2018/08/01 Oakhill Academy Certificate of Liability Insurance (3)-1 UAKNI-2
A� o�Ro CERTIFICATE OF LIABILITY INSURANCE F;DATE(MMIDD/YYYY)
08/28/2018
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 endorsements .
PRODUCER 619-937-0164 CONTACT Rancho Mesa Insurance Services
Rancho Mesa Insurance Services PHONE 619-937-0164 FAX
250 Riverview Parkway 9401 A/C, No, Ext : vc, No :619-937-0168
Santee. CA 92071 C ..A1
INSURED Oakhill Academy
29275 Santiago Road
Temecula, CA 92592
rnVGDAt2Cc
M of Menlfee
MY Clerk
ISEP 0 5 2018
Received
INSURER A: The Hanover Insurance Company 12229i
INSURER B : State Compensation Ins. Fund 135076
` ^"'•"'�^
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO
REVISION NUMBER:
THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES
DOCUMENT WITH RESPECT
TO WHICH THIS
DESCRIBED
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED
HEREIN IS SUBJECT TO
ALL THE TERMS,
INSR BY PAID CLAIMS.
TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY NUMBER POLICY EXP
A X COMMERCIAL GENERAL LIABILITY
LIMITS
CLAIMS -MADE [X] OCCUR
EACH OCCURRENCE
1,000,000
1000 OOO
X ZH3-D330460-01 08/01/2018 08/01/2019
DAMAGE TO RENTED
500,000
MED EXP (Any one erson
15,000
PERSONAL & ADV INJURY
1,000,000
L AGGREGATE LIMIT APPLIES PER:
POLICY E C LOCPRODUCTS
MOTHrR-
GENERAL AGGREGATE
3,000,000
- COMP/OP AGG
3,000,000
Emp Ben.
1,000,000
A AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
1,000,000
$
ANY AUTO ZH3-D330460-01 08/01/2018 08/01/2019
OWNED SCHEDULED
BODILY INJURY Per erson
AUTOS ONLY AUTOS
X AUTOS ONLY X AUUTOS ONLYY
BODILY INJURY Per accident
PROPERTY DAMAGE
Per accident
A
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
1,000,000
EXCESS LIAB
CLAIMS -MADE
UH3-D330461-01
08/01/2018
08/01/2019
AGGREGATE
1,000,000
DED RETENTION $
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
PER OTH-
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? I_ J
NIA
9215554-2018
08/01/2018
08/01/2019
E.L. EACH ACCIDENT
1,000 00
+ 0
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: OPERATIONS OF THE NAMED INSURED AS CERTIFICATE HOLDERS INTEREST MAY
APPEAR SUBECT TO POLICY TERMS, CONDITIONS, AND EXCLUSIONS. THE CITY OF
MENIFEE AND THE CITY OF MENIFEE COMMUNITY SERVICES DEPARTMENT, THEIR
OFFICERS, OFFICIALS, EMPLOYEES AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL
INSURED PER FORM 421-2915 06 15 ATTACHED.
/`C�TI Cl/�ATr I IA+ nr�
CITYMEN
CITY OF MENIFEE
29714 HAUN ROAD
MENIFEE, CA 92586
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Arnpn 7G /,3niry m
-- --'- V 1UBB-ZU'l5 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY BROADENING ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SUMMARY OF COVERAGES
1.
Additional Insured by Contract, Agreement or Permit
2.
Additional Insured — Primary and Non -Contributory
Included
3.
Blanket Waiver of Subrogation
Included
4.
Bodily Injury Redefined
Included
5.
Broad Form Property Damage — Borrowed Equipment, Customers Goods & Use of Elevators
Included
6.
Knowledge of Occurrence
Included
7.
Liberalization Clause
Included
8.
Medical Payments — Extended Reporting Period
Included
9.
Newly Acquired or Formed Organizations - Covered until end of olic
p y period
Included
10.
Non -owned Watercraft
Included
11.
