2022/07/01 Woodside 05S, LP, DBA Woodside Homes of California, LP,ACORD wooDGRo.ol
CERTIFICATE OF LIABILITY INSURANCE 6t29t2022
THIS CERTIFICATE IS ISSUEO AS A MATTER OF II{FORMATION ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRi'ATIVELY OR NEGATIVELY A END, EXTENO OR ALTER THE COVERAGE AFFORDEO BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE OOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEO
REPRESENTATIVE OR PROOUCER, AND THE CERTIFICATE HOLOER.
IMPORTANT: lf tho csrtificats holder Is an AODITIONAL INSURE0, tho policy(ie!) must havg ADDITIO AL INSUREO prov13ions or bo endoBed.
It SUBROGATION lS WAIVED, subjoct to the torms and conditlons ofthe policy, ce.tain policioa may rsqui.s an €ndorsomont. A statemont on
this cerlificate does not conler rights to the cortlflcate holdor in liou of such ondor3ement{s).
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INSU RERI SI A FFORDING COVERAGE
11000rNsuRER a : Sentinel lnsurance Company, LTD
pRooucER Llcens6 * 0025325
O.L,D. lnsurancg Brokors, lnc.
17712 Mitchell Northlrvins, CA 9261,1
Woodsldo 05S. LP, OBA Woodsido Homes of Califo.nla, LP
1250 corona Pointo ct., suits 500
Co,ona, CA 92879
INSUREO
COVERAGES
IHIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATEO. NOT\A4THSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR OTHER OOCUMENT\MTH RESPECTTO IA/TIICH THIS
CERTIFICAIE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFOROEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES. LIMITS SHO\AA MAY }TAVE BEEN REDUCED BY PAID CLAIMS.
SUBR
COMMERCIAT GENERIL LIABILIIY
CLA MS.MADE OCCUR
L AGGR
POLICY
ES PER
JECT LOC
t
DAM46E TO RENTEO
5
TTFOFXP lAnv one o€rsonl S
PFRSONAI &ADVINJI]RY 5
GFNERAI AGGREGATE $
PROOL]CTS COMP/OP AGG 5
5
AUTOMOBILE LIAAILjTY
OW\EOAUTOS ONLY
AUTOSONL/
SCHEDULEDAUTOS
NONOW\EO
coMBINED SINGLE LIMIT
S
BODILY INJL]RY lPeTetsonI s
BoDILY INIURY lP6. accrdentl $
3
s
EICESS LIAB
OCCUR EACH OCCURRENCE 5
5
DEO RETENTION 5 s
A WORXERS COMPEIISATIONAND EMPLOYERS' IABIJTY
ANY PROPRIETOR/PARTNER]EXECUTIVE
OFFICER]MEMBER E^CLlJOEO?
DFScRTPI oN oF oPFRATIONS beld
72 WEA AS3MPJ 7 t1t2022 71112023
x OTH
1,000,000S
FLDISEASE.EAEMPLOYEE 1,000,000s
E L. DISEASE. POLICY LIMIT 5 1,000,000
oEscRFTtorit oF opERAnoNs / LocATloNs / vEHrcLEs lAcoRo l ol , addlllonrr R.rurr. schedul., m.y b. .tt ch.d t mo. rp.c. l. r.qulr.d)
Romington. TR# 3'1390, Marigold-TRd3'1347, Mountain Gate-TR#28801-1, -2
Certificate issued as evidence ot worke6' compensation insurance
ACORD 25 (2016/03)
ER
City of Menilee
29714 Haun Road
M€nilso, CA 92586
SI]OULO ANY Of THE ABOVE OESCRIBEO POLICIES BE CAI{CELLED BEFORE
THE EXPIRATIOI/ DATE THEREOF, NOTICE WILL BE OELIVEREO IN
ACCORDANCE wlTH THE POLICY PROVISIONS.
AUTHORIZED REPRESEI{TATNE1r u,-
CANCE
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