2021/09/01 Wilson Utility Construction Co08t34t2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAIION ONLY AND CONFERS NO RIGHIS 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 NOI CONSTITUTE A COI{TRACT BETWEEI{ THE ISSUING IT{SURER(S), AUTHORIZEO
REPRESENTATIVE OR PRODUC€R, ANDTHE CERTIFICAIE HOLDER,
IMPORTANT: lf Lhe certificate holder is an ADOITIONAL INSURED, the policy(ies) musr have ADDIIIONAL INSURED p.ovisrons or be endorsed.
lf SUBROGATION lS WAIVED, subject to the terms and conditaons of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer riqhts to the certificate holder in lieu of such endo6ement(s).
lltccriff lnsurance Servrces, lnc.
P O Box 10265
&rm,nsham. AL 35202
IXSUREO
Wilson Uiility ConstruclEn Co
1190 NW Third Av€nue
Canby, OR 97013
CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NU MBER:(i\1cuMaCOVERACES REVISION NUMBER
THIS IS IO CERIIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONOITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
COTIMERCIAL GENERAL LIAAILITY
GEN'LAGGREGATE LIM T APPLIES PER
X
X
lncludrng WA Slop Gap
X
X
X
X
occuR
LOCJECT PRODL.]CTS COMP/OP AGG
PERSONAL & AD/ INJLJRY
GENERAL AGGREGATE
2,000.000
1.000.000
5.000
,.000.000
4.000.000
4-000-000
AUIOS ONLY
HIREO
a9lo1Qa21 2.000.000
$10,000 deductrb e $ corr $ro,ooo oeo
AUIOMOAILE LIABILITY
SO0TLY INJURY (P€r p6con)
BOOTLY TNJURY (Por aGdsnr)SCHEOIJLED
AUTOS
NON OWNED
E'(CESS LIAB
X TT
s
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OESCRPnOI OF OPEAAT|oI{S / IOCAIOI{S /VEI{ICLES {ACORD 101, Addtion.l R.m.rt Sch.dul., firy b. .tt ch.d il mo. 4rc. i. r.q!ind)
6386 SCE Va{ley South Subtransm6sion Prolect
Certifcate Holder is AddiUonal lnsured under General Lrabrlity as requrred by wntten conaacl
IVORKERS COCP€NSANOi{
ATD EXPLOYERS' LIABILITY
ANY PROPR FTOR/PARTNFfu FXECI]TIVE
OFFICER/MFMEFR FXCt I]DFO?
lncluding Stop Gap-ND, OH & wY a91a112A21 A9lA1l2A22
CANCELLATION
OTH
E L EACH ACCIOENT 1,000.000
EI DISFISE !A EMPIOYEE I
E L DISEASE . POLICY LIMIT
1.000,000
1,000,000OESCRIPTION OF OPERAT ONS h6ow
CERTIFICATE HOLDER
N
29714 Haun Road
Menrfee CA 92s86
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOREIHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POfICY PROVISIONS,
AUTHORIZEO REPRESENTAIIVE e{-
Pase 1 or 1 O 19EE-2015 ACORD CORPORATION. All rights.ese.ved
The ACORD name and logo are registered marks of AGORDACORO 25 (2016/03)
aaa 476 2211
kwsner@mcgntrcom
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