2018/06/01 CoreLogic, Inc. Certificate of Liability InsuranceAC`QI2'C7 CERTIFICATE OF LIABILITY INSURANCE 6/1/2019
DATE(MMIDDNYYY)
4/19/2019
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 Laddon 1nsUranOe BrokerSLLC
CA License #/OF15767
Three' �3 Center, SLifte 60Q
Sari FrarlciscoCA94111 City 4f Menifee
(415) 56UM0 City Clerk
cONTACT
NAME.
(A/C, No. Ext : C ko
E-MAIL
AFFORDING E
NAIC At
INSURER A; National Fire Insurance Co of Hartford
20478
INSURED Corii Inc. APR 3 OU19
1364390 and Its Covered subsidiaries
Cael-aglic _SduHCrls, LLC
40 Pad q Suite 9DO
IrvineCA92618 Received
INSURER B : American Casualty Company ofReadine. PA
20427
INSURER C : Transportation Insurance Company
20494
• Lloyds of London
INSURERF:
COVERAGES 9799.51 CERTIFICATE NLIMRFR: 19.316171 RF1114;InM NIIMRFR• YYYYYYY
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
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
POLICY EXPLTR
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
N
N
6057407975
4/19/2019
4/19/2020
EACH OCCURRENCE
1,000,000
CLAIMS -MADE U OCCUR
DRAMMGE_TO R oNT
1.000.000
rr nce
X
MED EXP LAny one person
15,000
Host Liq ror Liab-
No Dcductible
PERSONAL 8 ADV INJURY
$ 1,000,000
GE
N'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2 00O 000
POLICY❑ JEOT LOC
PRODUCTS - COMP/OP AGG
$ 2.000.000
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
aaccidentl
$ XXXXXxx
ANY AUTO
NOT APPLICABLE
BODILY INJURY (Per person)
$ XXXXXXX
OWNED SCHEDULED
AUTOS ONLY AUTOS
iBODILY INJURY (Per accident
$ XXXX��X
AUTOS ONLY AUUTOS ONLY
pROPEi3 a DAeAAGE
$ XXXXxxx
UMBRELLA LIAB
OCCUR
IEACH OCCURRENCE
$ XXXXXXX
EXCESS LIAB
CLAIMS -MADE
NOT APPLICABLE
AGGREGATE
$ XXXXXXX
DED I I RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
N
WC6572801967 (CA)
4/19/2019
4/19/2020
PER OTH-
X STATUTE ER
B
C
YIN
ANYPROPRIETOR/PARTN
OFFICER/MEMBER EXCLUDDED?ED? CUTIVE
�
WC657280953 AOS)
WC657280970 See Attached)
)
4/19/2019
4/19/2019
4/19/2020
4/19/2020
EL EACH ACCIDENT
$ 1 OOO,OOO
IEL. DISEASE - EA EMPLOYEE
1.000.000
C
(Mandatory in NH)
GAP 60557281021(See Attach)
4/19/2019
4/19/2020
under
D yes, DESCRIPTION
DESCRIPTION OF OPERATIONS belo11tN
E-L DISEASE - POLICY LIMIT
1 000,000
D
ProfE&OICYbcrLiab-
N
B0713MEDTE1801034 (E&O)
6/1/2018
6/1/2019
$5.000,000 CleitmMnde
Primary - Third
Prrty-Clpims
$S,0RO,01)0 Arcy=atc
Retention $2.500,Oi}I]
Retro Dates var
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Evidence of Coverage.
4CiS 1 iri4Ni C riVLLiCrc I.ANI.tLLAI IUN gee ikaacnmeni
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
12316371 AUTHORIZED REPRESENTATIVE
Oty of Menifee
29714 Faun Road
Menifee CA 92586
I
ACORD 25 (2016/03) @1981F.2015 AcoRUCORPORATICV. All rights reserved
The ACORD name and logo are registered marks of ACORD
Attachment Code: D547764 Master ID: 1364390, Certificate ID: 12316371
Effective: 4/19/2019 - 4/19/2020
Insurer (D): Transportation Insurance Company
Workers Compensation Employers Liability
Statutory Limits:
$1,000,000 - E.L. Each Accident
$1,000,000 - E.L. Disease - Ea. Employee
$1,000,000 - E. L. Disease - Policy Limit
$250K Deductible/ Per claim
Policies:
WC657280970 (AZ/DC/MA/MN/OR/WI)
GAP6057281021 (ND/OH/WA/WY)