2015/04/01 Burke, Williams & Sorensen, LLP Certificate of Liability InsuranceACORD CERTIFICATE OF LIABILITY INSURANCE F508 DATE TE(MM/015 DDffY) PRODUCER Serial # 100418 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ISU INSURANCE SERVICES / STANTON & ASSOCIATES CA LICENSE OB50569 T: 805.495.6999 F: 805.379.4196 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3625 THOUSAND OAKS BLVD., SUITE 319 WESTLAKE VILLAGE, CA 91362 INSURERS AFFORDING COVERAGE NAIC# INSURED BURKE, & SORENSLLP ATTN: ADMINISTRATIVE RATIVE OFFICCEE �;. 444 S. FLOWER ST., SUITE 2400 JUL Z 7 WE, LOS ANGELES, CA 90071 INSURER A: TWIN CITY FIRE INS CO (HARTFORD 29459 INSURER B: TRUMBULL INS CO (HARTFORD GROUP) 27120 INSURER c: HARTFORD CASUALTY INS CO 29424 INSURER D: TRAVELERS PROPERTY &CASUALTY CO 25674 INSURER E: COVERAGES 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L IN TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 A X COMMERCIALGENERAL LIABILITY CLAIMS MADE ❑X OCCUR 72 UUN UR 4713 * HARTFORD FORM 8/1/2015 8/1/2016 DAMAGE ToRaoccu�nce 5 300,000 MED EXP (Anyoneperson) 5 10,000 PERSONAL&ADVINJURY 5 1,000,000 X ADD'L INSUREDS * H00001 INCLUDES X I WAIVER OF SUBRO * GENERAL AGGREGATE 5 2,000,000 BLANKET ADD'L INSURED GEN'L AGGREGATE LIMIT APPLIES PER: /SUBROPROVISIONS As PRODUCTS - COMP/OPAGG $ 2,000,000 X POLICY JERO LOC REQ'D XXXXXXXXXXXXXX B AUTOMOBILE LIABILITY ANY AUTO 72 UUN UR 4713 ISO FORM CA 0001 8/1/2015 8/1/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS NOTE: NO OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ ANY AUTO $ AUTO ONLY: AGG C EXCESS/UMBRELLA LIABILITY X1 OCCUR CLAIMS MADE 72 XHU UR 1585 8/1/2015 8/1/2016 EACH OCCURRENCE $ 1,000,000 AGGREGATE 5 1,000,000 5 $ DEDUCTIBLE X RETENTION 5 10,000 $ D WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPP.IETOPJPARTNEPIEXECUTIVE OFFICER/MEMBEREXCLUDED? If yes, describe under SPECIAL PROVISIONS below IJUB-6627X65-5-15 BLANKET WAIVER OF SUBROGATION 4/1 /2015 4/1 /2016 X TWO RC LIM S OER EL EACH ACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEE 1 $ 1,000,000 EL DISEASE -POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS * A NOTE ABOUT HARTFORD'S CGL POLICY FORM HG0001: BURKE CLIENTS WITH WRITTEN CONTRACTS AUTOMATICALLY SECURE ADDITIONAL INSURED STATUS UNDER HARTFORD'S COMMERCIAL GENERAL LIABILITY POLICY FORM HG0001. THE HG0001 FORM ALSO PROVIDES PRIMARY / NON-CONTRIBUTORY INSURANCE, SEPARATION OF INTERESTS, AND WAIVER OF SUBROGATION WHERE REQUIRED. A PDF OF THIS 18-PAGE POLICY FORM IS READILY AVAILABLE BY EMAIL. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF MENIFEE ATTN: CITY ADMINISTRATOR 29714 HAUN RD. DATE THEREOF, THE ISSUING INSURER WILLXX MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, KX.XXYbxq XIiSXX y�y�XXX�XXX�QX&(�Cd�XXX MENIFEE, CA 92586 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE J041�18i?4�, CPCU, ARM ACORD 25 (2001108) © ACORD CORPORATION 1988