2018/03/13 Disability Access Consultants, LLC Certificate of Liability Insurance (3),Ac�Ro� CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/YYYY)
12/31 /2018
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: Ifthe certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or he 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 c ' a I eu of such endorsement($).
PRODUCER
City Clerk
CONTACT Cell Provo
NAME;
AssuredPartners of Minnesota LLC
PHCN u (651) 644-7200 FAX
C No : (651) 644-9137
FAI2361
Highway 36 West 1 /1 AI Il �f �O�n
JAN V a J
E-MAIL cprovo@apminnesota com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
St. Paul MN 55113
INSURERA; Continental Cas Cc
20443
INSURED Recelive
INSURERS: American Casualty Co Reading
20427
Disability Access Consultants, LLC
INSURERC: Transportation Ins Cc
20494
2243 Feather River Blvd
INSURER D : The Hartford
00914
INSURER E: Philadelphia Insurance Company
251
Orovllle CA 95965
INSURERF:
COVERAGES CERTIFICATE NUMBER: 19/20 Master REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTH E POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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
LTR
TYPE OF INSURANCE
L
1N D
SUBR
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICYEXP
MMIDD/YYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F_x] OCCUR
EACH OCCURRENCE
$ 2,000,000
A
PRE}vli5 S Ea occurrence
$ 300,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 2,000,000
A
Y
B6020052587
01/01/2019
01/01/2020
GGLN'LAGGREGATE LIMITAPPLIES PER:
PRO❑LOC
❑JECT
GENERAL AGGREGATE
$ 4,000,000
PRODUCTS
$POLICY 4,000,000
Employee Benefits
$ 1,000,000
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1.000,000
BODILY INJURY (Per person)
$
ANYAUTO
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
Y
BUA6020004782
01/01/2019
01/01/2020
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per arc.ft
$
Medical payments
$ 5.000
UMBRELLA LIAB X
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
C
EXCESS LIAB
CLAIMS -MADE
Y
B6020052637
01/01/2019
01/01/2020
DED I X1 RETENTION 5 0
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRiETOWPARTNER)EXECUTIVE YIN
OFFICERfMEMBEREXCLUDED?
(Mandatory InNH)
N/A
41WBAC5W3P
01/08/2019
01/08/2020
X1 S 11 ERH
EL EACH ACCIDENT
$ 1,000,000
EL.DISEASE- EAEMPLOYEE
$ 1,000,000
If yes, desci ibe under
DESCRIPTION OF OPERATIONS below
E L. DISEASE - POLICY LIMIT
$ 1,000,000
E
Professional Liability
PHSD1316595
03/13/2018
03/13/2019
Limit
$5,000,000
Deductible
$10,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Menifee ADA Self Evaluation and Transition Plan are listed as additional insured
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Menifee and its officers, employees, agents ACCORDANCE WITH THE POLICY PROVISIONS.
29714 Haun Road —
AUTHORIZED REPRESENTATIVE (�
Menifee CA 92586 9 A ,
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD