Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2015_PS-1500501 thru PS-1501000_ - PS-1500830

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ACU CERTIFICATE OF LIABILITY INSURANCEFDATE(20 SD�YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH USA INC. NAME: 122517TH STREET,SUITE 1300 PHONE 1FAX AIC o Ext): A!C No), DENVER,CO 80202-5534 E-MAIL Attn:Denver.certrequest@marsh.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC# 02220-TAC-ALL-14115 INSURER A:Greenwich Insurance Company 22322 INSURED AEG CYCLING,LLC INSURER B:N/A NIA 800 W.OLYMPIC BLVD,SUITE 305 INSURER c:N/A NIA LOS ANGELES,CA 90015 INSURER D:N/A N/A INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002611626-25 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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. INSR ADDL SUBR LTR TYPE OF INSURANCEINSR-MU POLICY NUMBER POLICY MMIDD EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY RG0300051300 11/15/2014 03/01/2016 MA E RENTED 1,000,000 PREMISES Ea occurrence $ CLAIMS-MADE M OCCUR MED EXP(Any one person) $ EXCLUDED X $100,000 SIR PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 20,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- 1-1 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIREDAUTOS NON-OWNED PROPERTY DAMAGE AUTOS er accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS E ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT $ (Mandatory in and E.L.DISEASE-EA EMPLOYE $ It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE:AMGEN TOUR OF CALIFORNIA AT SAN JOAQUIN COUNTY,VARIOUS COUNTY ROADS,STOCKTON,CA ON MAY 10-17,2015 SAN JOAQUIN COUNTY,ITS OFFICERS,AGENTS,AND EMPLOYEES ARE NAMED AS ADDITIONAL INSURED ON THE GENERAL LIABILITY IF REQUIRED BY WRITTEN CONTRACT.WAIVER OF SUBROGATION APPLIES IF REQUIRED BY WRITTEN CONTRACT OR AGREEMENT EXECUTED PRIOR TO LOSS. CERTIFICATE HOLDER CANCELLATION SAN JOAQUIN COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1810 E HAZLETON AVE. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN STOCKTON,CA 95205 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Sharon A.Hammer ��ts� CZ-��.� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD