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2019/12/01 R I C Construction Co. Inc. Certificate of Liability Insurance DATE(MM/DD/YYYY) ,4`"R" CERTIFICATE OF LIABILITY INSURANCE 121312019 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(Ees)must have ADDITIONAL INSURED provisions or be.endor"d. 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. CT PRODUCER patriot Risk& Insurance ServiceSCITYOf f"""' .NAME"_. 2415 Campus Drive, Suite#200 �Irae, P"°NE Nqkm- gag assasoo F,M No: 949 486-7950 Irvine, CA 92612 ��`jj EC k E-A;IL ADORE INSURERS AFFORDING COVERAGE NAIL 0 www.patdsk.com OK07568 INSURER A: Middlesex Insurance qqmwny 23434 INSURED R E C F,1 INSURERS: R I C Construction Co.Inc. 10675 E Avenue, Suite#1 INSURERC: Hesperia CA 92345 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 52691731 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 AVQITYPE OF INSURANCE INSD 5U n I POLICY NUMBER MM•!DD!YYV: POLICY Y MMIDPOLICY�"P LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES(Fa occurrencel $ MED EXP LMy one person) $ PERSONAL&ADV INJURY $ GENT AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ POLICY PRO ❑LOC PRODUCTS-COMP/OP AGG $ JECT OTHER. $ AUTOMOBILE LIABILITY fEa ecciden $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident $ AUTOS ONLY AUTOS ) HIRED NON-OWNED pROPER7YDAMAW $ AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION A0114746005 12/1/201 s 121112020 PE rurE ER AND EMPLOYERS'LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1 00O 000 OFFICEWMEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yea,describe under DESCRIPTION OF OPERATIONS below 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) Verification of coverage only. 30 days notice of Cancellation,10 days for non-payment of premium. 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 Attn:Gina Gonzalez, Project Manager ACCORDANCE WITH THE POLICY PROVISIONS. City Hall 29y14 Haun Road Menifee CA 92586 AUTHORIZED REPRESENTATIVE Dave Jacobson ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 52691731 1 19/20 GLAU/UMB/WC/IM AnngLke Romero 112/3/2019 9:04:52 AM (PST) Page 1 of 1 This certificate cancels and supersedes ALL previously issued certificates.