Specifications

ACORD
CERTIFICATE OF INSURANCE
ISSUE DATE (MM/DD/YY)
PRODUCER:
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND
OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
LETTER
A
COMPANY
LETTER
B
INSURED:
COMPANY
LETTER
C
COMPANY
LETTER
D
COMPANY
LETTER
E
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTHWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS
AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
GENERAL LIABILITY
GENERAL AGGREGATE
$
COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OP AGG.
$
CLAIMS MADE
OCCUR.
PERSONAL & ADV. INJURIES
$
OWNER'S & CONTRACTOR'S PROT.
EACH OCCURRENCE
$
FIRE DAMAGE (Any One person)
$
MED. EXPENSE (Any One person)
$
AUTOMOBILE LIABILITY
COMBINED SINGLE
$
ANY AUTO
LIMIT
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per Person)
HIRED AUTOS
BODILY INJURY
$
NON-OWNED AUTOS
(Per Person)
GARAGE LIABILITY
PROPERTY DAMAGE
$
EXCESS LIABILITY
EACH OCCURRENCE
$
UMBRELLA FORM AGGREGATE
$
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
STATUTORY LIMITS
AND
EACH ACCIDENT
$
EMPLOYERS' LIABILITY
DISEASE-POLICY LIMIT
$
DISEASE-EACH EMPLOYEE
$
OTHER
DESCRIPTION OF OPERATIONS/LOCATION/VEHICLES/SPECIAL ITEMS Re: All operations
The State of California, its officers, agents, employees and servants are hereby named as additional insured but only with respect to work performed for the
State of California.
CERTIFICATE HOLDER CANCELLATION
California Department of Corrections and Rehabilitation
Office of Business Services
9838 Old Placerville Rd, Suite B-2
Sacramento, CA 95827
FAX [phone]
Should any of the above described policies be cancelled before the
expiration date thereof, notice will be delivered in accordance with the
policy provisions:
Bid 6000001312
State of California
11/14/2013 2:35 PM
p. 135