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2015/03/23 Andrea Suarez Certificate of Liability InsuranceA� CERTIFICATE OF LIABILITY INSURANCE DATE TE(MM/D 5) PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION PHILIP J CLARK INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1015 CHESTNUT AVE, SUITE G3 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR O CARLSBAD, CA 92008 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: State Farm General Insurance Company 25151 25151 Andrea Suarez INSURER B: 3575 Rock Ridge Rd. INSURER C: Carlsbad, Ca 92010 INSURER D: 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 POLICIES 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 LTR ADDT INSRC TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS A X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR 90-BR-F-704 03/23/2015 03/23/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: x POLICY n PRO- LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS / UMBRELLA LIABILITY 1 OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y OFFICER/MEMBER EXCLUDED? El (Mandatory in NH) 1 yes, describe under WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 1,tK I II-II,A I t MULUtK UANI:tLLA I IUN CITY OF MENIFEE MEDIA OUTREACH SERVICES 29714 HAUN ROAD MENIFEE, CA 92586 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Cynthia Clark License #OD83172 ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. -r" - Af1r%m 1 ____ --A 1...... -C AI+^-- AAAA AOC 4­0AA 0 AA AC .I ULiM Policy No.: 90 BRW023 5 FE-6609 GE SECTION II ADDITIONAL INSURED ENDORSEMENT Policy No.: 90 BRW023 5 Named Insured: SUAREZ, ANDREA DBA CONNECT COMMUNICATIONS Additional Insured (include address): CITY OF MENIFEE MEDIA OUTREACH SERVICES 29714 HAUN ROAD MENIFEE, CA 92586 WHO IS AN INSURED, under SECTION 11 DESIGNATION OF INSURED, is amended to include as an insured the Additional Insured shown above, but only to the extent that liability is imposed on that Additional Insured solely because of your work performed for that Additional Insured shown above. Any insurance provided to the Additional Insured shall only apply with respect to a claim made or a suit brought for damages for which you are provided coverage. The Primary Insurance coverage below applies only when there is an "X" in the box. ® Primary Insurance. The insurance provided to the Additional Insured shown above shall be primary insurance. Any insurance carried by the Additional Insured shall be noncontributory with respect to coverage provided to you. All other policy provisions apply. FE-6609 Printed in U.S.A. FE-6671 Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Policy Number: 90 BRW023 5 Named Insured: SUAREZ, ANDREA DBA CONNECT COMMUNICATIONS Name and Address of Person or Organization: CITY OF MENIFEE MEDIA OUTREACH SERVICES 29714 HAUN ROAD MENIFEE, CA 92586 The following is added to Paragraph 10.b. of SECTION I AND SECTION II — COMMON CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of: a. Your ongoing operations; or b. Your work done under contract with that person or organization and included in the products - completed operations hazard. This waiver applies only to the person or organization shown in the Schedule. All other policy provisions apply. FE-6671 ©, Copyright, State Farm Mutual Automobile Insurance Company, 2008 Includes copyrighted material of Insurance Services Office, Inc., with its permission. FE-6671 (04109) Printed to U.S.A.