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2018/07/01 Santa Rosa Academy Certificate of Liability InsuranceSANTROS-02DQUERION CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/V2019 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 ri hts to the certificate holder in lieu of such endorsement s PRODUCER Teague Insurance Agency, Inc. CQNTACT [PHONe _ AIC, No, Ed L I SUPER S AFFORD NG INSURED INSURER A: Philadel hia Insurance INSURER B. Oak River Insurance CI Santa Rosa Academy 27687 La Piedra Road NSURERC:Philadel hia Indemnl tv Menifee, CA 92584 rNSURER n F: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSI INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRI EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM, WXX TYPE OF INSURANCE �� TDDL SUER T _ - POLICY NUMBER POLICY EFF POLICY Exp COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X PHPK1926664 Physical Abuse 1/9/2019 1/9/2020 L AGGREGATE LIMIT APPLIES PER: POLICY D PRO- JECT D LOC AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS ONLY NON -OWNED AUTOS ONLY A X UMBRELLA LIAB X OCCUR EXCESS LIAB CLAIMS -MADE DED X I RETENTION $ 10,000 ANY PROPRIETOR/PARTNER/EXECUTI VE Y I N pFFICERrM , BWW EXCLUOED9 N / A K andatory n ) If yes, describe under A 101rectors & Office C Student Accident; City of Menifee City Clerk UB660881 WC927105 Received 1/9/2019 1 1/9/2020 7/1/2018 j 7/1/2019 RED NAMED ABOVE FOR THE POLICY PERIOD R DOCUMENT WITH RESPECT TO WHICH THIS 3ED HEREIN IS SUBJECT TO ALL THE TERMS, ";_ EACH OCCU$ 1,000,000 DAMAGE TO 100,000 MISES iET MED EXP $ 5,Q00 PERSONAL a1,000,000 GENERAL AG.$ 31000,000PRODUCTS•3,000,000 1/9/2019 1 1/9/2020 IlLimit LIMIT 1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is raqu€red) City of Menifee is included as additional insured with respects to General Liability, per attached forms, when required by written contract or agreement for ongoing operations only City of Menifee 29714 Haun Road Sun City, 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD