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2018/03/12 Social Work Action Group Certficiate of Liability InsuranceCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 1 10/16/2018 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 520 Madison Avenue HONE FAX (PAIC, No. Ell: (888) 202-3007 (AIC, No): E-MAIL ADDRESS: contact@hiscox.com 32nd Floor New York, NY 10022 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Hiscox Insurance Company Inc 10200 INSURED INSURER B: Social Work Action Group INSURER C: 4055 Jurupa Ave Rm 25 INSURER D: INSURER E: Riverside CA 92506 INSURER F: GOVEKALitS r-FRTIFIrATF PJIIMRF=P- MC%1i0!r%k1 ki" Anco. 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 LTR I TYPE OF INSURANCE ADDLSUBRI INSD WVD POLICY NUMBER POLICY EFF 1MM/DDfYYYY) POLICY EXP (MM/DDffYYY) LIMITS X COMMERCIAL GENERAL LIABILITY —1 CLAIMS -MADE I —XI OCCUR CGL is on BOP Form - EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 X MED EXP (Any one person) s 5,000 — PERSONAL & ADV INJURY s Srr Each Occ. A Y UDC-2198811-BOP-18 03/12/2018 03/12/2019 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [::] PRO- JECT F7LOC GENERAL AGGREGATE s 2,000,000 PRODUCTS - COMP/OP AGG s S/T Gen. Agg. $ OTHER: AUTOMOBILE — LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ — BODILY INJURY (Per person) $ ANY AUTO A ALL OWNED SCHEDULED AUTOS AUTOS UDC-2198811-BOP-18 03/12/2018 03/12/2019 — BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS X AUTOS X PROPER DAMAGE (Par c. $ UMBRELLA LIAB IOCCUR EACH OCCURRENCE $ I AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? F NIA H- OE RT E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEEI $ (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Homeless Outreach Services — .. .--. — I- M IN t, r_ L LJR I I U r1i City of Menifee 29714 Haun Rd Menifee, CA 92586 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE J�.� @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MrXDDrffY-Y) I - 11/13/18 — 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 Hiscox Inc. 520 Madison Avenue, 32nd Floor CONT CT NAMP PHONE -202-3007 1 FAX fAIQ- No. Ftl- 888 E-MAIL contact@hlscox.com New York, NY 10022 ------______INSURERM AFFORDING COVERAGE NAIC 0 INSURERA: Hiscox Insurance Company Inc. 10200 INSURED INSURER B: Social Work Action Group INSURERC: 4055 Jurupa Ave Rm 25 INSURERD: River5lde, CA 92506 INSURER E: INSURER F: UL)VIzKAL:ilzb CERTIFICATIF MI]MRFR- D=%11-21rNK1 K1111IRMCD ................. .. 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, ' TNSR L7R TYPE OF INSURANCE ADDLISUBRI INSR wvn POLICY NUMBER POLICYIEFF IMMIDDIYM) POUCYEXP (MM1DDNYYYJ LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY ICLAIMS-MADELIOCCUR PREMISES (Ea-accurruence) 3 MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S I POLICY 1-1 ipge, F-1 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLEFIM—IT accident) S BODILY INJURY (Par person)_ $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS [Ea B " I J BODILY INJURY (Per accident) $ NON -OWNED AUTOS AUTOS P OF T, PROPERTY DAMAGE P.NHIRED r '.nt) UMBRELLA LIAS HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGG EGATE $ EXCESS LIAB FDED I I RETENTIONS $ A WORKERS COMPENSATION AND EMPLOYERSLIABILITY Y/N ANY PROPRIETORIPARTNEIVEXECUTIVE [-N-1 OFFICER/MEMBER EXCLUDE1 NIA UDC-0000141WCOO 03/09/18 03/09/19 STATU-1 JOTHI- TV01CRY LIMITS ER E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEO s 1,000,000 (MandatM In NH) If yes, describe under E.L. DISEASE -POLICY LIMIT 1 — $ 1,000, 1) DESCRIPTION OF OPERATIONS below 1 -1 - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) - City of Men ifee 29714 Haun Rd Menifee, CA 92586 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE At,UKU Z13 (ZU11.111.1b) @ 1988-2010 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD