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2021/07/01 Blackmore Co, LLCD� CERTIFICATE OF LIA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AN[ CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the poli If SUBROGATION IS WAIVED, subject to the terms and conditions of the p this certificate does not confer rights to the certificate holder in lieu of suc PRODUCER James G Parker Insurance Associates License #0554959 P O Box 3947 Fresno INSURED COVERAGES Blackmore Cc LLC Blackmore Equipment Co LLC 41571 Date St Temecula CA 92562 BILITY INSURANCE DATE(MM/DD/YYYY) 07/02/2021 CONFERS NO RIGHTh UPON THE CERTIFICATE HOLDER. THIS ND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED :y(€es) must have ADDITIONAL INSURED provisions or be endorsed. Ilicy, certain policies may require an endorsement. A statement on h endorsement(s). CONTACT Carrie Stubblefield CISR NAME: PHONEfAfC. H Ex (559) 222-7722 FAX Nor (559) 222-1724 ADDRESS! CarrieStubblefield@jgparker.com INSURER(S) AFFORDING COVERAGE NAIC p INS URERA: Evanston Insurance Company 35378 INSURER B : Oregon Mutual Ins CO 14907 INSURER C : XL Specialty Insurance Company 37885 INSURER D : INSURER E INSURER F : CERTIFICATE NUMBER- 21-22 GL BA IM LIMB DC\/IQ1fNKI 611111ICCO. 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. LTR TYPE OF INSURANCE O POLICYNUMBER MMR701YYYY MM1Dp�Y LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS OCCUR S -MADE PREMISES Ea oCCurrence 5 300,000 MED EXP IAny one person) S 5,000 A MKLV5PBC003461 07/01/2021 07/01/2022 PERSONAL& ADV INJURY S 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY 19 �JCT ❑ LOC PRODUCTS -COMPIOPAGG S 2.000,000 OTHER: Per ProjectAgg Cap $ 10,000,000 AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ 1,000,000 X ANYAUTO Ea accidert! BODILY INJURY (Per person) $ B OWNED AUTOS ONLY SCHEDULED AUTOS CM0921413 07/01/2021 07/01/2022 BODILY INJURY Per accident) $ �I /\ HIRED AUTOS ONLY yy ^ NON -OWNED AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLALIAB P�EOC, UR EACH OCCURRENCE 5 2,000,000 A EXCESSLIAB IMS•MAOE MKLV5EUL103409 07/01/2021 07/01/2022 ACr;RFC'ATF c 2,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETMPARTNERJEXECUTIVE OFFICEPJMEMBER EXCLUDED? ❑ N / A (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Rented/Leased Equipment C Scheduled Equipment UM00089059MA21A S EL, EACH ACCIDENT $ E.L.DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ $1,000 Deductible $585,000 07/01/2021 07/01/2022 $1,000 Deductible Per Schedule DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) t,crc i Irit HI a rEVLUtK CANCELLATION SHOULD ANY OF THE .Y,50VE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATETHEREOF, NOTICE WILL BE DELIVERED IN City of Menifee ACCORDANCE WITH THE POLICY PROVISIONS. 29714 Haun Rd AUTHORIZED REPRESENTATIVE Menifee CA 92586rj���.-, ©1 '388-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD