2021/10/01 Inland Valley Construction Company, Inc.ACORD'
COVERAGES
INLANDVAL-
CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NUMBER REVISION NUMBER
9t24t2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENO, 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 HOLOER.
IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endo6ed.lI SUBROGATION lS WAIVED, subject to the terms and conditions ofthe policy, certain poticios may requiro an endorsement. A statemenl on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
The Wooditch Company lnsu.an6e Services, lnc.'l Park Plaza, Suite 400lrvihe, CA 92614
[iI, ro,(949) ss3-0670
INSUREO
fodubIGcneeaUlNsERRep
INSURER C
URER B
fJ3,*'f", ."r, (949) 5s3-9800
E.MAILADDRESSI
INSURER(S) AFFORDING COVERAGE
INSURER O
INSURER E:
INSURER F:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED EELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTOWHICH THIS
CERT FICATE 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 CLAIIVS,
INSR ADOL SUBR POLICY EFF POLICY EXPIMM/OOIYYYYI IMM/DD|YYYYI
1,000,000
100,000
5,000
1,000,000
2,000,000
2,000,000
EACH OCCURRENCE
1CG96'19'1812
A
I
s
5
10t1t202,1 1011t2022 DAMAGE TO RENTED
PREMISESIEa o.rurrcnce)
MEO EXP (Any one perrson)
$
$
$
GEN'L AGGREGATE UMIIAPPL ES PER
eorrcv X !$so; Loc
OT'JER:
X coititERctAL GENERAL LtaBtLtrY
CLAIMS MADE X OCCUR
GENERAL AGGREGATE
PROOUCTS - COMP/OPAGG
A autouogtLe L,og,a,tt
X erv auro
OWNEO
AUTOS ONLYX llffoo, o^, "
COMBINED SINGLE TIMIT(E. acqd€oU
EooLLY!&lqSlllger peFon) t
BOOILY INJURY (Per a6idenl) $
PROPERTY DAMAGE(P aeidenr) t
$
1,000,000
Alca96't9'1812
Y NON OWNED
101112021 101112022
SCHEDI.]LEDAUTOS
UMBRELLA LIAB
FrcFss r lAa
DED RETENTION $
$
$
$EACH OCCURRENCE
AGGREGATE
A woRKERs coMPENgAnoirAND EITFLOYERS', LtABlLt fY Y/ N
ANY PROPRIETOF/.Ai{T Nf R LrLC U T lvLOFF CER]MEMSEA EXCLT'DEO'1(rr.nd6lory in NH)
ll y6s d6scnb€ und6rOFSCRTPTION OF OPERATIONS bel6w
EL EACHACCIq!:!L $
E L DISEASE - EA EMPLOYEE $
E L DISEASE. POLICY LIMI] $
1,000,000
1,000,000
1,000,000
A''CW96191812
OTH.ERx EiI',TE10t1t2021 10t112022
OESCRIPTION OF OPERATIONS / LOCATIONS / VEHICTES (ACORD 101 , Addhlon.l Romari. Schodulo, nay bo att..hod il no.o sp... Is r.quk6d)
RE: All opqrations performed by lho Named lnsured during tho cur.6nt pollcy period.
City o, Menifee
29714 Haun Rd.
Sun C ity, CA 92586
SHOULD ANY OF THE AAOVE DESCRIBEO POLICIES BE CANCELLEO BEFORE
THE EXPIRATION OATE THEREOF, NOTICE wlLL BE DELIVERED IN
ACCORDANCE wlTH THE POLICY PROVISIONS,
AUTHORIZEO REPRESEN'TATIVE
CERTIFICATE HOLDER
acoRD 2s (2016/03)
lnsurarce lqglpgration 241 39
lnland Valley Const.uction Company, lnc.
18382 Slover Ave.
Bloomington, CA 92316
TYPE OF INSURANCE
OCCUR
CLAIMS.MAOE
O'1988.2015 ACORD CORPORATION. All rights rsservod.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: INLANDVAL-
LOC #: 1
ADDITIONAL REMARKS SCHEDULE
JEANA
ACORL''Page 1 of I
NA ED INSURED
lnland Valley Construction Company, lnc.
18382 Slover Ave.
Bloomington, CA 92316POLICY NUMBER
SEE PAGE 1
NAIC CODE
EE PAGE 1 EEPl EFFEcnvE oATE: sEE PAGE 1
AODITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORO FORM,
FORM NUMBER: ACORD 25 FORM TITLE Certincate of Liability lnsuranc€
Cancellation:
'Except 10 days notice of Cancellation for non-payment of premium.*Should this policy be cancelled before the expiration date, The Wooditch Company will mail 30 (thirty) days written notice to those
Certificate Holders which require such action per contract or agreement.*
O 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD 101 (2008/01)