2019/07/01 Habitat for Humanity Inland Valley Certificate of Liability Insurance (3)CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
6/13/2019
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 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 fights to the certificate holder in lieu of such endorsement(s).
PRODUCER NT CT
Arthur J. Gallagher & Co. PHONE—- FAX
insurance Brokers of CA, Inc. LIC #0726293
1255 Battery Street, Suite 450 Anti less,
San Francisco CA 94111 INS U RFR(S) AFFOR DING COV ERAG E NAICA
INSURED
Habitat for Humanity Inland Valley
27475 Ynez Road #390
Temecula, CA 92591
INSURER A: NonProfits' United Vehicle Ins Pool
INSURER B
INSURER C:.
INSURER 0 :
INSURER E :
COVERAGES (FRTIFIr ATF NIIMi2FR•4ot'AFA7A" Gt I I r L%i^pLk arr rRen to.
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 ADDL SUOR' POLICY EFF POLICY EXP
LTR TYPEOF INSURANCE INSD WVQ POLICY NUMRrA MM ODIYYYY PAMrD"YYV
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE 5
CLAIMS -MADE I 1
OCCUR
DAMAGE T6 riSNTED
l_. _1
PREMISES (�a eoG(lrrpgE(q) 5 4
i
MED EXP (Any one person)
PERSONAL R ADV INJURY_ !6
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE 4
POLICY L_ JE O I� I
LOC
ARopt1C75 • COMP+OP AGG $u
... - ----$
OTHER:
A
AUTOMOBILE LIABILITY
Y
NPU1000-19
7/1/2019
7/1/2020
GOMBIN ED 81 N61LEUMT
(Ea aPCid.0p1)
$1,000,000
X ANY AUTO
BODILY INJURY (Per person)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
13001LY INJURY IPur a=dmrrl
$
HIRED NON -OWNED
AUTOS ONLY ;^•y AUTOS ONLY
PR'0PERtTYdAMA0E
.1per &)Xo nt) - —
$ - • - _ - _ -
-$ —
UMBRELLALIAB OCCUR
EACH OCCURRENCE
$
EXCESS LIAB CLAIMS -MADE
AGGREGATE
$
DED RETENTIONS
$
WORKERS COMPENSATION
PER I OTH-
AND EMPLOYERS' LIABILITY YIN
STATUTE] ER
ANYPROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBEREXCLUDE07
NIA
E.L. EACH ACCIDENT
-- — -- ----- ----
$
(Mandatory In NH)
E L, DISEASE - EA EMPLOYEE'
$
II yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
f
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached II more space is required)
Any Auto means any covered auto under the NPU Vehicle Insurance Program.
The City of Menifee, its officers, officials, employees, volunteers, agents, and representatives are included as additional insured-
r lv�Ci v • v L+AMY I=LLA I INN
I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Menifee
29714 Haun Road AUTHORIZED REPRESENTATIVE
Menifee CA 92586
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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NONPROFIT
UNITED
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Non Profits' United Vehicle Insurance Pool
Automobile Liability Coverage
ADDITIONAL COVERED PARTY ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
The "Who is an Insured" section of your Automobile Liability Insurance is changed by adding the
following:
Who is covered includes any person or organization from whom you have leased an auto, from
which you have received funding for your operations, or for who you provide services. These
persons or organization are protected, if they require to be named, and you agree to name them,
as an additional insured, if indicated on the attached Certificate of Coverage, but only with respect
to liability arising out of the ownership, use, maintenance, loading or unloading of a covered auto.
Cancellation:
Should any of the above described policies be cancelled before the expiration date thereof, the issuing
insurer will endeavor to mail 30 days written notice to the certificate holder named on the certificate, but
failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or
representatives.
Premium Payments:
Those persons or organizations are not responsible for paying premiums for your coverage.
Insured:
Policy Number:
Effective Date:
Authorized Representative:
NPU-VIP
As shown on the Certificate of Insurance attached.
NPU1000-19
July 1, 2019 to July 1, 2020 (or otherwise indicated)
2019-2020
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