2019/01/01 Dynatest North America, Inc. Certificate of Liability InsuranceCERTIFICATE OF LIABILITY INSURANCE
DATE01182019YYY)
1
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 pollcy(les) 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 holder in lieu of such endorsement(s).
PRODUCER
CONTACT
Aon Risk Services Southwest, Inc.
Houston TX Office City of Menifee
NAME.
(AfC.No.Efrt: (666) 283-7122 FAX (800) 363-0105
5555 San Felipe
suite 1500 City Clerk
E-MAIL
Houston TX 77056 USA
INSURER(S) AFFORDING COVERAGE
NAIC 9
INSURED -- -
INSURER A: Philadelphia indemnity Insurance Company
.18058
DVnatest North America. Inc.
Dynatest consulting, Inc.
11415 old Roswell Rd., Suite 100 Received
INSURERB: AXA Insurance Company
33022
INSURER C: U.S. specialty Insurance Co
29599
Alpharetta GA 30009-2084 USA
INSURERD: Tokio Marine Specialty Insurance Company
23950
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 570074725284 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLiC€ES OF INSURANCE LISTED BELOW HAVE BEEN fSSUED 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. Limits shown are as requested
LTR
TYPE OF INSURANCE
INSD
WV0
POLICY NUMBER
M/DD
MM10D
LIMITS
B
X
COMMERCIAL GENERAL LIABILITY
PC S
EACH OCCURRENCE
$ 5 , 000 , 000
CLAIMS -MADE OCCUR
PREMISES Eeoccurrence)
$100,000
MED EXP (Any one person)
$10 , 000
PERSONAL&ADV INJURY
$5,000,000
GEMLAGGREGATE LIMITAPPLIES PER:
PRO-
X
❑ JECT LOC
GENERAL AGGREGATE
$5,000,,000
-
0POLICY
,00
OTHER:
A
AUTOMOBILE LIABILITY
PHPK1923243
01/01/2019
41/01/2020
COMBINED SINGLE LIMIT
Es en
$1,000,000
BODILY INJURY ( Per person)
X ANYAUTO
OWNED -- SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
PROPERTYDAMAGE
Per arridenl
HIREDAUTOS NON -OWNED
ONLY AUTOS ONLY
Comp./Coll. Deductible
$1, 000
D
UMBRELLALIAB
X OCCUR
PuB660662
01/01/2019
01 O1 2020
EACH OCCURRENCE
$1,0007000
X
EXCESS LIAB
CLAIMS -MADE
AGGREGATE
$1, 000 , 000
DED RETENTION f
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
N / A
PER OTH-
STATUTE
E.L. EACH ACCIDENT
E.L. DISEASE -EA EMPLOYEE
(Mandatory In NH)
If Yes, describe under
DESCRIPTION OF OPERATIONS below
I
E.L. DISEASE -POLICY LIMIT
C E8A-PL-Primary
USS1929336
Claims Made
01/01/2019
01/01 2020
Per Claim/Aggregate
Deductible
$1,000,000
$35,0001
i
DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached ET more space Is required)
City of Menifee, its council Members, officers, agents and employees are included as Additional insured in accordance with the
policy provisions of the General Liability policy. I
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CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXP RATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS.
city of Meni fee AUTHORIZED REPRESENTATIVE
29714 Haun Road
Menifee CA 92586 USA
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