2020/04/01 Becker Pipeline CO Certificate of Liability Insurance Acc*?" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
`�. 10/7/2020
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 NAME, Vanessa Gilbert
The Empire Company PHONE (909)476-0600 N0. (909)976-0601
10201 Trademark St., Suite D E-MAIL filbert@empire-co.com
ADDRESS:v g
P.O. Box 5400 INSURERS AFFORDING COVERAGE NAIC#
Rancho Cucamonga CA 91729 INSURERA:Berkley Assurance CoMany 39462
INSURED INSURER B:California Auto Insurance Company 38342
Becker Pipeline Co INSURER C:Everest Premier Insurance Company 16045
1060 Northgate St, Ste B INSURER D:
INSURER E:
Riverside CA 92507 INSURER F:
COVERAGES CERTIFICATE NUMBER:20/21 MASTER ALL LINES 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
PXP
VTR TYPE OF INSURANCE i4 POLICY NUMBER MMIDIDIVWV MM DD/VYYY LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
DAMAGET RENTED
A CLAIMS-MADE FX-1 OCCUR P EMI ES Ea occurrence) $ 100,000
X VUMA0229080 9/20/2020 9/20/2021 MED EXP(Any one person) $ 5,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000
X POLICY JEa LOC PRODUCTS-COMP/OPAGG $ 2,000,000
OTHER $
AUTOMOBILE LIABILITY Fa ac COPriBIGNED3INGLELIMIT $ 1,000,000
den
B X ANYAUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED
AUTOS AUTOS 10/20/2020 10/20/2021 )]aA040000047525 BODILY INJURY $
(Per accident
HIRED AUTOS NON-OWNED PRt7:Er1,1AMAGE $
AUTOS Per ac en1
Uninsured molodsl combined single $ 100,000
UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000 000
A X EXCESS LIAB I I CLAIMS-MADE AGGREGATE $ 2,000,000
DED I I RETENTION$ VUMA0228090 9/20/2020 9/20/2021 1 1 $
WORKERS COMPENSATION X PET TE OERH
AND EMPLOYERS'LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 1,000,000
OFFICERIMEMBER EXCLUDED? ❑NIA
O
(Mandatory in NH) 16.0.17603201 4/1/2020 4/1/2021 E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000
f
DESCRIPTION OF OPERATIONS I LOCATIONS I 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 forms. (CG 20 10 12 19)
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
1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025(201401)