2023/01/01 Newport Harbor Const., Inc..---rACORD NhWPU54
12128t2022
IMPORTANTi lf the cortificate holdor is an ADDITIONAL INSUREO, the policy(ies) must havo ADOITIONAL INSURED provisions or be endo.sed.
lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, cortain policies may requiro an 6ndo6ement A statement onthis c€rtificate does not conler rights to tho certificate holdor in li6u of such ondorsem€n(s).
949-365-5169 fi8ilIlcr Debbie PeoPtes
lJ8,*nL,.", glg-gss-stss
imEss debbie.peoples@gig.ls
INSURERlS) AFFORDINQ COVERAGE
. Nsunena, Everest Pre!r!!91!!lsurance Co
INSURER B:
INSURER C:
INSURER D:
INSURER €:
16045
Brakkeschafnits Ins. Brokers
Liconso *0K07568
3 Polaris Wav. 4th Floor
Atiso vieio, CA 92656
Blakke Schafnit2 lnsuranco
II{SURED Newport Harbor Const., lnc.
Jacki6 Schulte
3419 Via Lido #602
Nowport Beach, CA 92663
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOO
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 ATFOROED BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERIVS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN INAY HAVE BEEN REOUCEO BY PAID CLAIMS
POLICY EFF POLICY EXPIMM/DDIYYYYI IMM/DD/YYYYI
S
s
COMMERCIAL GENERAL LIABITITY
CLA MS.MADE OCCUR
PERSONAL &ADVINJURY
GENERAL AGGREGATE
L PRODUCTS - Co!,t!'&l!Gq
GEN'! AGGREGATE !lMIT APPLIES PERt- .-^poLrcY lEdi Loc
OTHER
EACH OCCURRENCE - !
OAMAGE IO RENTED
PBEMISES (Ea occLrnBnce) $
MED EXP (Any onepeBonl I
OWNEDAU'TOS ONLY
AUTOS ONLY
COMBINEDSIN6LE LIMIT
L lEa acsdenu
aODlLY lNJllRY {Ps. o.r.on) $E-,." "rr-"*;;;T-PROPERTY DAMAGE(P6rac]d6nl) s
$
AUTOMOBILE LIABILITY
SCBEDULEOAUTOS
NON.OWNEOAI]TOS ONLY
t,
.sRETENIONSOED
occlJR
CLAIMS.MAOE
IACH OCCURRENCE
AGGREGATE
A woEKERs coMPaNsAroNANO EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER]EXECU-T VE
OFF CER/MEMBER EXCLUOED?{Mr.d.loryln NH)
ll v8s d6schbe lnderOFIi:RIP.rION OF APFRAT AIJS !A&
1,000,000
1,000,000
1,000,00c
7 600022921231 5
PER OTIISTATUTE ER
0110112023 0110112021 EL EACB ACc oENr
E L D SEASE, EA EMPLOYEE S
t L D SEASE POLI(JY L MIT S
OESCRiPTTON OF OPERAIONS / LOCATIONS /VEHICLES (AGORD 1ol, AddniodlR.mrt. Schedule, tuy be .tL.h.d t mo.prc.l! Equicd)
RE: Sky View 161 - Encroachment Permit
CITYMEN
City of Menifee
29714 Haun Road
Menifee, CA 92585
SHOULO ANY OF IHE ABOVE DESCRIEEO POLICIES BE CANCELLED gEFORE
THE EXPIRATION DATE THEREOF. I{OIICE WILL BE DELIVERED III
ACCOROANCE wlTH THE POLICY PROVISIOI{S,
AUTHORIZEO REPRESENTATlVEI'l*"* 4./,oph."-
ACORD 25 (2016/03)
THIS CERTIFICATE IS ISSUEO AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGANVELY AI{END, EXTEND OR ALTER TIIE 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.
lil ,",srs-ri:-srzo
CERTIFICATE OF LIABILITY INSURANCE I
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UMBRELLA LIAB
EMssftB
CANCE
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