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2018/07/30 CVS Health Corporation Certificate of Liability InsuranceDATE(MMIDDIYYYY) EVIDENCE OF PROPERTY INSURANCE I 06l01/2016 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PHO/C NEo Ext COMPANY Marsh USA Inc. See attached for a list of additional insurers 99 High Street cityof, Boston, MA 02110 Attn: CVSCaremark.cedrequest@Marsh I Fax: 212-948-5338 city I CODE: I SUB CODE: INSURED CVS HEALTH CORPORATION ONE CVS DRIVE, MC 2180 WOONSOCKET, RI 02895 YKUF'tK 1 T IIVI-UKIVIA I IUIV LOCATI ONID ESC RI PTI ON CVS Store #05267-01, Located: 26973 Newport Road, Menifee, CA 92584 AUG 092" LOAN NUMBER POLICY NUMBER See Attached EFFECTIVE DATE EXPIRATION DATE 07/30/2018 1 07/30/2019 CONTINUED UNTIL n TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: 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 EVIDENCE OF PROPERTY INSURANCE 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. .. ... ..I I I I I X COVERAGE IPERILS IFORMS AMOUNT OF INSURANCE DEDUCTIBLE PERILS: "All Risk" of direct physical loss or damage including Earthquake, Flood, Wind, subject to policy terms and conditions. 50,000,000 500,000 PROP COVERED: Real & Personal Property, Extra Expense, Improvements and Betterments, Structures in the Course of Construction, Newly Acquired Locations, Ordinance or Law and as more fully in the policy(ies). PROPERTY VALUATION: Replacement Cost except stock and as more fully described in the policy(ies). The Perils of Terrorism and Mold are excluded. Plate Glass damages are covered. Rental Value is included on an actual loss sustained basis but only to the extent required by the lease. Other deductibles may apply as per policy terms and conditions. City of Manifee is/are named as an Additional Insured as their interests may appear, as respects the leased premises, but only to the extent required under the lease of the premises or under any other written contract or agreement. 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. Ar%rli1rir%KlAl IIJTCoCCT NYC-008645684-11 NAME AND ADDRESS I ADDITIONAL INSURED LENDER'S LOSS PAYABLE LOSS PAYEE MORTGAGEE 05267-01 City of Manifee LOAN # Attn: City Manager 2974 Haum Road Menifee, CA 92586 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Yevgeniya Muyamina'�vy,Ia .+72t�ffam�.�a ACORD 27 (2016103) V 1yy3-ZU1b AUUKU L UKYUKA I IUIV. All rig NLS ru5uryCu. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101226639 LOC #: Boston o ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY Marsh USA Inc. POLICY NUMBER CARRIER NAIC CODE NAMED INSURED CVS HEALTH CORPORATION ONE CVS DRIVE, MC 2180 WOONSOCKET, RI 02895 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 27 FORM TITLE: Evidence of Property Insurance PARTICIPATING INSURERS: Factory Mutual Insurance Company Policy# 1042361 Interstate Fire & Casually Company Policy # RTX 200031 18 0 ' Endurance Specialty Ins. Ltd Policy No. BPD10011544201 Lloyd's (HCC) Policy No. BOWPN1800452 ' PICC Property and Casualty Co. Ltd. Policy No. A001201844030000001026 ACE American Ins. Co. Policy No. MAUD37869995 004 Aspen Specialty Insurance Company Policy #PRAEKQEI8 ' Allied World Assurance Co. Policy No. P0101541011 Lloyds (CGM/ASC) Policy No. BOWPNI800282 Starr Surplus Lines Ins. Co. Policy No. SLSTPTY11093718 Ironshore Specialty Insurance Co. Policy No. 003719000 ' Ironshore Insurance Ltd. Policy No. 443306118 Markel Bermuda Ltd Policy No.1377177-9769-PRMAN-2018 Hudson Specialty Ins. Co. Policy No. HCS102435 Lloyd's (Hiscox) Policy No. HNYPRP18746225 Maxum Indemnity Co. Policy # MSP6029155-03 Hallmark Insurance Company Policy # 73PRP189DE1 Boiler & Machinery $25,000,000 Limit / $250,000 Deductible XL Callin Insurance Company Policy No. US00085771PR18A Equipment Breakdown: Coverage for Property Damage, Spoilage, Business Interruption, Extra Expenses, and Utility Interruption per policy terms and conditions BERMUDA' THE PROPERTY INSURANCE NUMBERS BPD10011544201, A001201844030000001026, P0101541011, 443306118, 1377177-9769-PRMAN-2018 AND PX18-4405-01 PLACEMENTS WERE MADE BY BOWRING MARSH BERMUDA AND/OR BOWRING MARSH CHINA. MARSH USA INC. HAS ONLY ACTED IN THE ROLE OF A CONSULTANT TO THE CLIENT WITH RESPECT TO THIS PLACEMENT, WHICH IS INDICATED HERE FOR YOUR CONVENIENCE. EVIDENCE/CERTIFICATES OF INSURANCE Any evidence of insurance issued in connection with this policy, including electronic memorandums of insurance, shall be issued solely as a matter of convenience or information for the addressee(s), holder(s) or viewer(s) of said evidence of insurance, except where under written contract with a third party the Insured is required to provide property insurance for the benefit of a third party and include the interest of such third party under said property policy as either additional insured, loss payee or mortgagee pursuant to said contract. In such event, the interest of such third party as either additional insured, lass payee or mortgagee as its interest may appear shall be covered under this policy as of the inception date of this policy if the contract had been entered into by the Insured prior to the policy's inception date, or as of the date the Insured enters into contract with the third party if such date occurs subsequent to the policy's inception, subject otherwise to all of the policy's, terms, conditions and exclusion. Further, the inclusion of such additional interest(s) shall not increase this Company's limit of liability under this policy. It is also agreed that in the event of loss or damage to property insured under the Insured's property policy where the third party has an interest in said property per contract with the Insured as either additional insured, loss payee or mortgagee and is not otherwise specifically named under the policy or made known to the Company prior to loss, such interest will be notified to the Company on the date of the notice of loss per the policy's conditions or as soon as reasonably practicable thereafter. Failure to timely notify the Company in such event will not relieve this Company of any liability for said additional interests, but will be corrected as soon as possible. ACORD 101 (2008/01) U ZUUt3 AGUKU GUKNUKA 11UN. Au rlgnis reserveu. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101226639 LOC #: Boston AGENCY Marsh USA Inc. POLICY NUMBER CARRIER ArlfllTlr)NAI RFMARKC AMITIONAL REMARKS SCHEDULE NAIC CODE NAMED INSURED CVS HEALTH CORPORATION ONE CVS DRIVE, MC 2180 WOONSOCKET, RI 02895 EFFECTIVE DATE: ITHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 27 FORM TITLE: Evidence of Property Insurance STANDARD MORTGAGEE CLAUSE Loss or damage, if any, under this policy, shall be payable to any mortgagee, (or trustee) as designated herein by endorsement or certificate of insurance, as interests may appear, under all Present or future mortgages upon the property herein described in which the aforesaid may have an interest as mortgagee(or trustee), in order of precedence of said mortgagees, and this insurance, as to the interest of the mortgagee or trustee only therein, shall not be invalidated by any act or neglect of the mortgagor or owner of the within described property, nor by any foreclosure or other proceedings or notice of sale relating to the property, nor by any change in the fitle or ownership of the property nor by the occupation of the premises for purposes more hazardous than are permitted by this policy; provided, that in case the mortgagor or owner shall neglect to pay any premium due under this policy, the mortgagee or trustee, shall, on demand, pay the same. Provided also, that the mortgagee (or trustee) shall notify the Companies of any change of ownership or occupancy or increase of hazard which shall come to the knowledge of said mortgagee, (or trustee) and, unless permitted by this policy, it shall be noted thereon and the mortgagee (or trustee) shall, on demand, pay the premium for such increased hazard for the term of the use thereof; otherwise this policy shall be null and void. The Company reserves the right to cancel this policy at any time provided by its terms, but in such case this policy shall continue in force for the benefit only of the mortgagee (or trustee) for 90 days after notice to the mortgagee (or trustee) of such cancellation and shall then cease and the Companies shall have the right, on like notice, to cancel this agreement. Whenever the Companies shall pay the mortgagee (or trustee) any sum for loss or damage under this policy and shall claim that, as to the mortgagor or owner, no liability therefore existed, the Companies shall, to the extent of such payment, be thereupon legally subrogated to all rights of the party to whom such payment shall be made under all securities held as collateral to the mortgage debt, or may, at its option, pay to the mortgagee (or trustee) the whole principal due or to grow due on the mortgage with interest accrued thereon to the dale of such payments, and shall receive a full assignment and transfer of the mortgage and of all such other securities; but no subrogation shall impair the right of the mortgagee (or trustee) to recover the full amount of said mortgagee's (or trustee's) claim. CANCELLATION A. This policy may be canceled at any time at the request of the Insured or it may be canceled by the Company by mailing to the Insured at: Director of Risk Management One CVS Drive Woonsocket, RI 02895 and to the additional insureds/loss payees or mortgagee indicated on the certificates of insurance issued during the term of this policy, written notice stating when, not less than 90 days thereafter, such cancellation shall be effective. The earned premium shall be computed on a pro-rata basis. B.The mailing of notice as aforesaid shall be sufficient proof of notice and the effective date and hour of cancellation stated in the notice shall become the end of the policy period. Delivery of such written notice either by the Insured or by the Company shall be equivalent to mailing. C.Cancellation shall not affect coverage on any shipment in transit on the date of cancellation. Coverage will continue in full force until such property is safely delivered and accepted at place of final destination. D.In the event of non-payment of premium this policy may be canceled by the Company by mailing to the Insured at the address shown in A. above stating when, not less than 10 days thereafter, such cancellation shall be effective. Reinstatement of coverage shall be effective immediately upon receipt of premium by the Company. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Page 3 of 3 ACORD 101 (2008/01) U 2008 ACUKD CUKNUI<A I IUN. Au ngnts reservea. The ACORD name and logo are registered marks of ACORD 0001349 SP 0456-001-P01349-1 05267-01 City of Manifee Attn: City Manager 2974 Haum Road Menifee, CA 92586