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2021/04/02 Advance Refrigeration & Ice Systems, Inc. Certificate of Liability InsuranceADVRE-3 '4c�Ro9 CERTIFICATE OF LIABILITY INSURANCE DATE 91202YY) o�r2g/2o21 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 909-980-4211 CONTACT I NAME: Silverstone Insurance Services PHONE 909-980-4211 FAX Advantage Insurance vc No Ext : {wc, No): PO Box 1200 XMSS, sarahosilverstoneins.com Rancho Cucamonga, CA 91729 Robert W. Young INSURER(S)AFFORDING COVERAGE INSURER A , Insurance Comoanv of the West 127847 INSURED Advance Refrigeration & Ice Systems, Inc. 1433 W Linden St Ste A Riverside, CA 92507-6816 INSURER F : r:C]VFRAnFR r'FRTIFIrLATF Ali IMR1=R• Pr-1/49Zirl f PdI IMRFR- 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 CLAIMSTINSR—F _ 'T. TYPE OF INSURANCE ADDL SUER. POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED MED EXP am erso $ PERSONAL & ADV IN RY GEAGGREGATE LIMIT APPLIES PER: POLICY JpCT D LOC OTHER: ENERALAGGREGATE- PRODUCTS - C MP/OP AGG AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY A[JTQS ONL�OB L COM51NEDSINGLE LIMIT BODILY INJURY PerPerson) $ BODILY INJURY Per accident BODILY $ TY,DAMAGE $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4QAN�YPROPRIETOR/PARTNER/EXECUTIVE Y/N (MFal R/toryM IIn NH) EXCLUDED? If ves, describe under D RIPTI N OF OPERATIONS below N / A Y INSA505482601 04/02/2021 04/02/2022 X PER OTH- E.L EACH ACCIDENT 1,000,000 EL DISEASE - EA EMPLOYEE 1,000,000 $ E.L. DISEASE - P LI Y LIMIT 1 �00,00� DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Contract #5285. WCWOS per #WC990634 800 attached. '10 Day notice of cancellation in the event of non-payment of premium. "30 Day written notice for policy cancellation. Ir-IL.A I C 11110rlflla,II City of Menifee and its officers, employees,agents and authorized volunteers 29714 Haun Road 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 V.. - ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. B-00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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). The additional premium for this endorsement shall be otherwise due. Person or Organization ANY PERSON/ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT 2 % of the total California Workers' Compensation premium Schedule Job Description ALL CALIFORNIA OPERATIONS This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 04102/2021 Policy No. WSA505482601 Endorsement No. Insured Advance Refrigeration & Ice Systems, Inc. Premium $ INCL . Insurance Company INSURANCE COMPANY OF THE WEST A Countersigned By Vm..Alc��,Ut WC 99 06 34 (Ed. 8-00)