2017/12/30 California TrusFrame, LLC Certificate of Liability InsuranceACORD® CERTIFICATE OF LIABILITY INSURANCE
D09/07/2018DnYW)
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 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
Marsh Risk & Insurance Services
CA License #0437153
633 W. Fifth Street, Suite 1200
Los Angeles, CA 90071
s City of Menifee
CONTACT
NAME:
FAX
PHONEo Ext : A/C No):
E-MAIL
ADDRESS:
Attn: LosAngeles.CertRequest@marsh.com City Clerk
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: Pennsylvania Lumbermens Mutual
14974
CN116723689—GAUW-18-19
INSURED (OCT 12 2018
m California TrusFrae LLC
INSURER B : Alaska National Insurance Co.
38733
INSURER C :
23665 Cajalco Rd
Perris, CA 92570
_ Received
INSURER D :
INSURERE:
INSURER F :
COVERAGES CERTIFICATE NUMBER: LOS-002402200-01 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.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUBR
WVDPOLICY
NUMBER
POLICY EFF
MM/DD/YYYY)
POLICY EXP
(MMIDDIYYYYI
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE M OCCUR
04-CO29-05-17
12/30/2017
12/3012018
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER :
X PRO❑LOC
❑JECT
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMP/OP AGG
$POLICY 2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
04-0O29-06-17
12/30/2017
12/30/2018
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
Per accident
$
UMBRELLALIAB
EXCESS LIAB
HCLAIMS-MADE
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
DED I I RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED? Y❑
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
18EWS09716
05/16/2019
X PER oTH-
STATUTE ER'
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
1 L riULUtK
City of Menifee
29714 Haun Rd.
Menifee, CA 92584
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh Risk & Insurance Services
Susan L. Hedges t' .2- 1k.ifs-✓
@ 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
0004370 SP 0538-CO7-PO4372-1
City of Menifee
29714 Haun Rd.
Menifee, CA 92584
i