2018/03/13 Disability Access Consultants, LLC Certificate of Liability Insurance®
ACC)Rn CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
12131 /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: If the certificate holder is an ADDITIONAL INSURED, the policy(lies) 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 c eu of such endorsement(s).
PRODUCER
City Clerk
CONTACT Cell Provo
NAME:
PHONE (651) 644-7200 NG No: (651) 644-9137
Assured Partners of Minnesota LLC
2361 Highway 36 West JAN 0 7 2019
DDRL AESS: cprovo@apminnesota.com
ODR
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA: Continental Cas Cc
20443
St. Paul MN 55113
INSURED Received
INSURER B : American Casualty Co Reading
20427
INSURER C : Transportation Ins Co
20494
Disability Access Consultants, LLC
INSURER D : The Hartford
00914
2243 Feather River Blvd
INSURERE: Philadelphia Insurance Company
251
INSURER F :
Orovllle CA 95965
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 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,
IICY
LTR
TYPE OF INSURANCE
❑
POLICY NUMBER
MMIDD/YYYY
EXP
MMLDD/YYYY
LIMITS
x
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
CLAIMS -MADE Fx_] OCCUR
PREMISES Es*murfance
$ 300,000
MED EXP (Any oneperson)
$ 10,000
PERSONAL & ADV I NJURY
$ 2,000,000
A
Y
B6020052587
01/01/2019
01/01/2020
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ❑ JECT PRO ❑ LOC
GENERAL -AGGREGATE
$ 4,000,000
PRODUCTS - COMP/OPAGG
$ 4,000,000
Employee Benefits
$ 1,000,000
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
$
x ANY AUTO
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Y
BUA6020004782
01/01/2019
01/01/2020
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Peracederd
$
Medical payments
$ 5,000
x
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
C
EXCESS LIAB
CLAIMS -MADE
Y
B6020052637
01/01/2019
01/01/2020
AGGREGATE
$ 5,000,000
DED I RETENTION S 0
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/ N
ANY PRO FIR IETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? F
(Mandatory in NH)
NIA
41WBAC5W3P
01/08/2019
01/08/2020
STATUTE ER
X1 ER
E.LEACHACCIDENT
$ 1,000,000
E L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L DISEASE -POLICY LIMIT
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E
Professional Liability
PHSD1316595
03113/2016
03/13I2019
Limit
$5,000,000
Deductible
$10,000
DESCRIPTION OF OPERATIONS I LOCATIONS / 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 R ,
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD