2019/01/01 Disability Access Consultants, LLC Certificate of Liability Insurance'A � CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDD/YYYY)
03/18/2019
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 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 certificate hold in lieu of such endorsement(s).
PRODUCER
AssuredPartners of Minnesota LLC cityClerk
CONTACT Cell Provo
NAME:
PHONE (651)644-7200 (F (651)644-9137
AIC. No. Ext): A!C Na
2361 Hwy 36 W
MAR 2 5 2019
E-MAIL cprovo@apminnesota.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
St Paul MN 55113
INSURERA: Continental Cas Co
20443
INSURED
Receive
American Casualty Cc Reading
INSURER B : y g
20427
Disability Access Consultants, LLC
INSURER C : Transportation Ins Cc
20494
2243 Feather River Blvd
INSURER D : The Hartford
00914
INSURERE: Philadelphia Insurance Company
251
Oroville CA 95965
INSURERF:
COVERAGES CERTIFICATE NUMBER: 19/20 Prof 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
AVULISUOR
INSD
WVD
POLICY NUMBER
MMIDD/YM
MM/DD/YYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
$ 2.000,000
PREMISES JFsoccurrance
$ 300,000
MED EXP fAny one person
$ 10,000
PERSONAL & ADV INJURY
$ 2.000.000
A
Y
B6020052587
01/01/2019
01/01/2020
GEN'LAGGREGATE LIMITAPPLIES PER:
PRO-
POLICY JECT LOC
GENERAL AGGREGATE
$ 4,000,000
PRODUCTS-COMP/OPAGG
4,000,000
$
Employee Benefits
$ 1,000,000
OTHER_
AUTOMOBILE LIABILITY
COMBINED SINGLE Li Mr
Ea aceids 1
$ 1,000,000
X ANYAUTO
BODILY INJURY (Per person)
$
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
Y
6020004782
01/01/2019
01/01/2020
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
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 1 X RETENTION 8 0
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N
OFFICER/MEMBER EXCLUDED? �
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
41WBAC5W3P
01/08/2019
01/08/2020
SPER
X1 TATUTE FOR
E.L.EACHACCIDENT
1.000,000
$
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L DISEASE - POLICY LIMIT
$ 1,000.000
E
Professional Liability
PHSD1429572
03/13/2019
03/13/2020
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
VCRI Irit Air- MULUMM L:ANUELLATIUN
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 lw� R
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 'The ACORD name and logo are registered marks of ACORD