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2010/11/30 Bureau Veritas North America, Inc. Certificate of Liability Insurance® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/29/2011 F 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 endorsement(s). PRODUCER �°� , ®.®( ., Parsippany N7 office �/ Aon Risk Services Northeast, Inc.VAPR CONTACT NAME: PHONE (866) 283-7122 FAX <847) 953-5390 (A/C. No. Exq: (A/C. No.): E-MAIL ADDRESS: 10 Lamdex Center west ,I P.O. BOX 60$ /� h „�� , Parsippany N7 07054-0608 USA U `I MJ � INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Lexington Insurance Company 19437 Bureau Veritas North America, Inc. ----__,_ 11590 W. Bernardo Court, #100 _ San Diego CA 92127 USA INSURERS: NOW Hampshire Ins CO 23841 INSURERC: National Union Fire Ins Co of Pittsburgh 19445 INSURER D: Commerce & Industry Ins Co 19410 INSURER E: Granite State Insurance Company 23809 INSURER F: COVERAGES CERTIFICATE NUMBER: 57UU41936885 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADD INSR SUBR WVD POLICY NUMBER POLICY EF MM/DD P LI Y E P MM/DD LIMBS D GENERAL LIABILITY GL6439313 04101/2011 04/Ul/2012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occunence $1,000,000 CLAIMS -MADE x1 OCCUR MED EXP (Any one person) $25 , 000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2 , 000, 000 X LOC POLICY X PRO ff C AUTOMOBILE LIABILITY CA 3377177 04/01/2011 04/01/2012 COMBINED SINGLE LIMIT Ea accident $1,000,000 AOS BODILY INJURY ( Per person) E X ANY AUTO CA 3377178 04/01/2011 04/01/2012 ALL OWNED SCHEDULED MA BODILY INJURY (Per accident) AUTOS AUTOS NON -OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident D X UMBRELLA LIAR OCCUR BE55053428 04/01/2011 04/01/2012 EACH OCCURRENCE $5,000,000 H SIR applies per policy terns & condi ions AGGREGATE $5,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION S10, 000 B WORKERS COMPENSATION AND wc025842303 04/01/2011 04/01/2012 TO SMITU- OTH- X TORY LIMITS ER EMPLOYERS' LIABILITY Y/N A05 E.L. EACH ACCIDENT $1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE wc025842304 04/01/2011 04/01/2012 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) N/A CA E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000. A Archit&Eng Prof 026030221 11/30/2010 12/15/2011 Each Claim $1,000,000. SIR applies per policy ter s & condi ions Aggregate $1,000,0001 ■ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: Civil Plan Check. City of Menifee is included as Additional Insured with respect to General Liability and Auto Liability by is in favor policies where required written contract. A waiver of Subrogation granted of Additional Insured on the workers' Compensation policy where required by written contract. The insurance provided shall be primary and any other insurance maintained by the Additional Insured is excess and Non -Contributory. See attached Endt. CG20100704, 87950 (10/05), 74434 (10/99) and wC040361. i ■ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Menifee AUTHORIZED REPRESENTATIVE 29714 Haun Road Menifee CA 92586 USA fT. ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD