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2018/08/01 Harris & Associates, Inc. Certificate of Liability Insurance (7)
Ps260Uzxan CERTIFICATE OF LIABILITY INSURANCE 08/03/2018 ' 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER 0757776 1-800-877-4560 HOB International Insurance Services Inc. CONTACT NAME: PHONE 925 609-6500 FAX A1C No 925 609-6550 P.O. BOX 4047 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC9 INSURERA: Valley Forge Insurance Company Concord, CA 94524 INSURED INSURERB: Navigators Specialty Insurance Company Harris 8 Associates Inc. Attn: Susan Mandilag 1401 Willow Pass Road, Suite 500 INSURERC: Travelers Property Casualty Cc of Amer INSURERD: Continental Casualty Company INSURER E : INSURER F: Concord, CA 94520 COVERAGES CERTIFICATE NUMBER: 53610101 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MMIDD POLICY EXP MWDD LIMBS A B COMMERCIAL GENERAL LIABILITY 6072176739 08/01/18 08/01/19 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAAGE PREMMISES EsENTED occurrence $ 1,000,000 X MED EXP (Any one person) $ 15,000 Ded: 0 PERSONAL 8ADVINJURY $ 1,000,000 City of AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GENT City clerk PRODUCTS -COMP/OPAGG $ 2,000,000 POLICY JECT � LOC OTHER: 6' �j AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY rzeceived BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accdent $ $ B UIABRELLALL40 B OCCUR SF18RXC712701IC 08/01/18 08/01/19 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 B EXCESS UAB CLAIMS -MADE DED I % RETENTION $ 0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECUr[VE OFFICER/MEMBERF�CCLUDED7 (Mandatory In NH) NIA QB-8K458448-TIL-18 * 08/01/18 08/01/19 % STATUTE I ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1, 000, 000 If yes describe under DESCRIPTION OF OPERATIONS below D PROFESSIONAL LIABILITY ARH591891588 08/Ol/18 08/01/19 Per Claim 10,000,000 Claims -Made Aggregate 10,000,000 Ded. Each Claim 150,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addhlonal Remarks Schedule, may be attached N more space Is required) * Workers Compensation policy excludes monopolistic Btates ND, OH, WA, WY. General Liability Additional Insured status granted, if required by written contract/agreement, per attached form CHA75079XX 1016. City & its officers, employees, agents It authorized volunteers are additional insureds under General Liability if required by a written contract RE: On -call Professional Entitlement & Final Engineering Services (HA #1600586) 160-0586 (2022) 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 Public Works / Engineering AUTHORIZED REPRESENTATIVE 29714 Haun Road Menifee, CA 92586 1 USA ACORD 25 (2016/03) dgarcia 53610101 ©1988-2015 ACORD CORPORATION. All rights reservea. The ACORD name and logo are registered marks of ACORD YS260028W2 Blanket Additional Insured - Owners, Lessees or Contractors - with Products -Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract; or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products -completed operations hazard, and only if: 1. the written contract requires you to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10-01 edition of CG2037; or B. additional insured coverage with "arising out of" language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: CNA75079XX (10-16) Pagel of 2 Insured Name: Harris & Associates Inc. Policy No: 6072176739 Effective Date: 08/01/2018 Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. co 0 N N z w P526(N)28Uo2 CNA 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. VII. 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: 08/01/2018 EN , 0 In Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. P526U )UM2 Pr Architects, Engineers and Surveyors General Liability Extension Endorsement (6) of the Damage to Property Exclusion do not apply to property damage that results from the use of elevators. B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE — ELEVATORS Provision, the Other Insurance conditions is amended to add the following paragraph: This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis that is Property insurance covering property of others damaged from the use of elevators. 23. RETIRED PARTNERS, MEMBERS, DIRECTORS AND EMPLOYEES WHO IS INSURED is amended to include as Insureds natural persons who are retired partners, members, directors or employees, but only for bodily injury, property damage or personal and advertising injury that results from services performed for the Named Insured under the Named Insured's direct supervision. All limitations that apply to employees and volunteer workers also apply to anyone qualifying as an Insured under this Provision. 24. SUPPLEMENTARY PAYMENTS The section entitled SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended as follows: A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000. limit; and B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a $1,000. limit. 25. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named Insured's Coverage Part, the Insurer will not deny coverage under this Coverage Part because of such failure. 26. WAIVER OF SUBROGATION - BLANKET Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to add the following: The Insurer waives any right of recovery the Insurer may have against any person or organization because of payments the Insurer makes for injury or damage arising out of: 1. the Named Insured's ongoing operations; or 2. your work included in the products -completed operations hazard. However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in a written contract or written agreement, and only if such contract or agreement: 1. is in effect or becomes effective during the term of this Coverage Part; and 2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the claim. 27. WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured under a consolidated (wrap- up) insurance program by applicable state statute or regulation. CNA74858XX (1-15) Page 16 of 17 Insured Name: Harris & Associates Inc. Policy No: 6072176739 Effective Date: 08/01/2018 w 0 M copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. P526IM2NW2 w u. O v TRAVELERS J� WORKERS COMPENSATION AND r ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY > MUM, CT 06183 Z w ENDORSEMENT WC 99 03 76 ( A) — 001 POLICY NUMBER: (UB-BK458448-TIL-18) 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 02.000 % 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 DATE OF ISSUE: 08-02-18 ST ASSIGN: Page 1 of 1 rs26M28Uu2 IItiB International Insurance Services Inc. P.O. Box 4047 Concord, CA 94524 Electronic Service Requested C®C Q �( X(� �O 6� 0 ALL FOR AADC 923 2173 0.9555 AB 0.405 lil��ll�ul�l�lll�r��llrllll�lllulllsl�l,�llo�sllli°�Ill�ril� Cityy of Menifee 9 29714 HAUN RD PUBLIC WORKS / ENGINEERING MENIFEE, CA 92586-6540 This document was brought to you by CertificatesNow. 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