURER C:Everest Premier Insurance Company 16045 1060 Northgate St, Ste B INSURERD: INSURER E: Riverside CA 92507 INSURERF: COVERAGES CERTIFICATE NUMBER:19/20 BA 20/21 GL/WC/xS 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. TN-SR TYPE ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MIDD/YYYY DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE OCCUR DAMA ET R ED 100,000 PRE 1 E Ea occuuence S X VUMA0228000 9/20/2020 9/20/2021 MED EXP(Any one person) S 5,000 PERSONAL &ADV INJURY S 1,000,000 GENIAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ PRO JECT ❑LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE EMIT $ 1,000,000 Ea"a6 dent B X ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BA040000047525 10/20/2019 10/20/2020 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Peraceldent Uninsured motorist combined single $ 100,000 UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 2,000,000 A X EXCESS LIAB CLAIMS-MADE AGGREGATE S 2,000,000 DED I I RETENTION$ VUMA0228090 9/20/2020 9/20/2021 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N AT T R ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A C (Mandatory in NH) 7600017603201 4/1/2020 4/1/2021 E-L DISEASE-EA EMPLOYEE 5 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Menifee, its officers, employees and agents are named as Additional Insured where required by written contract per attached form CG2010 1219. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Menifee THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 29844 Haun Rd ACCORDANCE WITH THE POLICY PROVISIONS. Menifee, CA 92586 AUTHORIZED REPRESENTATIVE V Gilbert/VGILBE V� p { r C 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)