2013/07/12 Data Ticket, Inc. Certificate of Liability InsuranceDATE (MMIDDIM
ACORUM CERTIFICATE OF LIABILITY INSURANCE 10/29/2013 Y'
PRODUCER e 4 r(. t� �'( �? (`i'. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ashbrook-Clevidence, Inc. 6" ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3000 W. MacArthur Blvd., #320 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
License #0188788 NOV O 1 Zub
Santa Ana, CA 92704
INSURED Cam,1 e !v ire
Data Ticket, Inc. dba: Revenue E)tpOrts
4600 Campus Drive #200
Newport Beach, CA 92660
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: Hartford Casualty Insurance Co
INSURER B: State Compensation Ins Fund
INSURERC: Continental Casualty Co.
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.
S
LTR
NSR
TYPE OF INSURANCE
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MAUL ® OCCUR
POLICY NUMBER
84SBAIA9147
POLICY EFFECTIVE
DATE MM/DD/YY
11/01/13
POLICY EXPIRATION
DATE MM/DD
11/01/14
LIMITS
EACH OCCURRENCE
52 000 000
A
DAMAGE TO RENTED
rr
$300 000
MED EXP (Any one person)
$10 000
PERSONAL & ADV INJURY
s2,0001000
GENERAL AGGREGATE
s4,000,000
PRODUCTS - COMP/OP AGG
S4 00O 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO LOC
POLICY JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
84SBAIA9147
11/01/13
11/01/14
COMBINED SINGLE LIMIT
(Ea accident)
$2,000,000
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
X
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
S
OTHER THAN EA ACC
AUTO ONLY: AGG
$
S
A
EXCESS/UMBRELLA LIABILITY
X1 OCCUR CLAIMS MADE
DEDUCTIBLE
HX RETENTION $ 10000
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
HN'i PROl'1lIETOR/PARTr:EPJEXECU FIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
84SBAIA9147
90657312013
11/01/13
07/12/13
11/01/14
07/12/14
EACH OCCURRENCE
S1 000 000
AGGREGATE
S1,000,000
S
S
WC STATU- OTH-
XLIMIT
$
B
E.L. EACH ACCIDENT
S1,000,e00
E.L. DISEASE - EA EMPLOYEE
S1,000,00
E.L. DISEASE - POLICY LIMIT
$1,000,000
C
SPECIAL PROVISIONS below
OTHER Professional
Liability (E & O)
287188360
11/01/13
11/01/14
$2,000,000 Limit
$10,000 Retention
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate holder is included as additional insured as respects to General Liability coverages as their
interest may appear, as per the attached verbiage from the policy.
-' -.--' . .—._.. awn r�_.._ c_.. ��,.., o.,....,.,.,♦
C«
City of Menifee
ATTN: Kathy Bennett
29714 Huan 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 *In 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
REPRESENTATIVE
ACORD 25 (2001/08) 1 of 2 #S25866/M25864
—11. .-, Arnpn rnRPnRATION 198E
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-S (2001/08) 2 of 2 #S25866/M25864
BUSINESS LIABILITY COVERAGE FORK!
F. OPTIONAL ADDITIONAL INSURED
3. Additional Insured -Grantor Of Franchise
COVERAGES
WHO IS AN INSURED under Section C. is
amended to include as an additional insured
If listed or shown as applicable in the Declarations,
the person(s) or organization(s) shown in the
one or more of the following Optional Additional
Declarations a6 an Additional Insured -
Insured Coverages -also apply. When any of these
Grantor Of Franchise, but only with respect to
Optional Additional Insured Coverages apply,
--their liability as grantor of franchise to you.
Paragraph 6. (Additional Insureds When Required
4. Additional Insured - Lessor Of Leased
by Written Contract, Written Agreement or Permit)
of Section C., Who Is An Insured, does not apply
Equipment
to the person or organization shown in the
a. WHO IS AN INSURED under Section C. is
Declarations. -These coverages are subject to -the
amended to include' -as an additional
terms and conditions applicable 'to Business
insured the person(s) or organization(s)
.
Liability - Coverage . in this policy, except as
shown in the Declarations as an Additional
provided below:
Insured — Lessor of Leased Equipment,
"bodily
1:. Additional Insured - Designated Person Or
but only with respect to liability for
injury", "property damage" or "personal
Organization
and advertising injury" caused, in whole or
WHO IS AN INSURED under Section C. is
in part, by your maintenance, operation or
.amended to include as an additional insured
*in
use of; equipment leased to you by such
the person(s) or organization(s) shown the
person(s) oir organization(s).
Declarations, but only with respect to -liability
b. With respectto the insurance afforded to
for "bodily injury", "property damage" or
"personal and advertising injury" caused, in
these additional , this insurance
insureds
"occurrence" which
whole or in part; by your acts or omissions or
does not apply to any
takes place after you cease to lease that
the.acts or omissions of those acting on your
equipment
behalf:
a. In the performance of your ongoing
5. Additional Insured - Owners Or Other
Interests From Whom' Land Has Been
operations; or
Leased
b. In connection - with your premises owned
a. WHO IS AN INSURED under Section C. is .
7--by or rented to you.
amended to include as an additional
2. Additional Insured - Managers Or Lessors
insured the person(s) or organization(s)
Of Premises
shown in the Declarations as an Additional
a. WHO IS AN INSURED under Section C. is
Insured — Owners Or Other Interests From
to include as an additional insured.
Whom Land Has Been Leased, but only -
.amended
the person(s) or organization(s) shown in the.
with respect to liability arising out of the
Declarations as. an_ Additional Insured -
ownership, maintenance cruse of that part
Designated Person Or Organization; but only-
'of the land leased to you and shown in the
with respect to liability arising out of the
Declarations.
ownership, maintenance or use of that part of
b. With respect to the insurance afforded to
the premises leased to you and shown in the
these additional insureds, the following
Declarations.
additional exclusions apply:
b. With respect to the insurance afforded to
This insurance does not apply to:
these additional insureds, the following
(1) Any "occurrence" that takes place
additional exclusions apply:
after you cease to lease that land; or
This insurance does not apply to:
(2) .Structural alterations, new
(1) *Any "occurrence"which takes place
construction or demolition operations
after you cease to be a tenant in that y
performed by or*•on behalf of such
,
premises; or
person or organization.
(2) Structural alterations, new
g Additional Insured - State Or Political
construction or demolition operations
Subdivision —Permits
performed by. or on behalf of such
a. WHO IS' AN INSURED under Section C. is
person or organization.
amended to include as an additional
insured the state or political subdivision
shown in the De-Claraticns as an Addi"cr.al