Supplementary Payments Increased Limits
51 ft.
- Bail Bonds __J__
- Loss of Earnings $2,500
12. Unintentional Failure to Disclose Hazards $1000
13. Unintentional Failure to Notify Included
Included
This endorsement amends coverages provided under the Commercial General Liability Coverage Part through
new coverages, higher limits and broader coverage grants.
1. Additional Insured by Contract, Agreement or
Permit
The following is added to SECTION If — WHO IS
AN INSURED:
Additional Insured by Contract, Agreement or
Permit
a. Any person or organization with whom you
agreed in a written contract, written agreement
or permit that s uch person or organ ization to
add an additional insured on your policy is an
additional insured only with respect to liability
for "bodily injury", "property damage", or
"personal and advertising injury" caused, in
whole or in part, b y your acts or omissions, or
the acts or om issions of those acting on your
behalf, but only with respect to:
(1) "Your work" for the additional insured(s)
designated in the contract, agreement or
permit;
(2) Premises you own, rent, lease or occupy;
or
(3) Your maintenance, operation or use of
equipment leased to you.
b. The insurance afforded to such additional
insured described above:
(1) Only applies to th e extent permitted by
law; and
(2) Will not be brow der than the insurance
which you are required by the contract,
agreement or permit to provide for such
additional insured.
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Page 1 of 4
C.
(3) Applies on a primary basis if that is
required by the written contract, written
agreement or permit.
(4) Will not be bro ader than coverage
provided to any other insured.
(5) Does not apply if the "bodily injury",
"property damage" or "personal and
advertising injury" is otherwise excluded
from coverage under this Coverage Part,
including any endorsements thereto.
This provision does not apply:
(1) Unless the written contract or ritten
agreement was executed or permit was
issued prior to the "bodily injury", "property
damage", or "personal injury and
advertising injury".
(2) To any person or organization included as
an insured by another endorsement
issued by us an d made part of this 2'
Coverage Part.
(3) To any lessor of equipment:
(a) After the equipment lease expires; or
(b) If the "bodily injury", "property
damage", "personal and advertising
injury" arises out of sole negligence of
the lessor
(4) To any:
(a) Owners or other interests from. whom
land has been leased which takes
place after the lease for the la nd ex-
pires; or
(b) Managers or lessors of premises if:
(i) The occurrence takes place after
you cease to be a tenant in that
premises; or
(ii) The "bodily injury", "property
damage", "personal injury" or
"advertising injury" arises out of
structural alterations, new con-
struction or demolition operations
performed by or o n behalf of the
manager or lessor.
(5) To "bodily injury", "property damage" or
"personal and advertising injury" arising
out of the rend ering of or the f ailure to
render any professional services.
This exclusion applies even if the c laims
against any insured allege negligence or
other wrongdoing in th a supervision,
hiring, employment, training or monitoring
of others by that insured, if the
"occurrence" which caused the "bodily
injury" or "property damage" or the offense
which caused the "personal and
advertising injury" involved the rendering
of or failure to ren der any professional
services by or for you.
d. With respect to the i nsurance afforded to
these additional insureds, the f ollowing is
added to SECTION III — LIMITS OF
INSURANCE:
The most we will pay on behalf of the
additional insured for a covered claim is the
lesser of the amount of insurance:
1. Required by the contract, agreement or
permit described in Paragraph a.; or
2. Available under the applicable Limits of
Insurance shown in the Declarations.
This endorsement shall not increas a the
applicable Limits of Insurance shown in the
Declarations.
Additional Insured — Primary and Non -
Contributory
The following is added to SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 4. Other insurance:
Additional Insured — Primary and Non -
Contributory
If you agree in a written contract, written
agreement or permit that the insurance provided to
any person or orga nization included as an
Additional Insured under SECTION II — WHO IS
AN INSURED, is primary and no n-contributory,
the following applies:
If other valid and collectible insurance is available
to the Additional Insured for a loss covered under
Coverages A or B of this Coverage Part, our
obligations are limited as follows:
a. Primary Insurance
This insurance is primary to other insurance
that is available to the Additional Insured
which covers the
Additional Insured as a Named Insured. We
will not seek contribution from any other
insurance available tot he Additional Insured
except:
(1) For the s ole negligence of the Ad ditional
Insured;
(2) When the Ad ditional Insured is an
Additional Insured under another primary
liability policy; or
(3) when b. below applies.
