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2017/04/24 Stache, Inc. Certificate of Liability Insurance�-� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 0412OY2018 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 1S 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 714 935 1100 714 935 1101 The Wallace Insurance Agency 1820 W Orangewood Ave #210 Oran e , CA 92868 g _ CONTACT NAME:: BIII Wallace PHONE ,1.714 935 1100 is c Nei: 714 935 1101 a DRREss: bill@lboiiilliwaiiilaceagenicy.com PRODUCER 9UM-ME3Lo #: INSURERS AFFORDING COVERAGE NAIC # INSURED Stache, Inc. DBA M&M Group 16872 Bolsa Chica St., Suite 204 Huntington Beach, CA 92649 INSURER A: Covington Specialty Insurance Company INSURERS: State Compensation Insurance Fund INSURERC: INSURER D: INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER- RFVlclnht NI IMRFR- 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 SUER POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMlDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 5 A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE O OCCUR -MMA PREMISES Ea accunence 5 1 MOM MED EXP (Any one person) $ 5.000 VBA514982 06/16/2017 06/16/2018 PERSONAL & ADV INJURY S GENERAL AGGREGATE 5 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2,00 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) S ANY AUTO BODILY INJURY (Perperson) S ALL OWNED AUTOS BODILY INJURY (Per accident) S SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) S $ NON -OWNED AUTOS $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESS LIAB DEDUCTIBLE s S RETENTION 5 WORKERS COMPENSATION / WC STATU- OTH- B AND EMPLOYERS' LWBRJTY N OFFICER/MEMBER EXCLUDED? RIEXECUTIVE YI— (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A 9135328 04/24/2017 04/24/2018 E.L. EACH ACCIDENT S 1,000,000 E.L. DISEASE - EA EMPLOYE S 1,000,000 E.L DISEASE - POLICY LIMIT - S 1 , 000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addltlonal Remarks Schedule, IT more space Is required) Additional Insured: City of Menifee %I"r% 1 lr-1VA 1 G nvLNCR I.AfYIiGLLA I IUR City of Menifee 29714 Haun Rd Menifee, CA 92576 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 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD COVINGTON SPECIALTY INSURANCE COMPANY This Endorsement Changes The Policy. Please Read It Carefully. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s): Any person or organization whom you are required to add as an additional insured on this policy under a written contract which is currently in effect or becoming effective during the term of the policy and executed prior to the "bodily injury", "property damage", or "personal and advertising injury". 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 "bodily injury", "property damage" or "personal and advertising injury' caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted bylaw; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will 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 additional exclusions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. 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. All other terms and conditions of this policy remain unchanged. Policy No.: VBA514982 GBA 105003 0614