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2019/07/15 HP Communications, Inc. Certificate of Liability Insurance
Client#: 424269 HPCOMMU1 DATE (MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 7/11/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER C NTACT NAME: Gloria Bell Marsh & McLennan Agency LLC PHONE g58-768�041 C No Ext : AIC NO). Marsh & McLennan Ins. Agency LLC E-MAIL PO Box 85638 ADDREss: Gloria.Bell@narshmma.com San Diego, CA 92186 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Old Republic General Insurance Corp 124139 INSURED HP Communications Inc. INSURER B: The Continental Insurance Company 35289 13341 Temescal Canyon Road INSURER C : Atlantic Specialty Insurance Company 127154 i Corona, CA 92883 INSURERD: INSURER E : COVERAGES CERTIFICATE N1IMRFR- RFVISInN NI IMRFR- 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 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_ PDLI E POLICY EXP - {AIIMR]DIYYYY} (MMIDDIYYYY�� _ _ LIMITS 7/15/2019 07/15/2020 EACH OCCURRENCE $1 000 000 TNSR LTR ADD TYPE OF INSURANCElypVp SUB POLICYNUMBER X Al CG11171803 A —113g12 X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE X OCCUR R MAES u Eaocctxnence} $14000,000 X BI/PD Ded:10000 MED EXP (Any one person) $1 O,000 PERSONAL & ADV INJURY $1 000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2000,000 PRO - POLICY I X, EC7 7_1LOC PRODUCTS - COMP/OP AGG s2,000,000 OTHER: X A1CA11171803 $ A AUTOMOBILE LIABILITY X 7/15/2019 07/15/202Q E.aeBI�ident) LE LIMIT $2,000,000 BODILY INJURY (Per person) s X ANY AUTO OWNED SCHEDULED ' AUTOS ONLY AUTOS See attached for BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLYPer Hired Auto PROPERTYDAMAGE $ $ T ! Physical damage B UMBRELLA LIAB ]( OCCUR 6072189359 7/15/2019 07/15/2020 EACH OCCURRENCE $1 O OOO 000 AGGREGATE $1 O OOO 000 X EXCESS LIAB CLAIMS -MADE DEID I RETENTION S $ A WORKERS COMPENSATION X A1CW11171803 7/15/2019�07/151202 X ',PER I OTH-1 l AND EMPLOYERS' LIABILITY &NANY PR,OPRiETORIPARTNERIEXECLMVE Y / N E.L EACH ACCIDENT $1 OOO 000 IP E UMEMBER EXCLUDED? C N / A (Mandatory in NH) . E.L DISEASE - EA EMPLOYEE, $1 00O 000 If yes, describe under DESCRIPTION OF OPERATIONS below 7100336610006 ' E.L DISEASE -POLICY LIMIT ' $1,000,000 C Contractors 7/15/2019 07/15/2020 Scheduled: $7,134,389 Equipment Rented: $200,000 Item Floater - ACV Deductible: $2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Menifee is named as Additional Insured as respects to the General and Automobile Liability per the attached endorsements. City of Menifee City Clerk 29714 Haun Road Menifee, CA 92586-0000 a 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 ACORD 25 (2016/03) 1 of 1 #S4236242/M4235909 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WSJZH A�� 0 ADDITIONAL REMARKS SCHEDULE 2 Page of 2_ AGENCY Marsh & McLennan Insurance Agency LLC NAMED INSURED HP Communications Inc. CARRIER NAIC CODE EFFECTIVE DATE: KtMAKKtS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance ADDITIONAL COVERAGE E-Professional Liability — Berkley Assurance Company #PCADB50091050719 Term: 7/15/19 — 7/15/20 $5,000,000 Each Claim Limit $5,000,000 Policy Aggregate $25,000 Deductible Each Claim E-Pollution Coverage - Berkley Assurance Company #PCADB50091050719 Term: 7/15/19 — 7/15/20 $5,000,000 Each Claim Limit $5,000,000 Aggregate $25,000 Deductible Each Claim D-Crime Coverage - Travelers Cas & Surety Co of America #105983294 Term: 7/15/19 — 7/15/20 Employee Theft of Client Property $1,000,000; $10,000 Retention Fiduciary Limit $1,000,000; $0 Retention C-Installation Floater / Property Coverage - Atlantic Specialty Insurance Company #7100336610006 Term: 7/15/19 — 7/15/20 Actual Cash Value $2,000,000 Limit $2,500 Deductible Business Personal Property Coverage $556,600 Limit w/ $1,000 Deductible Business Interruption / Extra Expense Coverage $500,000 Limit Cyber Liability Carrier: Syndicate 2623/623 at Lloyd's Policy Number: W1FBO3190301 Term: 7/15/19 — 7/15/20 Aggregate Limit: $1,000,000 Retention: $25,000 Hired Auto Physical Damage (Comp & Collision): $100,000 Limit Comp $1,000 Deductible & Collision $1,000 Deductible Hired/Borrowed Auto Liability: $1,000,000 Limit Non -Owed Auto Liability: $1,000,000 Limit ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INSURED:HP Communications Inc. POLICY#: Al CG 11171803 POLICY PERIOD: 07/15/2019 TO: 07/15/2020 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations All persons or organizations as required by written As designated in written contract with the Named Insured contract with the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the 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. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 INSURED: HP Communications Inc. POLICY #: AlCG11171803 POLICY PERIOD: 07/15/2019 TO 07/1512020 OLD REPUBLIC GENERAL INSURANCE, CORPORATION CHANGES ADDITIONAL INSURED PRIMARY WORDING SCHEDULE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY_ THIS ENDORSEMEf T MODIFIES INSURANCE. PRia-vilDED DNLDER THE FOLLOV'./tNG, COMMERCIAL GENERAL LIABILITY COVE,Ry�E FORE-49 Name of Additional Insured Person(s) Location(s) of Covered Operations Or Organizationts)!: As required by written contract As Required Per Written Contract IrtfoFrnntion required to eLmpletethis Schedli-le, if not sh+ wn ibo-ve; viill be shown in the Declarations. The I.risu.Tar7~:F pr(yvidryd bythIs 1rx!arsenient IS p iniany insairat tce and we',,iII not s-e eK crmtributkjrr fx)m any other in u.ranc-e of is like kind ava:ilaWe to fl-3e persona, organization shown iri the schedule above Unless tie either int- rancp is prorJded by a ceantr@cto7 atherthan the pe✓rsuxn or organization ;hown in the kr't€�r_ir�lr✓ �!?saae f��r tt��:uzu��C s�prsr�ie+r� Ord jt€lt;� c,��#ir_r€. If sr; �e �i�ill '�ti�re t�ith 11��zI �rit�er irisuranca by the niethod desuribak! in paracrraph 4.c. of section IV— C�---irnrnereia! General Liability Conditions, All utfier terms and c-an-ditions remain unchanged. INSURED: HP Communications Inc. POLICY #: AlCA11171803 POLICY PERIOD: 07/15/2019 TO: 07/15/2020 OLD REPUBLIC GENERAL INSURANCE CORPORATION THIS ENDORSEMENT C .NGf-S THE F aCV`_ PLEASE REAV IT CAARF;FML'Y. THIS ENDORSEMENT MODWIES INSURANCE PROODED UNDER THE FOLLOWING: BUSINESSS AU 00 COVERAGE FORM Wvth ref: to cavern provided bye endomen)ent. Ilia prov of fte-C&vefageForm apptyunlew modirfoed by, V% endorsernem. T er4orsenwt idenffies rtmw(s) oe at (v wrto 'insureds' under the Who Ar Insured Pru--!--sonoft Cove Form.ibis v+adrs ierai obes ,ate= Bove prDvKied in the Coivesrege Fo r;_ Tl"s eiclivsernent cl-m r — the poficy eftc7 Pe, on the mepbCm date of the f 5' unless anadw date is indscated { %ly. SCHEDULE Ilarne U' Per54n(Sl at organu nionfs, City of Menifee 29714 Haun Road Menifee, CA 92586-0000 i If no entry appears above, mformaboin regWred to coimpolete this en< offer rat will be sh~ in the DetlaraUofts as apphca * to the erxwsen,ent) Each person or ccqartzibon show-, in ttte Schedu is an ' ured' for L Coverage, bLI only to the exam that person or wganizati n qualffioes as an'in � under the sJs W Is An tnsrresl Provisim oonmira in Section tt aft Coveragef:srm- ffthepersw or oqlanicimbon shy mtrw schedule quallifies as an'insureiffor LrabilityCoverage, and they have c*werage as a firy named im1rw under another potty this pokey is pnffwy to and n 4vuhbutory wfth `arras other insurance All o-twt�---ns_ and essciuskx-is apply - CA E y Gahi 0044 02 1-2 Page 1 Oe