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2012/10/30 Animal Friends of the Valleys Certificate of Liability Insurance
City os Menii ae NOV 0 9 2012 ANIMA-2 OP ID: JL A�oRo• CERTIFICATE OF LIABILITY INSURANCE; DAT11/08D/YYYY) 11/08/12 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 909-436-0230 CONTACT NAME: Sawyer Cook Insurance 909-798-7971 1200 California St., Ste 260 Redlands, CA 92374 Bob Zentner PHONE FAX vC No Ext : Alc No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Mercury Casualty Company 11908 INSURED Animal Friends of the Valleys 33751 Mission Trail Wildomar, CA 92595 INSURER B : INSURERC: INSURER D : INSURER E : INSURER F rr)VFRAr.FS rFRTIFIrATF NI IMRFR• RFVICI(1N NI IMRFR- 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 OF INSURANCE ADDLTYPE INSR WVQ SUER POLICY NUMBER MMIDDIYEYYY MPOLICY UCD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE To RENTEIJ__ PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: POLICY r PRO LOC PRODUCTS - COMP/OP AGG S $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS CCA0002415 10/30/12 10/30/13 COEaMBINED SINGLE LIMIT accident S 1,000,00 BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident S 5 UMBRELLA LIAB EXCESS LUAB OCCUR CLAIMS -MADE EACH OCCURRENCE S Id AGGREGATE $ DED I I RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WCSTATU- OTH- TORY LIM TS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Verification of auto only l.Gl[ I lr*lt A I r I'1VLLJCFC VANUMLLA I IVIV 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Y of hf enifee OP ID: JL CERTIFICATE OF LIABILITY INSURArUC-t?012 DATD/YYYY) 07/27 07/27/12 CERTIFICATE THIS CDOES NOT AFATE IS FIRMATIVELY VE YAS A EOR NEGATIVELY AMEND, R OF INFORMATION Y EXTEND OR ALTER AND CONFERS NO, RIGHTS EAI HE OVERA`6TPF DBY 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 909-435-0230 Sawyer Cook Insurance 1200 California St., Ste 260 909-798-7971 Redlands, CA 92374 Bob Zentner _ CONTACT PHONE FAX A/c No Ext : A IC,No): E-MAIL ADDRESS: PRODUCER ANIMA-2 CUSTOMER ID #: INSURERS AFFORDING COVERAGE NAIC # INSURED Animal Friends of the Valleys 33751 Mission Trail Wildomar, CA 92595 INSURER A: Preserver Insurance Company 15586 INSURER B: Philadelphia Insurance INSURERC:Mercu Insurance Group 11908 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 LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MM/DDPOLICY/YYYY MM/DDfYYYY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR X PHPK897277 07/22/12 07/22/13 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED PREMISES Ea occurrence 100 00 $ , MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECTLOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CCA0002415 10/30/11 10/30/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PHUB390837 07/22/12 07/22/13 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ DEDUCTIBLE RETENTION $ $ X $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WCCO02261800 09/01/11 09/01/12 X WCSTATU- OTH- T RY LIMIT ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is named as additional insured with respects to general liability. RE: Services performed by the insured �_vaa•�•L�a:� 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 ACORD 25 (2009/091 ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and Inno are registered marks of ACORD