2019/08/01 Harris & Associates, Inc. Certificate of Liability Insurance (3)P5200028002
DATE (MMIDDIYYYY)
s AC V CERTIFICATE OF LIABILITY INSURANCE 07/18/2019
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.
0
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(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 endorsements .
10
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PRODUCER LIC #0757776 800-877-4560
CAME CT
HUB International Insurance Services Inc.
N
PHONE FAX
191C 925 609-6500 0.925 609-6550
ADOE
P.O. Box 4047
INSURERS AFFORDING COVERAGE
NAIC #
INSURERA: Valley Forge Insurance Company
Concord, CA 94524
INSURED INSURERB: The Continental Insurance Company
Harris & Associates Inc.
INBURERC:Travelere Property Casualty Co of Amer
Attn: Susan Mandilag
1401 Willow Pass Road, Suite 500 INSURERD; Continental Casualty Company
INSURER E : _
Concord, CA 94520 INSURERF.,
COVERAGES CERTIFICATE NUMBER- 534799684 REVISION NUMBER!
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.
INBR
TYPE OF INSURANCE
IN L
SU R
POLICYNUMBER
NX, EFF
Plblcp EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
6072176739
08/01/19
08/01/20
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE u OCCUR
p DAMAGE$
1,000,000
X
MED EXP (Any one person
$ 15,000
Dade 0
PERSONAL & ADV INJURY
$ 1,000,000
GEnAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICYJPEC [X]LOC
PRODUCTS - COMPIOPAGG
S 2,000,000
$
OTHER.
B
AUTOMOBILE
LIABILITY
BUA 6076590520
08/01/19
09/01120
a cI LE LIMIT
$ 1,000,000
X
ANY AUTO
BODILY INJURY (Per person)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAM AGE
Per acclden
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$
X
Dad: 0
B
UMBRELLALIAB
X
OCCUR
CUE 6076590551
08/01/19
08/01/20
EACH OCCURRENCE
$ 10,000,000
AGGREGATE
$ 10,000,000
X
EXCESS LIAB
CLAIMS -MADE
DED I X I RETENTION $ 10, 000
$
C
WORKERS COMP NATION
WORKERS COMPENSATION
AND YIN
ANYPROPRIETORIPARTNERIEXECUTIVE a
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
NIA
UB-8R458448-19-43-G • 08/01/19
08/01/20
X T T TE ER
E.LEACH ACCIDENT
S 1,000,000
E.L. DISEASE- EA EMPLOYEN
$ 1,000,000
If as, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
D
PROFESSIONAL LIABILITY
ABH591891588 08/01/19
08/01/20
Per Claim 10,000,000
Claims -Made
Aggregate 10,000,000
Dad. Each Claim 150,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more apace Is required)
+ Workers Compensation policy excludes monopolistic states ND, OH, WA, WY.
General Liability and Auto Liability Additional Insured Status granted, if required by written contract/agreement, per
attached forma CNA75079XX 1016 and CNA63359XX 0412 (pg. 1, I.A.3).
City & its officers, employees, agents & authorized volunteers are additional insureds under General Liability and Auto
Liability if required by a written contract.
RE: FY 17/18 On -call Engineering Services (Recoverable) (HA #1700317)
ULK t IFIUA I t MULLit" UASNULLLA I IU14
170-0317 (2020)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Menifee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Allen Yun
29714 Haun Road AUTHORIZED REPRESENTATIVE
Menifee, CA 92586
USA
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
dgarcia
534799684
P5260028002
1_7
Blanket Additional Insured - Owners, Lessees or
Contractors - with Products -Completed
Operations Coverage Endorsement
Primary and Noncontributory Insurance
With respect to other insurance available to the additional insured under which the additional insured is a named
insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a
written contract requires the insurance provided by this policy to be:
1. primary and non-contributing with other insurance available to the additional insured; or
2. primary and to not seek contribution from any other insurance available to the additional insured.
But except as specified above, this insurance will be excess of all other insurance available to the additional
insured.
VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL
GENERAL LIABILITY CONDITIONS is amended as follows:
The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the
addition of the following:
Any additional insured pursuant to this endorsement will as soon as practicable:
1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim;
2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the
investigation, defense, or settlement of the claim; and
3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer
or self -insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part.
However, if the written contract requires this insurance to be primary and non-contributory, this paragraph
3. does not apply to insurance on which the additional insured is a named insured.
The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer
receives written notice of a claim from the additional insured.
Vll. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended
to add the following definition:
Written contract means a written contract or written agreement that requires you to make a person or
organization an additional insured on this coverage part, provided the contract or agreement:
A. is currently in effector becomes effective during the term of this policy; and
B. was executed prior to:
1. the bodily injury or property damage; or
2. the offense that caused the personal and advertising injury;
for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes
effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown
below, and expires concurrently with said Policy.
CNA75079XX (10-16)
Page 2 of 2
Insured Name: Harris & Associates Inc.
Policy No: 6072176739
Effective Date: 08/01/2019
0
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Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
CNA63359XX
POLICY NUMBER: BUA 6076590520 (Ed. 04/12)
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. o
CONTRACTORS EXTENDED COVERAGE ENDORSEMENT
- BUSINESS AUTO PLUS -
M
This endorsement modifies insurance provided under the following: z
BUSINESS AUTO COVERAGE FORM w
I. LIABILITY COVERAGE
A. Who Is An Insured
The following is added to Section II,
Paragraph A.1., Who Is An Insured:
1. a. Any incorporated entity of which the
Named Insured owns a majority of the
voting stock on the date of inception of
this Coverage Form; provided that,
b. The insurance afforded by this
provision A.1. does not apply to any
such entity that is an "insured" under
any other liability "policy" providing
"auto"coverage.
2. Any organization you newly acquire or
form, other than a limited liability company,
partnership or joint venture, and over which
you maintain majority ownership interest.
The insurance afforded by this provision
A.2.:
4. An "employee" of yours is an "insured"
while operating an "auto" hired or rented
under a contract or agreement in that
"employee's" name, with your permission,
while performing duties related to the
conduct of your business.
"Policy," as used in this provision A. Who Is An
Insured, includes those policies that were in
force on the inception date of this Coverage
Form but:
1. Which are no longer in force; or
2. Whose limits have been exhausted.
B. Ball Bonds and Loss of Earnings
Section 11, Paragraphs A.2. (2) and A.2. (4)
are revised as follows:
1. In a.(2), the limit for the cost of bail bonds is
changed from $2,000 to $5,000; and
2. In a.(4), the limit for the loss of earnings is
changed from $250 to $500 a day.
a. Is effective on the acquisition or C. Fellow Employee
formation date, and is afforded only
until the end of the policy period of this Section II, Paragraph B.5 does not apply.
Coverage Form, or the next
anniversary of its inception date, Such coverage as is afforded by this provision
whichever is earlier. C. is excess over any other collectible
insurance.
b. Does not apply to:
(1) "Bodily injury" or "property damage"
caused by an "accident" that
occurred before you acquired or
formed the organization; or
(2) Any such organization that is an
"Insured" under any other liability
"policy" providing "auto" coverage.
3. Any person or organization that you are
required by a written contract to name as
an additional insured is an "insured" but
only with respect to their legal liability for
acts or omissions of a person, who qualifies
as an "insured" under Section II — Who Is
An Insured and for whom Liability Coverage
is afforded under this policy. If required by
written contract, this insurance will be
primary and non-contributory to insurance
on which the additional insured is a Named
Insured.
II. PHYSICAL DAMAGE COVERAGE
A. Glass Breakage — Hitting A Bird Or Animal —
Falling Objects Or Missiles
The following is added to Section III,
Paragraph A.3.:
With respect to any covered "auto," any
deductible shown in the Declarations will not
apply to glass breakage if such glass is
repaired, in a manner acceptable to us, rather
than replaced.
