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2018/11/14 Video Voice Data Communications Certificate of Liability Insurance
VIDEO VOIC ECHARLES 14� R" CERTIFICATE OF LIABILITY INSURANCE DATE 11113/2018Y) 11/13/2018 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 The Wooditch Company Insurance Services, Inc. 1 Park Plaza, Suite 400 City of Merl I i ee Irvine, CA 92614 City Clerk CONTACT NAME: lvco,NN , Ext): (949) 553-9800 FAX No):(949) 553-0670 gDDRLSS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Old Republic General Insurance Corporation �24139 INSURED INSURER B : Endurance Risk Solutions Assurance Co ;43630 INSURER C : Video Voice Data Communications 12691 Pala Drive Garden Grove, CA 92841 Received INSURER D : INSURER E INSURER F : COVERAGES CFRTIFICATF N"MRFR• DcvlcrnAl LU IRADCo. 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. NSR ILTR TYPE OF INSURANCE AN p SUBR! POLICY NUMBER POLICY EFF MMIDD POLICY EXP - MM DD I LIMITS A X n I COMMERCIAL GENERAL LIABILITY CLAIMS -MADE i X - OCCUR 1 X A1CG12781801 11/14/2018 11/14/2019 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence 100,000 5 S 5'000 MED EXP (Anv one erson PERSONAL & ADV INJURY S 1,000,000 GEN'L h AGGREGATE LIMIT APPLIES PER: POLICY a PE� LOC GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMP/OP AGG S 2'000,000 S OTHER: A AUTOMOBILE XIANY ! I hHIRED LIABILITY AUTO AUTOS ONLY I OWNED AUTOS SCHEDULED r NON -OWNED AUTOS ONLY I✓ AUTOS ONLY A1CA12781801 11/14/20111 11/14/2019 O agINEDt SINGLE LIMIT BODILY INJURY Per erson S 1,000,000 S BODILY INJURY Per accident S PROPERTY DAMAGE Per accident S IS B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EXC30000209902 11/14/2018 11/14/2019 EACH OCCURRENCE S 3,000,000 AGGREGATE s 3,000,000 DED RETENTION S Is A ' AND EMPLOY EMPLOYERS' COMPENSATION ANY PROPRIETOWPARTNER/EXECUTIVE YI �NI OFFICER/MEMBER EXCLUDED? (Mandatory in NH) L—' If yes, describe under DESCRIPTION OF OPERATIONS below NIA A1CW727S1 HU7 11/14/2018 11/14/2019 PER X STATUTE ERH �E ACCIDENT 5 1'606'��� ,000,000 _ E.L. DISEASE - EA EMPLOYEE 1 5 E.L. DISEASE - POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Permit, 29645 Glenneyre. glai(CG2012) City of Menifee is included as Additional Insured as respects General Liability per attached endorsement. 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: VIDEO VOIC ECHARLES ACORO- LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Video Voice Data Communications 12691 Pala Drive Garden Grove, CA 92841 POLICY NUMBER EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 'SEE P 1 EFFECTIVE DATE: SEE PAGE 1 AUUI I IUNAL KtMAKKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Cancellation: *Except for 10 days notice of cancellation for non payment of premium. *Should this policy be cancelled before the expiration date, The Wooditch Company will mail 30 (thirty) days written notice to those Certificate Holders which require such action per contract or agreement.* AC:URU 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AlCG12781801 COMMERCIAL GENERAL LIABILITY CG 2012 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: City of Menifee Information required to complete this Schedule, if not shown above will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. B However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. 'Bodily injury" or "property damage" included within the "products -completed operations hazard". 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. CG 20 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1