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2019/12/01 Guy F. Atkinson Construction, LLC Certificate of Liability Insurance
DATE (MM/DDNYYY) ARo CERTIFICATE OF LIABILITY INSURANCE 5/22/2020 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 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 endorsements . PRODUCER CONTACT NAME Monica Talmo Alliant Insurance Services, Inc. PHONE FAX 7108 Fairway Drive ENo, ,E�• 561.214.6366 Arc Nn Suite 225 ADDRESS: ClarkcertS alliant.com Palm Beach Gardens, FL 33418 INSU RER(Sl AFFORDING COVERAGE NAIC # INSURED Guy F. Atkinson Construction, LLC 18201 Von Karman Avenue Suite 800 Irvine CA 92612 INSURER A: Zurich American Insurance Comp 16535 INSURER B: ACE American Insurance Company 22667 INSURER C : ACE Property & Casualty Insura 20699 INSURER D INSURER E CnVFRAGFS CERTIFICATE NUMRFR! 17771fi1..59P REVISION NUMRFR- 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. LTR TYPEOFINSURANCE AL-DLSUBR POLICYNUMBER JNPjO&LRCQYMEnFMF MOLIQ IYY LIMITS B X COMMERCIAL GENERAL LIABILITY Y Y HDOG71080109 6/1/2020 6/1/2021 EACH OCCURRENCE $2,000,000 CLAIMS -MADE OCCUR P AhASES. RENTEr ance $ 1,000,000 X MED EXP (Any one parsonj $ 10,000 Contractual Liab X X,C,U Cov PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY [K PRO- JECT FX] LOG PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER: B AUTOMOBILE LIABILITY Y Y ISAH09094052 6/1/2020 6/1/2021 COMOINED INGLE LIMIT fen G=Identl $ 5,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROP RTYDAMAGE Per accident $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY c UMBRELLALIAB OCCUR Y Y XCQG7180673AO01 6/1/2020 6/1/2021 EACH OCCURRENCE $8,000,000 X N AGGREGATE $ 8.000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ AL OCC/AGG $ 5.000.000 B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE Y WLRC50803399 (ADS - Stop Gap for ND, OH, WY) WCUC50803405 (WA) 6/1/2020 6/1/2020 6/1/2021 6/1/2021 ER X STATUTE ER EL EACH ACCIDENT $ 2,000,000 OFFICER/MEMBEREXCLUDED? N/A E.L DISEASE - EA EMPLOYEE $ 2.000.000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E-L. DISEASE -POLICY LIMIT $ 2,000,000 A Inland Marine/CE/Property Leased/Rented/Borrowed Equip. CPP532198714 12/1/2019 12/1/2020 Any One Item Per Occurrence $2,500,000 $2,500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 150348, Scott Road 1-215 - Menifee and Murrieta, CA. The County of Riverside, its Agencies, Districts, Special Districts and Departments, their respective directors, officers, Board of Supervisors, elected and appointed officials, employees, agents, and representatives, State of California, Department of Transportation, its elected and appointed officials, officers, directors, employees, agents, and representatives, The City of Menifee, its elected and appointed officials, officers, directors, employees, agents, and representatives, The City of Murrieta, its elected and appointed officials, officers, directors, employees, agents, and representatives, Eastern Municipal Water District (EMWD), its officers, directors, employees, agents, and representatives, Frontier Communications, its officers, directors, employees, agents, and representatives are included as an Additional Insured on a Primary/Non-Contributory basis with respect to the above General Liability and Automobile Policies as required by a written contract. Waiver of Subrogation Applies to both General Liability and Workers Compensation. No policy will permit cancellation or modification without thirty (30) days prior written notice. City of Menifee 29714 Haun Road Menifee CA 92586 LeI R► L91 q el IgG11 I Lei 9 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD