Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2020/07/01 R.J. Noble Company, Inc. Certificate of Liability Insurance
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 6/30/2020 Patriot Risk & Insurance Services 2415 Campus Drive, Suite #200 Irvine, CA 92612 (949) 486-7900 (949) 486-7950 www.patrisk.com 0K07568 Dave Jacobson R. J. Noble Company, Inc. 15505 Lincoln Avenue P.O. Box 620 Orange CA 92856-9020 56310001 3 3 33 3 City of Menifee, its elected officials, officers, employees, agents, representatives, consultants, contract employees and volunteers endorsement attached where required by written contract. Coverage is Primary and Non-contributory. Waiver of subrogation applies. City of Menifee 29844 Haun Road Menifee CA 92586 Re: RJN #91734 / CIP 19-06 Scott Road and Murrieta Road Traffic Signal & Intersection Improvements are named as Additional Insured but only as respects work done by, for, or on behalf of the named insured. *Excess/Umbrella Liability follows form. 30 days notice of cancellation, 10 days for non-payment of premium. A 1,000,000VTJ-EXGL-9F338142-TIL-20 7/1/2020 7/1/2021 300,000 3 3 1,000,000 2,000,000 3 Contractual Liability 2,000,0003 B VTC2E-CAP-9F338154-TCT-20 7/1/2020 7/1/2021 2,000,000 3 3 3 A CUP8N1480642025 7/1/2020 7/1/2021 10,000,0003 10,000,000Policy Follows Form Over3 Underlying General Liab. A UB-7N939386-20-25 7/1/2020 7/1/2021 3 1,000,000 1,000,000 1,000,000 Travelers Property Casualty Company of America 25674 Travelers Indemnity Company of Connecticut 25682 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 1 of 13 This certificate cancels and supersedes ALL previously issued certificates. R. J. Noble Company, Inc. VTJ-EXGL-9F338142-TIL-20 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 2 of 13 This certificate cancels and supersedes ALL previously issued certificates. 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 3 of 13 This certificate cancels and supersedes ALL previously issued certificates. R. J. Noble Company, Inc. VTJ-EXGL-9F338142-TIL-20 07/01/2020 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 4 of 13 This certificate cancels and supersedes ALL previously issued certificates. R. J. Noble Company, Inc. VTJ-EXGL-9F338142-TIL-20 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 5 of 13 This certificate cancels and supersedes ALL previously issued certificates. 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 6 of 13 This certificate cancels and supersedes ALL previously issued certificates. 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 7 of 13 This certificate cancels and supersedes ALL previously issued certificates. R. J. Noble Company, Inc. VTC2E-CAP-9F338154-TCT-20 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 8 of 13 This certificate cancels and supersedes ALL previously issued certificates. 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 9 of 13 This certificate cancels and supersedes ALL previously issued certificates. 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 10 of 13 This certificate cancels and supersedes ALL previously issued certificates. 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 11 of 13 This certificate cancels and supersedes ALL previously issued certificates. R. J. Noble Company, Inc. VTC2E-CAP-9F338154-TCT-20 07/01/2020 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 12 of 13 This certificate cancels and supersedes ALL previously issued certificates. 6/30/2020 UB-7N939386-20-25 56310001 | 20/21 - GL/AU/EXC/WC | Annette Romero | 6/30/2020 1:06:34 PM (PDT) | Page 13 of 13 This certificate cancels and supersedes ALL previously issued certificates.