2018/10/01 ADT, LLC Certificate of Liability InsuranceACOR17® CERTIFICATE OF LIABILITY INSURANCE
ATE 1
D09/282018DnYYY)
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
Marsh USA Inc.
1560 Sawgrass Corporate Pkwy, Suite 300
Sunrise, FL 33323 City of Menifee
Attn: FtLauderdale.Certs@marsh.com City Clerk
CONTACT
NAME:
EFAX
A/CON 0, Ex AIC No):
E-MAIL
ADDRESS:
INSURER S AFFORDING COVERAGE
NAIC #
INSURER A: Old Republic Insurance Co
24147
CN109418288-ADT-GAW-18-19
INSURED
ADT LLC dba Protection One CCT
INSURER B :
INSURER C :
1120 Palmyrita Ave., Ste. 280
Riverside, CA 92507
Received
INSURER D
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: ATL-004399363-07 REVISION NUMBER: 2
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
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MMIDD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
SIR: $500,000
MWZY314318
10/01/2018
10/01/2019
EACH OCCURRENCE
$ 2,000,000
DAMAGE( RENTED
PREMISES Ea occurrence
$ 1,000,000
X
MED EXP (Any one person)
$
X
Professional Liab Included
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO LOC
X F—IJECT
OTHER:
GENERAL AGGREGATE
$ 4,000,000
PRODUCTS - COMP/OP AGG
$ 4,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
MWT8314319
10/01/2018
10/01/2019
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
UMBRELLALIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED I I RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
MWC31431700
10/01/2019
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
$ 2,000,000
E.L. DISEASE - POLICY LIMIT
$ 2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Professional Liability is included under the General Liability policy subject to the policy provisions.
I.CK 1 Ir[L A 1 C r1ULUCK UANL;t LLA I IUN
City of Menifee
29714 Haun Road
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
of Marsh USA Inc.
Vincent Zollo
@ 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
0003348 SP 0602-001-P03349-1
City of Menifee
29714 Haun Road
Menifee, CA 92586
q