B. Transportation Expenses
Section III, Paragraph A.4.a. is revised, with
respect to transportation expense incurred by
you, to provide:
a. $60 per day, in lieu of $20; subject to
b. $1,800 maximum, in lieu of $600.
CNA63359XX Copyright, CNA Corporation, 2000. Page 1 of 3
(Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission.
MW
CNA
b. An "auto" used by that "executive officer"
while working in a business of selling,
servicing, repairing or parking "autos."
Such Liability and/or Physical Damage
Coverage as is afforded by this provision.
(1) Equal to the greatest of those
coverages afforded any covered "auto";
and
(2) Excess over any other collectible
insurance.
2. For purposes of this provision, "executive
officer" means a person holding any of the
officer positions created by your charter,
constitution, by-laws or any other similar
governing document, and, while a resident of
the same household, includes that person's
spouse.
Such "executive officers" are "insureds" while
using a covered "auto" described in this
provision.
IV. BUSINESS AUTO CONDITIONS
A. Duties In The Event Of Accident, Claim, Suit
Or Loss
The following is added to Section IV,
Paragraph A.2.a.:
(4) Your "employees" may know of an
"accident" or "loss." This will not mean
that you have such knowledge, unless
such "accident" or "loss" is known to
you or if you are not an individual, to
any of your executive officers or
partners or your insurance manager.
The following is added to Section IV,
Paragraph A.2.b.:
(6) Your "employees" may know of
documents received concerning a claim
or "suit." This will not mean that you
have such knowledge, unless receipt of
such documents is known to you or if
you are not an individual, to any of your
executive officers or partners or your
insurance manager.
B. Transfer Of Rights Of Recovery Against
Others To Us
CNA63359XX
(Ed. 04/12)
The following is added to Section IV,
o
Paragraph A.5. Transfer Of Rights Of
0
Recovery Against Others To Us:
We waive any right of recovery we may have,
o
because of payments we make for injury or
damage, against any person or organization for
N
whom or which you are required by written
contract or agreement to obtain this waiver from
w
US.
This injury or damage must arise out of your
activities under a contract with that person or
organization.
You must agree to that requirement prior to an
"accident" or "loss."
C. Concealment, Misrepresentation or Fraud
The following is added to Section IV,
Paragraph B.2.:
Your failure to disclose all hazards existing on the
date of inception of this Coverage Form shall not
prejudice you with respect to the coverage afforded
provided such failure or omission is not intentional.
D. Other Insurance
The following is added to Section IV,
Paragraph B.5.:
Regardless of the provisions of Paragraphs 5.a.
and 5.d. above, the coverage provided by this
policy shall be on a primary non-contributory
basis. This provision is applicable only when
required by a written contract. That written
contract must have been entered into prior to
"Accident" or "Loss."
E. Policy Period, Coverage Territory
Section IV, Paragraph B. 7.(5).(a). is revised
to provide:
a. 45 days of coverage in lieu of 30 days.
V. DEFINITIONS
Section V. Paragraph C. is deleted and replaced
by the following:
"Bodily injury" means bodily injury, sickness or
disease sustained by a person, including mental
anguish, mental injury or death resulting from any of
these.
CNA63359XX Copyright, CNA Corporation, 2000. Page 3 of 3
(Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission.
P5260028002
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1 p�VG �L1[S r WORKERS COMPENSATION o
1 R YG G SJ AND
ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY
HARTFORD CT 06183
ENDORSEMENT WC 99 03 76 ( A) - 001
N
POLICY NUMBER; UB-8K458448-19-43-G
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WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
ENDORSEMENT - CALIFORNIA
(BLANKET WAIVER)
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule.
The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre-
mium.
Schedule
Person or Organization Job Description
ANY PERSON OR ORGANIZATION FOR
WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED
PRIOR TO LOSS TO FURNISH THIS
WAIVER.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise
stated.
(The information below is required only when this endorsement is issued subsequent to preparation of
the policy.)
Endorsement Effective Policy No. Endorsement No.
Insured Premium
Insurance Company
Countersigned by
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