2018/05/08 Dennis Janda, Inc. Certficiate of Liability Insurance (6)CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
10/29/2018
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()es) 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
Strachota Insurance Agency, Inc. - Temec NAME:
27710 Jefferson Ave., Ste. 100 PHONE (951) 676-2229 FR%
A!C No: f 951) 676-7391
CI of Menifee-MAIL
Temecula CA 92590 City ADORES :
INSURED
Dennis Janda Inc.
42164 Remington Avenue
Temecula CA 92590
City Clerk INSURERS AFFORDING COVE
_ INGURIERA z C01OLIX XA8 Co
NOV0 7 2018 INSURER 8: Amguard Insurance Com a
_INSURERC:Ohio Security Insurance
INSURERD:Admiral Insurance Co
Received ue�,oeo c
COVERAGES r'FRTIGI1 ATr: All Wnr!D•
NAIC p
39993
42390
24856
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 ADOg
LTR TYPE OF INSURANCE WVOPOLICY NUMBER MMWDC EFF MWDD� I LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE . •� I OCCUR
Y
i
103GLOO2584400
09/28/2018
09/28/2019
EACH OCCURRENCE
I S 1,000,000
p A5 S aoocurrence
S 1001000
M EO EXP LAnX one perw)
$ exdluded
PERSONAL& AOV INJURY
Is 1,000,000
AGGREGATE LIMIT APPLIES PER:
POLICY E] jE O LOC
GENERAL AGGREGATE
jS 2,000,000
GEN'L
PRODUCTS-COMPIOPAGG
I S included
Is
OTHER'
AUTOMOBILE
LIABILITY
I COMBINED aade�SIN LE LIMIT
S 1,000,000
S
B
ANY AUTO
ALL OWNED SCHEDULED
AUTOS X AUTOS
HIRED AUTOS X I NON -OWNED
AUTOS(Par
Y
DEAU936781
11/08/2018
11/08/2019 BODILY INJURY (Per person)
BODILY rA
PROPERTY DAMAGE
ac n
N
S
S
�S
I
UMBRELLA LIAB
H OCCUR
[EACH OCCURRENCE
S
(AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED 1 1 RETENTIONS
5
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN,
ANYPROPRIETORMARTNEWEkECUTIVE
OFFICERIMEMBER EXCLUDED? El
(Mandatory InNH)
DI Mperibe unde
TIoN OF OrPERATIONS be[ow
NIA
XWS56173896
07/03/2018
07/03/2014
�E.LDISEASE
PERSTATUTE TH-
E. EACH ACCIDENT
S 1,000,000
- EA EMPLOYS
$ 1,000,000
E.L.DlSEASE- POLICYLIMIT I $ 1,000,000
D
E&O - Architects & Engine
LHR834663 05/08/201B
05/08/2019
Per Claim S 11000,000
Ded: 5,000 Per Claim
(Aggregate
$ 11000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Certificate Holder is an Additional Insured with respects to the General Liability per the attached
CG20100413 endorsement. Also an Additional Insured with respects to the Commercial Automobile per
the attached BA99040618 endorsement.
CERTIFICATE HOLDER rANr-Fl I ATfrim
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
Q01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
Page 1 of 1
COMMERCIAL AUTO
BA 99 04 06 18
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED WHEN REQUIRED BY CONTRACT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
This provision does not apply in regard to any ownership, maintenance or use of the additional insured's "autos."
Additional Insured When Required by Contract
(1) Paragraph A.1. — WHO IS AN INSURED —
of Section II — Liability Coverage is
amended to add:
d. When you have agreed, in a written
contract or written agreement, that a
person or organization be added as an
additional insured on your business auto
policy, such person or organization is an
"insured", but only to the extent such
person or organization is liable for
"bodily injury" or "property damage"
caused by the conduct of an "insured"
under paragraphs a. or b. of Who Is An
Insured with regard to the ownership,
maintenance or use of a covered "auto."
The insurance afforded to any such
additional insured applies only if the
"bodily injury" or "property damage"
occurs:
(1) During the policy period, and
(2) Subsequent to the execution of such
written contract, and
(3) Prior to the expiration of the period
of time that the written contract
requires such insurance be provided
to the additional insured.
(2) How Limits Apply
If you have agreed in a written contract
or written agreement that another
person or organization be added as an
additional insured on your policy, the
most we will pay on behalf of such
additional insured is the lesser of:
BA 99 04 06 18
(a) The limits of insurance specified in
the written contract or written
agreement; or
(b) The Limits of Insurance shown in
the Declarations.
Such amount shall be a part of and not
in addition to Limits of Insurance shown
in the Declarations and described in this
Section.
(3) Additional Insureds Other Insurance
If we cover a claim or "suit" under this
Coverage Part that may also be covered
by other insurance available to an
additional insured, such additional
insured must submit such claim or "suit"
to the other insurer for defense and
indemnity.
However, this provision does not apply
to the extent that you have agreed in a
written contract or written agreement
that the insurance is primary and non-
contributory with the additional insured's
own insurance.
(4) Duties in The Event Of Accident, Claim,
Suit or Loss
If another person or organization is
added as an additional insured on your
policy, the additional insured shall be
required to comply with the provisions in
A. Loss Conditions 2. — Duties In The
Event Of Accident, Claim, Suit Or
Loss — of SECTION IV — BUSINESS
AUTO CONDITIONS, in the same
manner as the Named Insured.
Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1