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2019/03/23 Counts Unlimited, Inc. Certificate of Liability InsuranceA CERTIFICATE OF LIABILITY INSURANCE DA3/13DD/YYYY) 0/13/2019 PRODUCER (855) 266-2135 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR Fixated Financial & Insurance Solutions, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 2445 Newport Beach CA 92659- INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A:CNA (Continental Casualty Co. 20443 INSURER B: CNA (National Fire Ins CO ) 20478 Counts Unlimited, Inc. INSURER C: Employers Preferred Ins. Co. 10346 P.O. BOX 1178 INSURER D:HisCOX 10200 Corona I CA 92878— INSURER E: C(3VFRAt.FS 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, POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDITIONS OF SUCH INSR AAOWL TYPE OF JNSUP-ANCE POLICY NUMBER POLICY EFFECTIVE / POLICY EXPIRATION LIMITS A X GENERAL LIABILITY 5092255087 03/23/2019 03/23/2020 EACH OCCURRENCE $ 2,000 000 X COMMERCIAL GENERAL LIABILITY / / / / A �R'ITb PREMISES fEa occurrencpl $ 300,000 MED EXP (Any one arson $ 10,000 CLAIMS MADE ® OCCUR / / / / PERSONAL & ADV INJURY $ 2 000 000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 / / / / X POLICY JECPRO LOC / / / / Employment Practices 10,000 B X AUTOMOBILE X LIABILITY ANY AUTO 5092255137 03/23/2019 / / 03/23/2020 / / COMBINED SINGLE LIMIT (Ea accident) $ 11000,000 _ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS City of Menifee City Clerk MAR 2 5 2019 / / / / / / / / / / DY (PerrpersloN)URY BODILY INJURY (Per accident) $ $ X X X PROPERTY DAMAGE (Per accident) COMP DED. $500 / / / / / / / / $ X COLLISION DED $500 GARAGE LIABILITY I Received / / / / AUTO ONLY- EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO / / / / $ AUTO ONLY: AGG EXCESS I UMBRELLA LIABILITY / / / / EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE / / / / $ DEDUCTIBLE / / / / $ RETENTION $ / / / / C WORKERS COMPENSATION EIG-2343559-03 AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED, 03/23/2019 / / 03/23/2020 / / X WCSTATU- OTH- E.L EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYE $ 11000,000 (Mandatory in NH) If yes, describe under / / / / E.L DISEASE -POLICY LIMIT $ 1. 000 000 SPECIAL PROVISIONS below / / / / OTHER Professional Liab. MPL1763539.18 06/10/2018 06/10/2019 Aggregate Limit 11000,000 D / Each Claim 1,000,000 TtPdncti]he_Pe:L_cla' S 000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The City of Menifee, its elected and appointed officers, employees and agents are being named as Additional Insureds as their interests may appear per Attached Al Blanket Endorsement. *10 DAYS NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUM. L.CIS I IVtL.A I t MULULK CANCELLATION (951) 639-1368 141 (951) 679-3843 00 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Attn: Jon Hofert DATE THEREOF, TH SUING 1 SURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CEir;'I'Ij7GRBIjkTY LOER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL CITY OF MENIFEE IMPOSE NO OBLIG TI OF ANY KIND UPON THE INSURER, ITS AGENTS OR 29714 Haun Road REPRESENTATIVES AUTHORIZED REPRE�E TIV Menifee CA 92586- ACORD 25 (2009/01) © 198$• 9 CORD CORPORATION. All riahts reserved. INbUL5 (200901) The ACORD name and logo are registered marks of ACORD SB-146935-A (Ed. 01 /06) Page 1 of 2 Policy Number 5092255087 IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C.I. OF THIS ENDORSEMENT FOR THESE DUTIES. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S SCHEDULED AND BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS -COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: The City of Menifee, its elected and appointed officers, employees and agents (Coverage under this endorsement is not affected by an entry or lack of entry in the Schedule above.) A. Paragraph C. WHO IS AN INSURED is amended to not in addition to, the Limits of Insurance shown include as an insured any person or organization, in the Declarations. including any person or organization shown in the schedule above, (called additional insured) whom you are required to add as an additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior to the "bodily injury," "property damage," or "personal and advertising injury." B. The insurance provided to the additional insured is limited as follows: 1. That person or organization is an additional insured solely for liability due to your negligence specifically resulting from your work for the additional insured which is the subject of the written contract or written agreement. No coverage applies to liability resulting from the sole negligence of the additional insured. 2. The Limits of Insurance applicable to the additional insured are those specified in the written contract or written agreement or in the Declarations of this policy, whichever is less. C. These Limits of Insurance are inclusive of, and 3. The coverage provided to the additional insured by this endorsement and paragraph F.9. of the definition of "insured contract" under Liability and Medical Expenses Definitions do not apply to "bodily injury" or "property damage" arising out of the "products -completed operations hazard" unless required by the written contract or written agreement. 4. The insurance provided to the additional insured does not apply to "bodily injury," "property damage," or "personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services including: a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, or inspection activities performed as part of any related architectural or engineering activities. As respects the coverage provided under this endorsement, BUSINESSOWNERS LIABILITY COVERAGE FORM is amended as follows: SB-146935-A (Ed. 01 /06) Page 2 of 2 1. The following is added to E.2. Duties In The Event of Occurrence, Offense, Claim or Suit: e. An additional insured under this endorsement will as soon as practicable: (1) Give written notice of an occurrence or an offense to us which may result in a claim or suit under this insurance; (2) Tender the defense and indemnity of any claim or suit to any other insurer which also has insurance for a loss we cover under this Coverage Part; and (3) Agree to make insurance which has for a loss Coverage Part. available any other the additional insured we cover under this f. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a claim or suit from the additional insured. 2. The following is added to Paragraph H. of the BUSINESSOWNERS COMMON POLICY CONDITIONS: H. Other Insurance 4. This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing.