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2018/07/03 Dennis Janda, Inc. Certificate of Liability Insurance (5)E® AC CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 05/08/2019 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 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 endorsemellt(s). PRODUCER CONTACT Strachota Insurance Agency, Inc. NAME: Lawrence E Potter 27710 Jefferson Avenue, Suite 100 PHf_C�o�Ext1:_(951) 676-2229 FA)(�;(951) 676-7391 E-MAIL Temecula CA 92590 AQ0REW__t_&ryU@Btrachota.com. strachota.com City of Menifee INSURE -4AFFCRDINo00VERAGE NAICN INSUREColony Insurance qaq!psny 39993 ClerkCity INSURED Dennis Janda Inc. „ ^� r1019 {jNfH INSURERB:AmGUARD Insurance Com an 42390 INSURERC:Ohio SecurityInsurance Company-24082 42164 Remington Avenue 33138 INSURER D: Landmark American Insurance Co, INSURER E: Temecula CA 92590 Received INSURER F COVERAGES ('FRTIFIf`ATC IJI IaAGCG• ne Tn ocoe 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 AWOL WI90 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/ POLICY 1POLI C EXP LIMITS A X I COMMERCIAL GENERAL LIABILITY �l CLAIMS -MADE OCCUR Y 103GL002584400 09/28/201a 09/28/2019 EACH OCCURRENCE $ 1,000,000 PREgMaoar�anoe $ 100,000 MEDEXP (Any one person) $ excluded — PERSONAL & ADV INJURY $ 1, 000, 000 GENERAL AGGREGATE $ 2, 000,000 GEML AGGREGATE LIMIT APPLIES PER: POLICYI �PR LOC PRODUCTS - COMP/OPAGG $ *included $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _(Ea accident)$ 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO Y DEAU936781 11/08/201811/08/2019 —, ALL OWNED SCHEDULED .AUTOS AUTOS BODILY INJURY Per accident ( ) $ X HIRED AUTOS ]( NON -OWNED AUTOS I PROPERTY DAMAO.E (FW accident) $ UMBRELLA LIAB 1__J OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION S $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N I A XWS56173896 07/03/2018 07/03/2019 PER OTH- X TA ER E L. EACH ACCIDENT $ 1,000,000 E L. DISEASE - EA EMPLOYE $ 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1, 000, 000 DESCRIPTION OF OPERATIONS below D Professional Liability LHR837440 05/08/2019 05/08/2020.Each Claim $ 1,000,000 Aggregate $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Menifee, its councilmembers, officers, agents and employees are an Additional Insured with respects to the General Liability per the attached CG20100413 endorsement. Also an Additional Insured with respects to the Commercial Automobile per the attached BA99040618 endorsement. I.CK I II -ILA I t MULULK CANCELLATION City of Menifee 29714 Haun Road Menifee CA 92586 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Page 1 of 1 103 GL 0025844-00 POLICY NUMBER: 103 GL 0025844-00 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) I Location(s) Of Covered Operations All persons or organizations as required by written As designated in written contract with the Named contract with the Named Insured Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 103 GL 0025844-00 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a oontract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance; 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 10 0413 COMMERCIAL AUTO BA 99 04 06 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED WHEN REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This provision does not apply in regard to any ownership, maintenance or use of the additional insured's "autos." Additional Insured When Required by Contract (1) Paragraph A.1. — WHO IS AN INSURED — of Section II — Liability Coverage is amended to add: d. When you have agreed, in a written contract or written agreement, that a person or organization be added as an additional insured on your business auto policy, such person or organization is an "insured", but only to the extent such person or organization is liable for "bodily injury" or "property damage" caused by the conduct of an "insured" under paragraphs a. or b. of Who Is An Insured with regard to the ownership, maintenance or use of a covered "auto " The insurance afforded to any such additional insured applies only if the "bodily injury" or "property damage" occurs: (1) During the policy period, and (2) Subsequent to the execution of such written contract, and (3) Prior to the expiration of the period of time that the written contract requires such insurance be provided to the additional insured. (2) How Limits Apply If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the most we will pay on behalf of such additional insured is the lesser of: (a) The limits of insurance specified in the written contract or written agreement; or (b) The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations and described in this Section. (3) Additional Insureds Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract or written agreement that the insurance is primary and non- contributory with the additional insured's own insurance. (4) Duties in The Event Of Accident, Claim, Suit or Loss If another person or organization is added as an additional insured on your policy, the additional insured shall be required to comply with the provisions in A. Loss Conditions 2. — Duties In The Event Of Accident, Claim, Suit Or Loss — of SECTION IV — BUSINESS AUTO CONDITIONS, in the same manner as the Named Insured. BA 99 04 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 1