If this insurance is primary, our obligations are
not affected unless any of the other insurance
is also primary. Then, we will share with all
that other insurance by the method described
in c. below.
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b. Excess Insurance
(1) This insurance is excess over any of the
other insurance, whether primary, excess,
contingent or on any other basis:
(a) That is Fire, Ex tended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work";
(b) That is Fire insurance f or premises
rented to the Additional Insured or 3
temporarily occupied by the Additional
Insured with permission of the owned
(c) That is insurance purc hased by the
Additional Insured to cover the
Additional Insured's liability as a
tenant for "property damage" to
premises rented to the Additional
Insured or temporarily occupied by the
Additional with permission of the
owner; or
(d) If the loss arises out of the
maintenance or use of aircraft, "autos"
or watercraft to the extent not subject
to Exclusion g. of SECTION I —
COVERAGE A — BODILY INURY
AND PROPERTY DAMAGE
LIABILITY.
(2) When this insurance is excess, we will
have no duty under Coverages A or B to
defend the insured against any "suit" if any
other insurer has a duty to d efend the
insured against that "suit". If no other
insurer defends, we will undertake to do
so, but we will be entitled to the insured's
rights against all those other insurers.
(3) When this insurance is excess over other
Insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(a) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(b) The total of all deductible and s elf
insured amounts under all that other
insurance.
We will share the remaining loss, if any,
with any other insurance that is not
described in this Excess Insurance
provision and was not bought specifically
to apply in excess of the Li mits of
Insurance shown in the Declarations of
this Coverage Part.
insurer contributes equal amounts until it has
paid its applicable limit of insurance or none of
the loss remains, whichever comes first. If any
of the other insura nce does not perm it
contribution by equal shares, we will contribute
by limits. Under thi s method, each insurer's
share is based on the ratio of its applicable
limit of insurance to the total applicable limits
of insurance of all insurers
Blanket Waiver of Subrogation
The following is added to SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 8. Transfer Of Rights
Of Recovery Against Others To Us:
We waive any right of recovery we may have
against any person or organization with whom you
have a written contract that requires such waiver
because of payments we make for damage under
this coverage form. The damage must arise out of
your activities under a written contract with that
person or organization. This waiver applies only to
the extent that subrogation is waived under a
written contract executed prior to the "occurrence"
or offense giving rise to such payments.
4. Bodily Injury Redefined
SECTION V — DEFINITIONS, Definition 3. "bodily
injury" is replaced by the following:
3. "Bodily injury" means bodily injury, sickness or
disease sustained by a person including death
resulting from any of these at any time. "Bodily
injury" includes mental anguish or other
mental injury resulting from "bodily injury".
5. Broad Form Property Damage — Borrowed
Equipment, Customers Goods, Use of
Elevators
a. SECTION I — COVERAGES, COVERAGE A —
BODILIY INJURY AND PROPERTY
DAMAGE LIABILITY, Paragraph 2.
Exclusions subparagraph j. is amended as
follows:
Paragraph (4) does not apply to " property
damage" to borrowed equipment while at a
jobsite and not being used to perform
operations.
Paragraphs (3), (4) and (6) do not ap ply to
"property damage" to "customers goods" while
on your premises nor do they apply to the use
of elevators at premises you own, rent, lease
or occupy.
b. The following is added to SECTION V —
DEFINTIONS:
c. Method Of Sharing 24. "Customers goods" means property of
If all of the other insurance perm its your customer on your premises for the
contribution by equal shares, we will follow this purpose of being:
method also. Under this approach each
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