2022/01/31 VCI Construction, LLCoaTE(tlwoo/YYYY)
01143t2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF TNFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE OOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OB ALTEB THE COVERAGE AFFOROEO BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSUFANCE OOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREB(S), AUTHORIZEO
REPRESENTATIVE OH PRODUCER, ANO THE CERTIFICATE HOLDER.
IMPORTANT: ll tho certilicate holder is an ADOITIONAL INSURED, th6 pollcy(los) must h6ve ADDITIONAL INSUREO proviaions or bo sndora€d.
It SUBROGATION lS WAIVED, sublect lo the terms and condlllons ol tho pollcy, certain policies may requiro an endo.sement. A atatomenl on
thls cortlllcst€ doos not conlor rights to tho carllllcste holder ln li6u ol such endorsement(+
PBODUCEA"Marsh USA, lnc
Iwo Alliance Cenler' 3560 Lenox Road Suite 2400
A anra GA 30326
CNl 02986923 upl-GAWU-22.23
CONTACT
PHONE
L
INSUREF(S) AFFOEOING COVERAGE
lNsuFEF a 1 Libe8 Mutuai F[e lnsurance Compaay 23035
INSUFEDVClConllruclon. LLC
1921 W llrh Streel
Upland, CA 91786
rtrlsUFEF B: LM lnsurance Corporaton 33600
tNsuREFc I Lrbefiy Surplus lnsurance CorD
Ir{suREF D: Libertv lnsurance Corporaton 42404
INSUNEB €
INSUBEB F
CERT!FICATE OF LIABILITY INSURANCE
COVERAGES CERTIFICATE NUMBER:ATr.0045S5349-17 REVISION NUMBEH: 1
THIS IS TO CERTIFY THAT THE POLICIES OF INSUBANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOB THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REOUIREMENT, TEFM OF CONDITION OF ANY CONTRACT OR OTHEH DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR [,iAY PEBTAIN. THE INSURANCE AFFOROEO BY THE POLICIES DESCFiIBEO HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSF TYPE OF INSUFAIiCE POLICY NUMBER POLICY EXP Lmtls
X COMMERCIAL GENEBAL LIABII.ITY
CLAIMS.MAOE OCCUR
GFN'L AGGREGATE LIMIi APPLIES PER:
POUCY
OTHEB
JECT LOC
X
x
TB2 631 004260.012 a1rJ1t2A22 0t/31/2023 EACli OCCI]RRENCE s s 000,000
DAMAGETO FENTEO
PREMISES (Ea6urcnce)$1.000 000
MED EXP (Anv one person)$
PEFISONAL & ADV ]NJUBY s 5,000,000
GENEFAL AGGBEGATE s 10,000 000
PBOOUCTS. COMP/OP AGG 5 10,000 000
s
X
OWNEOAUTOSONLY
HIAEO
AuTOS ONLY
SCHEDULED
AUIOS
NON.OWNEO
AUTOS ONLYXX
AS2.631 .004 260.022 0113112022 41131t2023 D SINGLE LIMIT s 5.000 000
BOOILY TNJUFY (P€r p€rson)$
BOOILY INJURY {P6. accd6nt)$
$
s
C
EICESS LIAB
X OCCUR
CLAIMS,MAOE
RFE.631-510?33.r42 01t3112422 01131Q423 EACH OCCUFFENCE s 5.000 000
AGGFEGATE s 5.000 000
DEI)EETENT]ON$$
s
B
0
WOFKEBS COIIPENSATION
AND EITIPLOYEBS' LIABILITY
ANYPf]OPFIEIOF/PAFTNEF/EXECUTIVE
OFF CEF/MEMBEF EXCLI]DED?
ofsaFrPTroN oF opFearroNs bar.*
N
wAs.63D-004260.032 (A0S)
wc5-631 004260 042 (MN,WD
wA7-63D 510689 512 (MA)
41131t2022
a113112022
0113112022
01/31/2023
0t/31/2023
01t31t2023
x STATUTE
oTu
ER
E L EACH ACCIOENT I 000 000$
E L. OISEASE. EA EMPLOYEE $r 000,000
€ L DISEASE. POLJCY LIMIT $r 000,000
DESCHIPTIoN oF oPEaAIOt{S / IOCAIIONS / VEHICLES (Acoao 101, Addnion.l Rldrk sch.dul., n.y b..n.ch.d il mo6.p.6l. r.qslEd)
Cenillcale holder is includedas an Addilional lnsured asrespecls to General Liabilily as required by wrnen contracl
CEFTIFICATE HOLDER CANCELLATION
City ol Menilee
€nqineerinq Depanmenl
29683 New Hub Drive
Meni{ee. CA 92584
AUTHOBIZED BEPRESENTAIIVE
%:anaz 2/.5i4 ,*c.
@ 1988-2016 ACOFD COBPORATION. All riqhts reserved.
The ACOFD name and logo are registered marks ol ACORDACOBD 25 (2016/03)
10)25
AUTOMOAILE LIABIIIry
I
SHOULD ANY OF THE AAOVE DESCBIAEO POLICIES BE CANCELLED BEFOFE
THE EXPIRATION DATE THEBEOF, NOTICE WILL BE OELIVEFED IN
ACCOFDANCE WITH THE POLICY PROVISIONS,
ffi O Marsh
1 1001 Lakeline Blvd., Building I , Suite 200,
Austin. TX 78717
443 6City of MenifeeEngineering DepartmenE
29583 New Hub DriveMeni-fee, CA 92584 ffi
0004835 0001 0001 04935