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2011/12/15 Bureau Veritas North America, Inc. Certificate of Liability InsuranceCity of Ailenifee ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/30/2012 F THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE'q' ,,RTIFICit1i'.E;MOLDER. 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 Aon Risk Services Northeast, Inc. Parsippany NJ office 10 Lanidex Center West P.O. BOX 608 CONTACT NAME: PHONE (866) 283-7122 FAX 847 (AIC. No. Ext): (AIC. No.): ( ) 953-5390 E-MAIL ADDRESS: Parsippany N7 07054-0608 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED Bureau Veritas North America, Inc. 10620 Treena Street, Suite 200 INSURERA: Lexington Insurance Company 19437 INSURER B: National Union Fire Ins CO Of Pittsburgh 19445 INSURER C: Granite State Insurance Company 23809 San Diego CA 92131 USA INSURER D: Commerce & Industry Ins Co 19410 INSURER E: Insurance Company of the State of PA 19429 INSURER F: COVERAGES CERTIFICATE NUMBER: 570045748678 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 UBR WVD POLICY NUMBER POLICY FF MMIDD POLICY MMIDD LIMITS B GENERAL LIABILITY GLS076409 04/01/201204/01/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TORENTED rr PREMISES Ea occuence $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 POLICY X PRO X LOC B AUTOMOBILE LIABILITY CA 3377177 04/01/2012 04/01/2013 COMBINED SINGLE LIMIT Ea accident)$1,000,000 ADS BODILY INJURY ( Per person) C ANY AUTO CA 3377178 04/01/2012 04/01/2013 ALL OWNED SCHEDULED MA BODILY INJURY (Per accident) AUTOS AUTOS PROPERTY DAMAGE HIRED AUTOS NON -OWNED 11 AUTOS Per accident D X UMBRELLALIAB OCCUR BE15434257 04/01/2012 04/01/2013 EACH OCCURRENCE $5,000,000 H SIR applies per policy terns & condl ions AGGREGATE $5,000,000 EXCESS LIAB CLAIMS -MADE DIED I X RETENTION S10, 000 E WORKERS COMPENSATION AND WCO25842303 04/01/2012 04/01/2013 X WC STATU- oTH- EMPLOYERS' LIABILITY Y / N ADS TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 B ANY PROPRIETOR/ PARTNER I EXECUTIVE OFFICER/MEMBEREXCLUDED? N/A WCO25842304 04/01/2012 04/01/2013 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) CA If yes, describe under E.L. DISEASE -POLICY LIMIT $1, 000 , 000 DESCRIPTION OF OPERATIONS below A Archit&Eng Prof 026030221 12/15/2011 01/01/2013 Each Claim $1,000,000 SIR applies per policy ter In s & condil ions Aggregate $1,000,000 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 where required by written A waiver is in policies contract. of Subrogation granted favor 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. CO rn co Co n v 0 n U) ti. ti■ 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 Meni fee AUTHORIZED REPRESENTATIVE y 29714 Haun Road Menifee CA 92586 USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD MEMO RE: 2012 Renewal Certificates of Insurance Policy Period: 04/01/2012 to 04/01/2013 Dear Certificate Holder: We are pleased to provide you with the renewal Certificate of Insurance for subject policy period. This evidence of insurance is provided to you on behalf of Bureau Veritas North America, Inc. (BVNA), National Elevator Inspection Services, Inc. (NEIS) and OneCIS, Inc. If evidence of coverage is no longer required, please write "CANCEL" across the face of the Certificate and fax it to: Stephen Pechloff at 1-800-363-0105. PLEASE NOTE: Direct any requests concerning certificates of insurance to your insured contact not to Aon Risk Services. Best Regards, Stephen Pechloff Senior Client Specialist Aon Risk Solutions Aon Risk Solutions I Aon Client Service Center 1000 North Milwaukee Avenue I Glenview, IL 60025 t: +1.866.283.7122 1 f: +1.866.363.0105 1 aon.com