2021/12/31 Workforce Business Services CA, LLC (5)A,CORI)'DATE IMT,OO,IYYY)
12t0712021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFENS NO RIGHTS UPON THE CERTIFICATE HOLOER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGANVELY AMENO, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF II{SURANCE OOES NOT CONSTITUTE A CONTBACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEO
REPRESENTATIVE OR PRODUCER. AND TTJE CEBNFICATE HOLDER.
IMPOBTANT: lt the certlficate holder is an ADDITIONAL INSURED, the pollcy(ies) mu8t have ADOITIONAL INSUREO provlsions or be endorsed,
ll SUBROGATION lS WAIVED, subject to the te.ms and conditions ol the policy, certaln pollcles may requlre an endoJsemenl. A statemenl on
thls certlflcate does nol conrer rlghts to lhe cerlltlcale holder ln lleu ol such elqorsernenl(3).
PnooucEa
Bouchard lnsurance for WBS ' TG
PO Box 6090
Ctearwator. FL 33758-6090
II€UFEO
WorklorEe Busrn€5s Ssrvicos CA LLC Labor Cornlaclor. lor co-€mploye€a oli Moore
Fonce Cofipsny Inc. dba: Moore Fence 8 lmlaltslion Company loc.
1401 Manaloe Avo. Wast Sle 600
Bradonton. FL 34205-6708
COETICY
PBOi{E
Todd George
{966) 293'3600 ext. 623 {rJc. No)E-l/l4[
^QSEESS:
IiISUREF A:
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INSUBEF E :
INSUBER F r
INSUREFIS) AFFOBDING COVEFAGE
Zurich-Amer can lnsurance Company 16535
CERTIFICATE OF LIABILITY INSURANCE
CEFTIFICATE NUMBEB:21 F1079865435COVERAGES BEVISION NUMBERI
THIS IS TO CERTIFY I}|AT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSURED NAIUED ABOVE FOF THE POLICY PEBIOD
INOICATED, NOTWTHSIANOING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHEB DOCUMENT WITH RESPECT TO WHICH'T}]IS
CERTIFICATE MAY AE ISSUEO OR MAY PERTAIN, THE INSURANC€ AFFORDEO BY THE POLICIES OESCBIBEO HEREIN IS SUEJECT TO ALL THE TEBMS.
EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
AODL SUBF POUCY EFT(Li(DoYYYYI LII/lISTYPEOFINSUFANCEPOUCY NUMEEF
COIIIT/IEFCIAT OEXEEAL LIASruTY
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AI{D EUPLOYEAA' LIAEIITTY. ANYPFOPN ETON PAFITNEF EXECU'IIVEA oFFrcEilMEMaEBExcLUoEo?([.nd.lo.y ln NH)'n lEs-fi*aQrEftErDEscFrProN oF oPEFAToNS b.row
v PER OTrr}1 S1ATUTE EF
E L EACH ACCIOENI S 1,090,000
1,000,000
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wc 58-18-606-08 12t31t2021 12J3',U2022
E L, OISEASE EA EMPTOVEE 5
E L orsEAsE ioLrcY aitt ' t
Locstlon Coverage Perlod: 12131/2021 1213112022 Cllenl# 054198
oEscFtETtot{ op OpEiATIolGt/ loc^no.rs , VENTLE!| (ACoFD r01, Ad.roon larn rtt scn dur.. m.y b..ibclt.d lt mor..p.c. lr r.quli.d)
Moore F€nc€ Company lnc. dba: Moore Fenco & Monileo Public wo*s Yard
ffi]#"{*ffi# hsra at,oncorm;yr;c. 'r1T,i,:?1"J.*f
ro: Peris, CA 92570
CERTIFICATE HOLOER CANCELLATION
City ol M6nifee
29775 Haun Rd
Menilos. CA 92586
SHOULD ANY OF THE ABOVE OESCBIBEO POUCIES BE CA'IC€LLED BEFOBE
THE EXPIRATION OATE THEBEOF. I{OTICE wlLL gE OELIVEAED IT{
ACCOBDANCE wlIH TH€ POLICY PROVISIONS,
AUIHOFIZEO REPF€SENTA-IIVE
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O 1988.2015 ACORD COBPORATION. All rlghts reserved.
ACOBD 25 (2016/03)The ACORD name and looo aro reoiste.ed marks ol ACOBD 2'ol2 39040