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2019/05/31 SCG-Spicer Consulting Grp, LLC Certficiate of Liability Insurance (6)'s DATE (MMIDDlYYYY) CERTIFICATE OF LIABILITY INSURANCE 06/12/2019 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 have ADDITIONAL INSURED provisions or 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 ISU 1 tiAME: Helena Orosco INSURED nsurance Services Cormarc Tasman 25220 Hancock Ave, Suite 200 Murrieta, CA 92562 License #: OE63467 ADOWrss: holarlaosticormarc.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER B : SCG-SPICER CONSULTING GRP LLC I DBA SPICER CONSULTING GROUP NSURERC: LIO d's of London 41619 MARGARITA RD, STE 101 INSURER D: TEMECULA, CA 92591 INSURER E: INSURER F : COVERAGES C:FRT1Ftr'ATE NIIMRFR• nnnnnnnn_7rQAR DF\/Iclnnl AlI1MRCq• s 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, IIN,TR TYPE OF INSURANCE A00 �SUBR -WVD POLICYNIIMBER POLICY EFT MMIDDFnY POLICY EXP MMIO IYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ;XI OCCUR Y 680-21-1870106 05/31/2019 05131/2020 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENIEt) PREMI E . IFa occurre $ 300,000 MED EXP Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GE�N'L AGGREGATE LIMIT APPLIES PER: X� POLICY PEa LOC GENERAL AWREGAT6 S 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER A AUTOMOBILE LIABILITY 680-2H870106 05131/2019 05/3112020 CWI�INEO SIN Llrµn S 1,00QQ00 ANY AUTO BODILY INJURY (Per person) fi OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident)', $ HIRED yy NON -OWNED AUTOS ONLY A AUTOS ONLY $ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE D- I I RETENTIONS $ 13 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) f yes, describe under DESCRIPTION OF OPERATIONS below N I A Y SCWC994693 10/07/2018 10/07/2019 PER OTH- X TA?UTE R 1,000,000 E.L. EACH ACCIDENT ,F 1,000,000 E-L. DISEASE - EA r=MPLOYEE 5 1,000,000 E.L. DISEASE - POLICY LIMIT $ C Prof Lia MPL175558019 05/31/2019 05131/2020 Limit 2,000,000 retro date 5/31/16 Retention 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: On -Call Municipal Finance Consulting Services. City of Menifee, its officers, employees, agents and authorized volunteers are named as additional insured in respects to General Liability coverage is Primary and Non -Contributory per CGD1050494. Waiver of Subrogation applies to Work Comp per WC040306. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Menifee MENI297 ACCORDANCE WITH THE POLICY PROVISIONS. 29844 Haun Road Menifee, CA 92586 AUTHORIZED REPRESENTATIVE w ©1902015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by ORO on June 12, 2019 at 01:12PM COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: 1 2. WHO IS AN INSURED (SECTION II) is amended to include as an insured any person or organiza- tion (called hereafter "additional insured") whom you have agreed in a written contract, executed prior to loss, to name as additional insured, but only with respect to liability arising out of "your work" or your ongoing operations for that addi- tional insured performed by you or for you. With respect to the insurance afforded to Addi- tional Insureds the following conditions apply: a. Limits of Insurance — The following limits of liability apply: 1. The limits which you agreed to provide; or 2. The limits shown on the declarations, whichever is less. b. This insurance is excess over any valid and collectible insurance unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. 3. This insurance does not apply: a. on any basis to any person or organization for whom you have purchased an Owners and Contractors Protective policy. b, to "bodily injury," "property damage," "per- sonal injury," or "advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, in- cluding: 1. The preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, change or- ders, designs or specifications; and 2. Supervisory, inspection or engineering services. CG D1 05 04 94 Copyright, The Travelers Indemnity Company, 1994. Page 1 of 1 Includes Copyrighted Material from Insurance Services Office, Inc. WORKERS COMPENSATION AND EMPLOYERS 1 (ABILITY 114SURANCE POLICY WC: Od 03 OC (Ed. 4-a4) WAIVER OF OUR RIGHT TO RECOVER: FROM OTHEO.4 ENDORSEMENT--CALIFORNIA We have the right to recover our payrnenb from anyone liable for an injury covered by this policy. We will not. enforce our right against the person or organization named in the Schedule, (This agreement applies only to the .extent that you perform work under a wrkterl contract: that requiresyou to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees white engaged to .the; work described in the Schedule- TlmB catmalu-nial loco :fiival ttilf thib U"tiftE)F aR71 Tt 3)IL 5:1ZdiI Ergs 1...02 %p of Vie Gatlrt3ll:rlet: YVIJI:Iccf.Ss IFf ett:Ellfiit otherwise clue on suoh:rernuneration. Schedule Person t r (JrganI.... ;ort Job Description, B"et Waiver -Any person or otgsni2a6on for whom the All CA Operations:: Narncd Insured has awcod by w tton contract to furrxish ibis. +;diver. Tills ertcleirae r ersf'r>#iaric�e�s