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2019/01/16 Valley Pipeline Services, Inc. Certificate of Liability Insurance (4)
C�l\ 1 l�J CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 12/03/2019 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 poilcy(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 endorsemengs). PRODUCER Temecula Insurance Services 41923 Second Street Suite 201 CITY OiliANCE�Ef Temecula CA 92590 CONTACr NAME: Cynthia Cadenhead PHONE (951) 694-5200 X (951) 302-0470 Arc No Ext : AIC ND E-MAIL cynthia@temecufa,,isuranceservices.com AnnRE55: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Kinsale Insurance Company 14027 INSURED £- � �� Valley Pipeline Services, Inc. t_ 47-110 Washington St RECEIVED Ste. 201 La Quinta CA 92253 INSURERB: WeStAmerican Insurance Company 44393 INSURER C : State Compensation Ins. Fund 35076 INSURERD: Ohio Security Insurance Company 24082 INSURER E: INSURERF: nnVFRAnPA CFRTiFICOTF NIIMRFR, CL1911002254 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 LTR TYPE OF INSURANCE WV POLICY NUMBER POLICY EFF MM/DDIYYW POLI Y EXP MMIDDIYYYY LIMITS X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR PREMISES Eaoccurrenca $ 100,000 MED EXP (Any oneperson) $ Excluded PERSONAL &ADV INJURY $ 1.000,000 A Y 0100049221-2 03/31/2019 03/31/2020 GEfYLAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2.000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY ® PRO - POLICY F1 LOC Deductible $ 5,000 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea aodde l $ 1,000,000 BODILY INJURY (Per person) $ X ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 0 BAW56619091 12/05/2019 12/05/2020 BODILY INJURY (Per accident) $ PROPERTY DAMAGE per accident $ Deductible $ 1,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2, 000,000 A X EXCESS LIAB CLAIMS -MADE 0100049292-2 03/31/2019 03/31/2020 DIED T RETENTION $ Deductible $ 0 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE N] OFFICERIMEMBER EXCLUDED? (Mandatory in NH) NIA 9086042 01/16/2019 01/16/2020 %� PEATllTE ER E L. EACH ACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,000 EL DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below Scheduled Limit 1,111,353 D Contractors Equipment/BPP Deductible $1,000 BKS56619091 03/31/2019 03/31/2020 Rent/Leased Equipment $300,000 BPP Limit $28,136 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: North Canyon Drive Drainage Improvements CIP 17-06. City of Menifee and it's elected officials, officers, employees, agents, representatives, consultants, contract employees and volunteers are hereby added as additional insures but only as respects work done by, for, or on behalf of the named insured. The Umbrella Liability follows the General Liability and Auto Liability. L.GYLIO'IL.AI t NULL3tX L.ANI..tLLAI IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Menifee ACCORDANCE WITH THE POLICY PROVISIONS. 29714 Haun Road AUTHORIZED REPRESENTATIVE Menifee CA 92586 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD