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2020/09/01 Wilson Utility Construction Co Certificate of Liability Insurance (3)
AC"Ro® CERTIFICATE OF LIABILITY INSURANCE 7E(MM/DDfYYYY) �� /27/2020 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 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 endvrsement(s). PRODUCER CONTACT MCGRIFF,SEIBELS&WILLIAMS,INC. NAME_ P.O.Box 10265 CITY OF MENIFEE PHCNC 800-476-2211 fA Birmingham,AL 35202 FINANCE E HP:.VfS1 -tIVR Nod: A6DRE53: SEP0 1 2020 INSURERS AFFORDING COVERAGE NAfC# INSURED INSURER A:Arch Insurance Company 11150 Wilson Utility Construction Co RECEIVED INSURER B; 1190 N.W.Third Avenue INSURER C: Canby,OR 97013 INSURER D INSURER E INSURER F; COVERAGES CERTIFICATE NUMBER:C569Q53M 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, INSR ADOO W V POLIGT E F POLICY EXP 10 LTR TYPE OF INSURANCE IN b1 b POLICY NUMBER I MMIFHy15' MMtt7p1YYYy LIMITS A X COMMERCIAL GENERAL LIABILITY f 31PKG8959901 0910V2020 09)01/2627 2,000,000 I EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREINISES_E(_a xcurrerwe $ 300,000 X MED EXP[Orly one ggi $ 5,000 PERSONAL&ADV INJURY $ 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000.000 POLICY FX1PRO- ❑JECT LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: $ A AUTOMOBILE LIABILITY 31PK 95390Y 09/01/2020 09/01/2021 EOMBIINED L 5 2�QDU 400 SINGLE IMI X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED -PROAERTY qq AUTOS ONLY AUTOS ONLY MAGE _f,Pcracridenl $ Card -510,000 deductible $ Coll.$10.000 ded JUMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LABCLAIM$-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION 31WC18959761 09/01/2UY0 09/01/2021 PER I JOTH, AND EMPLOYERS'LIABILITY Y/N 34WC18959801 CA,NY,OR,PA X _0AT ,U ANY PROPRIETOR/PARTNER/EXECUTIVE Including Stop Gap-NO,OH,WA& OFFI C ER/MEMBER EXCLUDED? ❑ N/A WY E.L._EACH ACCIDENT $ 1,000,000 (Mandatory in N If E.L.DISEASE-EA EMPt.OYEE $ 1,000,000 yyaass UESIF710N OF OPERATIONS helvx Ci;describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 6386 SCE—Valley South Subtransmission Project. Certificate Holder is Additional Insured under General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Menifee I AUTHORIZED REPRESENTATIVE 29714 Haun Road Menifee,CA 92586 Page 1 of 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD