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2018/11/28 CN Engineering, Inc. Certficiate of Liability Insurance DATEM/(MDD/YYY1f) AC"RUP CERTIFICATE OF LIABILITY INSURANCE 01/14/2019 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 NAME• Hiscox Inc.d/b/a/Hiscox Insurance Agency in CA PHaNr 888 202-3007 ac No): 520 Madison Avenue ADDRESS: rontact@hiscox.com 32nd Floor INSURERS AFFORDING COVERAGE NAICN New York,NY 10022 INSURER A; Hiscox Insurance Company Inc 10200 INSURED INSURER B: CN Engineering, Inc. INSURER C: 26776 Rhapsody Ct. INSURER D: I INSURER E: f!f Menifee CA 92584 INSURER F: I COVERAGES CERTIFICATE NUMBER: 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' RDDL UBR I POLICY EFF - POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER YY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE � OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any oneperson) $ 5,000 A Y UDC-2413934-CGL-18 11/28/2018 11/28/2019 PERSONAL&ADV INJURY $ 1,000,000 �GEtPl.AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 /1 POLICY PEC LOC PRODUCTS-COMP/OP AGG $ SIT Gen.A . OTHER: $ C70—AUTOMOBILE LIABILITY accident) GL LIM17 Ea $ Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL O SCHEDULED AUUTOSS AUTOS UDC-2413934-CGL-18 11/28/2018 11/28/2019 BODILY INJURY(Per accident) $ �/ X HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Aporsiocidontl CGL}aired/Non-Owned Auto $ 1,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/M EMBER EXCLUDED? N/A. (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ ff yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT. $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) City of Menifee and its Officers,Employees,Agents,and Authorized Volunteers are listed as Additional Insured on the Commercial General Liability Policy subject to the policy terms and conditions. Reference FY 2018/19 on-call engineering services(recoverable). CERTIFICATE HOLDER CANCELLATION City of Menifee 29714 Haun Rd SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Menifee,CA 92586 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r �^ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD '4C R"� CERTIFICATE OF LIABILITY INSURANCE ___[ DATE(MWDD/YYYY) 01/14/2019 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 endorsements. PRODUCER CONTACT NAME: Hiscox Inc.d/b/a/Hiscox Insurance Agency in CA PHONE (ggg)202-3007 FAX N 520 Madison Avenue E-MAIL contact@hiscox.com 32nd Floor ADDRESS: New York,NY 10022 INSURERS AFFORDING COVERAGE NAIL# INSURER A: Hiscox Insurance Company Inc 10200 INSURED INSURER B CN Engineering, Inc. INSURERC: 26776 Rhapsody Ct. Menifee,CA 92584 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF PDLi 0 E7(PLTR LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES iEa occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ _[Ea acc4dent) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N TUT ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liability Y ' UDC-2413934-EO-18 11/28/2018 11/28/2019 Each Claim:$1,000,000 i Aggregate:$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Menifee and its Officers,Employees,Agents,and Authorized Volunteers are listed as Additional Insured on the Professional Liability Policy subject to the policy terms and c onditions.Reference FY 2018/19 On-Call Engineering Services(Recoverable). CERTIFICATE HOLDER CANCELLATION City of Menifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 29714 Haun Rd THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Menifee CA 92586 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014✓01) The ACORD name and logo are registered marks of ACORD CN January 14,2019 Dear Ms. Margarita Cornejo: CN Engineering,Inc. (CNE) is pleased to provide the attached requested insurance policies with the City of Menifee as the additional insured. CNE currently is operated by owners only and does not have any employees. Therefore, the Workers' Compensation and Employer's Liability Insurance is not applicable at this time. Also,our company currently hires or utilizes non-owned autos in lieu of owning any autos. As a result, the provided insurance will cover hired and non-owned autos. In the event if any of the above condition changes, CNE will provide updated insurance policies in accordance with the City of Menifee's contract requirements. Please feel free to contact me for any questions or clarification. We look forward to providing quality engineering services for the City of Menifee. Sincerely, A4VU_,, �-/V Crysta Nguyen, PE CEO/President 26776 Rhapsody Ct. Menifee,CA 92584 (951)440-9890 crystal @cnengineefservices.com