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Item 20 - Agreements for On-Call Emergency Asphalt and Concrete Services
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Item 20 - Agreements for On-Call Emergency Asphalt and Concrete Services
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Last modified
3/28/2024 11:14:07 AM
Creation date
8/10/2023 1:50:48 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Clerk of the Council
Item #
20
Date
5/2/2023
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AGENCY CUSTOMER ID: <br />LOC #: <br />�►co ADDITIONAL REMARKS SCHEDULE <br />AGENCY NAMED INSURED <br />Scott & McCauley Insurance Agency LLC EBS GENERAL ENGINEERING, INC <br />POLICY NUMBER 1345 Quarry St <br />7018007493 Suite 101 <br />CARRIER NAIC CODE Corona, CA, 92879 <br />NATIONAL FIRE INSURANCE COMPANY OF HARTFORD 20478 EFFECTIVE DATE: 02/01/2023 <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />Page , of <br />COVERAGE PROVIDED PERTHE FOLLOWING COVERAGE FORMS: <br />GL - CNA75079XX (10-16)- Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement <br />GL - CNA74705XX (1-15)- Additional Insured - Primary And Non -Contributory To Additional Insured's Insurance <br />GL - CNA74705XX (1-15)- General Aggregate Limits of Insurance- Per Project <br />GL - CNA74705XX (1-15)- Waiver of Subrogation - Blanket <br />Auto - CNA63359XX (04-12) - Blanket Additional Insured when required by written contract <br />Auto - CNA63359XX (04-12) - Additional Insured - Primary And Non -Contributory To Additional Insured's Insurance <br />Auto - CNA63359XX (04-12) - Blanket Waiver Of Subrogation when required by written contract <br />WC - G-19160-B - WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA <br />*UMBRELLA IS FOLLOW -FORM* <br />The ACORD name and logo are registered marks of ACORD <br />
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