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2019/02/06 Hospice of the Valleys SC Certificate of Liability InsuranceClient#: 430474 HOSPIVALLE1 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 5/13/2019 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 policy(Les) 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 endorsament(s). PRODUCER City o Menifee N Chelsea Lindow Marsh &McLennan Agency LLC City Clerk 858-587-7162 „% Na, 858-452-7530 Marsh & McLennan Ins Agncy LLC ADdRIEsg: Chelsea.Lindow�M&rshMMA.com San Box o, 38;CA 92 L6 #OH18131 MAY 2 Q 2019 INSURER S) AFFORDING COVERAGE NAIC # San Diego, CA 92186 _ INSURER A : American Altemallve Insurance 19720 INSURED Hospice of the Valleys SC Received INSURERC: 25240 Hancock Ave, Suite 120 Murrieta, CA 92562 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE Nt1MBER- RFVICIn1J kIIIMRFR- 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 CONTRACTOR 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. IN L TYPE OF INSURANCE DDL SUB POLICY NUMBER PoolrcY EFFF M<NIDDIYYYY POLICY P NiMJD LIMITS A X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE u OCCUR X VHHHHG305135013 32/06/2019 02/06/202C EACH $1 000000 Hp��,OCCURRENCE PR�MI5ESOEaEoNc7r0ence $1 000 000 MED EXP (Any one person) $ 50 000 PERSONAL & ADV INJURY $1,000 000 GEN'L AGGREGATE LIMIT APPLIES PER PRO. F POLICY ECT LOC OTHER: GENERAL AGGREGATE $3,000000 PRODUCTS - COMP/OP AGG $ 3,000 000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMTT a. danl BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Par accidenl $ UMBRELLA LIAB IEXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFRCERIh1EM8ER EXCLUDED? (Mandatory In NH) If as, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH. E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L, DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: City of Menifee named as an additional insured per the attached endorsement. City of Menifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29714 Haun Road ACCORDANCE WITH THE POLICY PROVISIONS. Sun City, CA 92586 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S4130688/M3984058 WSCAT INSURED: Hospice of the valleys SC POLICY #: VHHHHG305135013 POLICY PERIOD: 02/06/2019 TO 02/06/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: HOSPICE AND HOME HEALTH CARE LIABILITY COVERAGE FORM SCHEDULE Name of Person(s) or Organization(s): City of Menifee 29714 Haun Road Sun City, CA 92586 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations.) A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for injury or damage caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: I. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance` afforded to such additional insured vvi:l not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured Is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. HGL307 (04/13) Copyright 2012 American Alternative Insurance Corporation. Page 1 of 1 All rig his reserved. 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