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2016/08/01 Harris & Associates, Inc. Certificate of Liability Insurance (3)CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECT PRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence)$ DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)LIMITS WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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 WVD SUBR N / A $ $ (Ea accident) (Per accident) 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 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). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 06/26/2017 06/26/2017 City of Menifee 1-800-877-4560 1-800-877-4560 08/01/17 C 150,000 Allen Yun 10,000,000 5,000,000 08/01/17 X 2,000,000 Ded: 0 Ded. Each Claim Aggregate Per Claim X 0 4,000,000 08/01/17 2,000,000 10,000,000 1,000,000 X 10,000 08/01/17 LA16EXC712701IC D 4,000,000 X Menifee, CA 92586 X X Concord, CA 94524 Concord, CA 94524 170-0317 (2018) X 0757776 0757776 RE: FY 17/18 On-call Engineering Services (Recoverable) (HA #1700317) required by a written contract ZBF9201722 07 City & its officers, employees, agents & authorized volunteers are additional insureds under General Liability if MAN-0426 0715 & MAN-0427 0715. General Liability Additional Insured status granted, if required by written contract/agreement, per attached forms * Workers Compensation policy excludes monopolistic states ND, OH, WA, WY. smandilag A 1401 Willow Pass Road, Suite 500 1401 Willow Pass Road, Suite 500 1,000,000 29714 Haun Road 925 609-6500 925 609-6500 AEH591891588 B 08/01/16 08/01/16 PJUB8166N36A16 * N Continental Casualty Company Continental Casualty Company Travelers Property Casualty Co of Amer. Travelers Property Casualty Co of Amer. 1,000,000 Navigators Specialty Insurance Company Navigators Specialty Insurance Company Citizens Insurance Company of America Citizens Insurance Company of America 08/01/16 USA Attn: Susan Mandilag Attn: Susan Mandilag Harris & Associates Inc. Harris & Associates Inc. 10,000,000 925 609-6550 925 609-6550 HUB International Insurance Services Inc. HUB International Insurance Services Inc. Claims-Made PROFESSIONAL LIABILITY X P.O. Box 4047 P.O. Box 4047 08/01/16 1,000,000 X Concord, CA 94520 Concord, CA 94520 50185321 50185321