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2016/08/01 Harris & Associates, Inc. Certificate of Liability InsuranceThe ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECT PRO-POLICY GEN'L AGGREGATE LIMIT A PPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$ DAMAGE TO RENTE D EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETEN TIONDED CLAIMS-M ADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)LIMITS PER STAT UTE OT H- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETO R/PARTNE R/EXECUTIV E If yes,describe under DESCRIPTION OF OPERATIO NS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y /N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTO S NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERT Y DAMAGE $ $ $ $ THIS IS TO CERT IFY THAT THE POLICIES OF INSURANCE LIST ED BELOW HAVE BEEN ISSUED T O T HE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICAT ED. NOT WITHSTAND ING ANY REQUIREMENT ,TER M OR CONDITION OF ANY CONT RACT OR OTHER DOCUMENT WITH RESPECT T O WHICH THIS CERT IFICAT E MAY BE ISSUED OR MAY PERT AIN,T HE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT T O ALL T HE TERMS, EXCLUSIONS AND CONDITION S OF SUCH POLICIES. LIMIT S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OT HER: 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). 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. 06/27/2017 Old Republic Insurance Company Marsh Sponsored Programs a division of Marsh USA Inc. PO Box 14404 Des Moines, IA 50306-9686 1-877-320-9393 riskmanagement@marshpm.com 515-365-0895 HARRIS & ASSOCIATES, INC 1401 Willow Pass Road, Ste 500 Concord, CA 94520 24147 A X X X L100554-16 08/01/2016 08/01/2017 RE: FY 17/18 On-call Engineering Services (Recoverable) (HA #1700317) City of Menifee and its officers, employees, agents, and authorized volunteers are included as Additonal Insureds where required by written contract. GPBR: 1XL1 City of Menifee 170-0317 (2018) Attn: Allen Yun 29714 Haun Road Menifee, CA 92586 Vendor ID: 31459 Policy provides protection for any & all operations/jobs performed by the named insured where required by written contract. Certificate holder is an Additional Insured where required by written contract. Waiver of Subrogation included where required by written contract. Insurance is primary and non-contributory. 1,000,000 9463959 CA 560 002 1213 Page 1 of 1 L100554-16 08/01/2016 - 08/01/2017 HARRIS & ASSOCIATES, INC OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Schedule Person(s) or Organization(s): City of Menifee 170-0317 (2018) 29714 Haun Road Menifee, CA 92586 City of Menifee and its officers, employees, agents, and authorized volunteers. 1. SECTION II – COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured is amended to include the person(s) or organization(s) designated in the Schedule above but only for damages: a. Which are covered by this insurance; and b. Which you have agreed to provide in a written contract. 2. The limits of insurance afforded to such person(s) or organization(s) will be: a. The minimum limits of insurance which you agreed to provide, or b. The limits of insurance of this policy whichever is less. POLICY NUMBER: COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 04 44 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 {Insert Policy Number Named Insured Policy Period in format mm/dd/yyyy - m m/dd/yyyy} WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) T his endorsement modifies insurance provided under the following: AUT O DEALERS COVERAGE FORM BUSINESS AUT O COVERAGE FORM MOT OR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. T his endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: <Enter Endorsement Effective Date as MM/DD/YYYY> {Enter only if endorsement is issued after policy issuance} SCHEDULE Name(s) Of Person(s) Or Organization(s): All persons or organizations as required by written contract or agreement. Information required to complete this Schedule,if not shown above, will be shown in the Declarations. T he Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss"under a contract with that person or organization. L100554-16 HARRIS & ASSOCIATES, INC 08/01/2016 - 08/01/2017 HARRIS & ASSOCIATES, INC 06/19/2017