2019/06/01 Assistance League of Temecula Valley Certificate of Liability InsuranceACC>R" CERTIFICATE OF LIABILITY INSURANCE DA'E`m""°°"Y"
ik�_ 09/0912019
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 Stromsoe Insurance Agency
24910 Las Brisas Road, Ste 117
Murrieta, CA 92562
License #: 0006577
Rachel Hindle
IUD INSL)RERB: Hailh_American Elko Insurance Co
Assistance League of Temecula Valley INSURERC:
28720 Via Montezuma INSURERD:
Temecula, CA 92590 INSURERE:
INSURER F :
COVERAGES CERTIFICATE NUMBER: OODODBOO-362543 REVISION NUMBER: 71
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.
um U& TYPE OF INSURANCE lid-M W l n POLICY NUMBER POLICY tYF PL1iICY1 7P LIMA
A X COMMERCIALGENERAL UABILfTY Y MHH010307 06/01/2019 0610112020 EACH OCCURRENCE $
1,000,000
CLAIMS -MADE Fx_1 OCCUR
500,000
tg $
MED EXP (Any one person) $
20,000
PERSONAL & ADV INJURY $
1,000.000
G,hULNAdNtGAtELIMII APPLIES PEW GENFRALAGGREGATE $
3,000,000
POLICY 0 JJEE T LOC PRODUCTS - COMPIOP AGG $
3,000,000
OTHER: Liquor Liabili $
100,000
A
AUIOMOBILEUABILnY
Y
2019-18787-NPO
06/01/2019
061012020
COMBINED SINGLELIMT
$
1000 000
BODILY INJURY (Per person)
$OWNED
ANY AUTO
SCHEDULEDAUTOS ONLY AUTOS
IX
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
X
OPERIY AMASS
W'r.
$
AUTOS ONLY AUTOS ONLY
$
UMBRELLA UAB
HCLAIMS-MADE
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LAB
DED I I RETENTION
$
WOFIXERS COMPENSATION
SPTERTU OTH-
AND EMPLOYERS LIABILITY YIN
EL EACH ACCIDENT
ANY PROPRIEfORIPARTNERlD(ECUTIVE
$
OFFICERIMEMBERB(CLUDED?
NIA
E L DISEASE - EA EMPLOYE
$
(Mandatory In W
It ee, dascncry under
EL DISEASE -POLICY LIMIT
$
IPTI N0 F PERAT7 0 NS 1
A
Directors & Officers
2019-18787-DO-NPO
06/012019
06/01/2020
annual Aggregate
1,000,000
B
Bus Personal Proper
2019-18787-PROP
06/012019
06101/2020
RC
190,000
DESCRIPMON OF OPERATIONSI LOCATIONS I VEHCLES (ACORD 101, Addaonal Rsmarks SchedWe, may be attached if more space Is requlrsd)
Certificate holder and the following are named as additional insureds as covered by the general liability policy as per the
attached endorsement CG2010 (4113): The City of Menifee, its officers, employees and agents are named as additional
Insured.
CERTIFICATE 14OLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Menifee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Attn: Margarita Comejo, Contract A Procurement Administrator ACCORDANCE WITH THE POLICY PROVISIONS.
29714 Haun Road
Menifee, CA 92586 AUTHORIZED REPRESENTATIVE
G` K^ 4 " L_ (RAF
®1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Printed by RAH on September 09, 2019 at 09:3aAM