the r>til :fit try r i ks' t i at Gfi�el grid is Eve,,ssi� tl;.e Ia ,ass etl:rttiC� s aEh r is st teel:: (7 toe Inform all on valow ss rsqurrecl My wtt:ert tars OWN)MMmnt rs issuga sr�b ant :tie prep�r2rt�vn ot'the purr�y,l FWormi-iew Fitmv.:tj�ev I MM. I's#liry.NG, S C9446.C3 Insurance Carrtpauy L'puT.mofSig'rlo I Ef`4 Endar�ommrii No: ol a'aa Eay the, VYorkar#' 0Omper+3afion tFt.v,ur Sn.OG r,afing L7umu of Onof..4.m tL Ail rlghta ro"mod Cl CWA021011 CERTIFICATE OF INSURANCE This certificate Is issued for Inforrmatlonal purposes only. It certifies that the policies listed in this document have been Issued to the Named Insured. It does not grant any rights to any party nor can it be used, In any way, to modify coverage provided by such policies. Alteration of this certificate does not change the terms, exclusions or conditions of such policies. Coverage is subject to the provisions of the policies, Including any exclusions or conditions, regardless of the provisions of any other contract, such as between the certificate holder and the Named Insured. The limits shown below are the limits provided at the policy inception. Subsequent paid claims may reduce these limits. Certificate Holder. CITY OF MENIFEE ATTN: DEPARTMENT OF FINANCE 29844 HAUN RD MENIFEE, CA USA 925866539 Named Insured: SPICER CONSULTING GROUP LLC 41619 MARGARITA RD STE 101 TEMECULA CA 92591-2986 Automobile Liability Insurer Name: Allstate Insurance Company Poll Number. 648827849 1 -Any Auto 2 - Owned Autos Only 3 - Owned Priv. Pass. Autos Only 4 - Owned Autos Other Than Priv. Pass. Autos Only 5 - Owned Autos Subject to No Fault 6 - Owned Autos Subject to a Compulsory UM Law x 7 - SNcifically Described Autos 8 - Hired Autos Only x 9 - Nonowned Autos Only Policy Effective Date: 0 9 -14 - 2 018 Policy Expiration Date: 0 9 -14 - 2 019 Limits of $1, 000, 000 Combined Single Limit (each accident) Insurance: BI Per Person I BI Per Accident PD Per Accident Description of Operations/Locations/Vehicles/Endorsements/Special Provisions Interested Party T : Additional Insured - Munici alit THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER. IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES) MUST EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH POLICY LANGUAGE OR ENDORSEMENT. Producer. ADRIANA CUEVAS Authorized Representative: Date: 05-24-19 Cl CWA021011 Includes copyrighted material of Insurance Services Office, Inc., with its permission Allstate Insurance Company Insured Full Copy Page 1 of 1 POLICY NUMBER: 648827849 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: SPICER CONSULTING GROUP LLC Endorsement Effective Date: 0 5— 2 4— 2 019 SCHEDULE Name Of Person(s) Or Organ¢ation(s): CITY OF MENIFEE ATTN: DEPARTMENT OF FINANCE 29844 HAUN RD MENIFEE, CA USA 925866539 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph Al. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 Insured Full Copy CHUEaall ISSUING COMPANY ACE AMERICAN INSURANCE COMPANY NCCI CARRIER CODE 12165 POLICY NUMBER X] New ❑ Renewal Symbol: WLR Number: C6 56 25 87 8 PREVIOUS POLICY NO. Individual ❑ Partnership Symbol: Number: ❑X Corporation ❑ Joint Venture Item 1. I TRINET GROUP, INC. Named L/C/F SCG SPICER CONSULTING GROUP LLC Insured 9000 TOWN CENTER PARKWAY BRADENTON FL 34202 Mailing Address I Workers' Compensation and Employers Liability Insurance Policy Information Page ❑ Rewrite EAssociation ❑ Other Legal Entity Inter/Intrastate ID No.: Federal Employer ID No.: 953359658 Employer's ID No.: PIIC CODE: 6282 For other named insured see Extension of Information Page — Schedule of Named Insured, WC 99 99 99 A For other workplaces see Extension of Information Page — Schedule of Other Workplaces, WC 99 99 99 B Item 2. Policy period: From 12-16-2018 To 07-01-2019 12:01 A.M., standard time at the named insured's mailing address. Item 3A. Workers' Compensation Insurance: Part One of the policy applies to the Workers' Compensation Law of the states listed here: CA Item 3B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 2.000,000 each accident Bodily Injury by Disease $ 2,000,000 policy limit Bodily Injury by Disease $ 2,000,000 each employee Item 3C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here ALL STATES EXCEPT ND,OH,WA,WY, AND STATES DESIGNATED IN ITEM &A Item 3D. This Policy includes these endorsements and schedules: See schedule of Forms and Endorsements WC999999D Item 4. The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. SEE EXTENSION OF INFORMATION PAGE —CLASSIFICATIONS If indicated here, interim adjustments of premium will be made: ❑ Semi -Annually ❑ Quarterly ❑ Monthly PRODUCER NAME AND MAILING ADDRESS USI INSURANCE SERVICES NATIONAL INC 2601 SOUTH BAYSHORE DRIVE 16TH FLOOR SUITE 1600 COCONUT GROVE FL 33133 PRODUCER CODE: Z05455 56-1882208 DAU Minimum Premium collected in CA $ Total Estimated Premium $ Deposit Premium $ MARKETING OFFICE: DALLAS BRANCH ISSUE DATE: 12/27/2018 5�;:� Authorized Representative WC 00 00 01A (05/88) Copyright 1987 National Council on Compensation Insurance INSURED COPY