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2019/01/01 Girl Scouts of San Gorgonio Council Certificate of Liability Insurance���� T 0 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) F 1/15/2019 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 holder in lieu of such endorsement(s). PRODUCER Bolton & Company 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 City of Menifee City Clerk www.boltonco.com 0008309 CON NAME T PHONE 626 799 7000 LAXNe : 626 583 2117 ADDAIL S: INSURERS AFFORDING COVERAGE NAIC # INSURER A : Scottsdale Indemnity Company 15580 INSURED Girl Scouts of San Gorgonio Council JAN 2 3 201 1751 Plum Lane Redlands CA 92374-4533 Received INSURER B : National Casualty Company 11991 INSURERC: _ INSURERD: _ INSURER E : INSURER F : Cr)VFRAC;FS CFRTIFICATF Nl1MRFR- AAr,7anng RFvic;inN Nr1MRFR- 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 LTR TYPE OF INSURANCE POLICY NUMBER MM/D�YYYYY POLICY WDIYYW LIMITS A �/ COMMERCIAL GENERAL LIABILITY KK122654000 1/1/2019 1/1/2020 EACH OCCURRENCE $1 )00000 CLAIMS -MADE 7OCCUR PRFRISES a occune $ 1 000 000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1 000 000 GFOL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 POLICY ❑ PECOT- LOC PRODUCTS - COMP/OP AGG $ 5 000,000 $ OTHER: A AUTOMOBILE LIABILITY KK122654100 1/1/2019 1/1/2020 COMBINEDSINGLE LIMIT $1 000000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per aeddenl $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY B UMBRELLALIA13 ,/ OCCUR XK022654200 1/1/2019 1/1/2020 EACH OCCURRENCE $10.000,000 AGGREGATE $10.000 000 EXCESS LIAR CLAIMS -MADE oED I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N STATllTEI ER ANYPROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ OFFICERIM EM OER EXCLUDF.67 ❑ NIA EL DISEASE - EA EMPLOYEE $ (Mandatory In NH} If yas. describe under DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT I s I DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) They City of Menifee and the City of Menifee Community Services Department their officers, officials, employees and volunteers are named as Additional Insured on the General Liability Policy for all approved events and meetings of the Girl Scouts of San Gorgonio Council. CERTIFICATE HOLDER CANCELLATION Recruitment and Parent information Meetings City of Menifee Attn: Community Services 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 Debra Rosas ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 46576005 1 GIRLSCO-Cl 1 19/20 GL,AU,XS-Insd Access-Specifc Endts-Need Appr I Gayana Asatryan 1 1/15/2019 11:43:08 AM (PST) I Page 1 of 2 POLICY NUMBER:KK122654000 COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED 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): City of Menifee Attn: Community Services 29714 I• Faun Road Menifee CA 92586 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 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 is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract 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. 2. If coverage provided to the additional insured is This endorsement shall not increase the applicable required by a contract or agreement, the Limits of Insurance shown in the Declarations. CG 20 26 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 46576005 1 GIRLSCO-Cl 1 19/20 GL,AU,XS-Insd Access-Specifc Endts-Need Appr I Gayana Asatryan 1 1/15/2019 11:43:08 AM (PST) I Page 2 of 2 Bolton & Cornpany 3475 E. Foothill Slvd., Suite 100 Pasadena, CA 91107 City of Menifee Attn: Community Services 29714 Haun Road Menifee CA 92586 MAIL DOCUMENT f'surelsb" Sender: Gayana Asatryan Phone: (626) 799-7000 Subject: Cert No. 46576005 - Certificate of LiabilitY: Girl Scouts of San Gorgonio Council - City of�llenifee Date: 1 /15/2019 No. of Pages: 3 1-RI www.boltonco.com Attached is the requested certificate of insurance for the insured in the subject above. The certificate was created in eCertsOnline and is in PDF format. You need to have Adobe Acrobat Reader installed on your system to view the certificate. To download the Adobe Reader for free, please visit www.Adobe.com. If you have any questions on the certificate, please contact Bolton & Company at 626-799-7000. THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBYNOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED, IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMEDIATELY BYTELEPHONE, AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. Certificate of Insurance Delivered by ecertsonllneTM Insurance Visions, Inc. All rights reserved.