2018/11/01 WSP USA, Inc. Certificate of Liability InsuranceACOIRD`g CERTIFICATE OF LIABILITY INSURANCE
DATE(YYYY)
1 10/2912029l2018
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 pollcy(les) 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
Arthur J. Gallagher Risk Management Services, Inc,
250 Park Avenue, 5th Floor
New York NY 10177
CONTACT
NAME: AJG Service Team
a,c°MN : 212-981-2485 AIC.No:212-994-7074
E-MAIL
ADDRESS: GGB.WSPUS.CertRe uests a' .corn
INSURERS AFFORDING COVERAGE
NAIC#
INSURER A: QBE Specialty Insurance Company
11515
INSURED WSPGLOB-01
WSP USA Inc.
INSURERS
INSURER C :
One Penn Plaza
INSURER D :
New York, NY 10119
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 11320821364 RFViginKi NIIMRFR:
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.
1�7p TYPE OF INSURANCE IINNSD W VD I POLICY NUMBER MoucD YYY MM DDNYY LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 71OCCUR
EACHOCCURRENCE
$
DAMAGE TO RENTEI5__
PREMISES Ea Occurrence
$
MED EXP (Any one person)
$
Gty of Menifee
PERSONAL & ADV INJURY
$
City Clerk
GEN'L
AGGREGATE LIMIT APPLIESPER:
POLICY u PRO-
JECT _� LOC
GENERAL AGGREGATE
S
�� 72018
PRODUCTS - COMP/OP AGO
S
$
OTHER'
AUTOMOBILE
LIABILITY
ANY AUTO
I !
IL pp��,,,,��,,������
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(EO aBINdEeDiSINGLE LIMIT
)
BODILY INJURY Wor person)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
BODILY INJURY (Per accident)
S
PROPERTY err accident) DAr�IAGE
$
5
UMBRELLA LIAR
EXCESS LIAR
OCCUR
I CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
S
DED I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETORrPARTNER%E,CECUTIVE Y 1 N
OFFICER!MEMBER EXCLUDED
N / A
PER OTH•
STATUTE I I ER
E.L. EACH ACCIDENT
5
E.L. DISEASE - EA EMPLOYEE
S
(Mandatory in NH)
It yes. describe under
E.L. DISEASE - POLICY LIMIT
S
DESCRIPTION OF OPERATIONS below
A
Professional Liability
CLAIMS -MADE
OPL0022630
1111/2018
10/31/2019
Per Claim/Aggregate
S1.000.000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
12840A- NPDES storm water services
City of Menifee
29714 Haun Road
Menifee CA 92586
USA
1149ILei 91
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
C--
REPRESENTATIVE
U 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
3 of 6 14968
ACORE)rCERTIFICATE OF LIABILITY INSURANCE
FDATE,M2
10i29/2018 l912
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
Arthur J. Gallagher Risk Management Services, Inc.
250 Park Avenue, 5th Floor
New York NY 10177
NT CT
E. AJG Service Team
PHONE FAX
Ar N Ext : 212-981-2485 Arc Ne: 212-994-7074
ADDR SS: GGB.WSPUS.CertRequests@ajg.com
INSURERS AFFORDING COVERAGE
NAICN
INSURER A: QBE Specialty Insurance Company
11515
INSURED WSPGL0B-01
WSP USA Inc.
One Penn Plaza
New York, NY 10119
INSURER B
INSURER C :
INSURER D :
INSURER E:__-----
INSURER F:
COVERAGES CERTIFICATE NUMBER: 11781799R4 F21=11ICInhl K1111,1GCG.
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.
INSfl
LTR
jj --
TYPE OF INSURANCE
Abu
INSD
SUBRI
WVDI
POUCYNUMBER
POLICY EFF POLICY EXP
MMIDDIYYYY I MMrDDlYYY
— --
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADEOCCUR
1-1
EACHOCCURRENCE
S
DAMAGE TO RENTED
PREMISES (Ea occurrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
S
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
S
POLICY
u JPE`C LOC
PRODUCTS • COMPrOP AGO
S
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident'
$
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident]
R
_
$
UMBRELLA LIAB OCCUR
i--,
I
EACH OCCURRENCE
$
AGGREGATE
S
EXCESS LIAB CLAIMS -MADE
DED I RETENTION $
$
i
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
I
STATUTE I ERH
-E.L. ACCIDENT
AN YPROPR iETORrPARTN ER,EXECUTIVE
OFFICERWEMBEREXCLUDED?
N / A
E.L. DISEASE • EA EMPLOYEE
S
(Mandatory in NH)
II yes, describe under
E.L. DISEASE - POLICY LIMIT
S
DESCRIPTION OF OPERATIONS below
I
A
Professional Liability
CLAIMS -MADE
QPL0022630
1111/2018 I 1013V2019
Per Claim/Aggregate
S2,000.000
DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
THIRTY (30) DAYS NOTICE OF CANCELLATION
12789A - Menifee Traffic Assistance
City of Menifee
29714 Haun Road
Menifee CA 92586
USA
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
U 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
4 of 6 14968
ACC?R& CERTIFICATE OF LIABILITY INSURANCE
�..—�1
DATE(MM/DD/YYYY)
10/29/2018
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(les) 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
Arthur J. Gallagher Risk Management Services, Inc.
250 Park Avenue, 5th Floor
New York NY 10177
CONTACT
NAME: AJG Service Team
AHONN txt 212-981-2485 pc,Ne:212-9947074
E-MC.AIL
ADDRESS: GGB.WSPUS.CertRequests@ajg.com
INSURERS AFFORDING COVERAGE
NAIC4
INSURER A: QBE Specialty Insurance Company
11515
INSURED WSPGLOB-01
WSP USA In
INSURER B
INSURERC:
One Penn Plaza
INSURER D
New York, NY 10119
INSURER E:
INSURER F :
U0VLKAULs CERTIFICATE NUMBER:12nsR77r»R RFVIRIr1N NIIMRFR-
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 -ADDL SUBR ^)- POLICY EFF POLICY ERP -
LTR TYPE OF INSURANCE INSO W VD I POLICY NUMBER MNVDD/YYYY MMIDD.'YYY LIMITS
COMMERCIALGENERAL LIABILITY
EACH OCCURRENCE
$
PREMISES Ea oca ence
S
CLAIMS -MADE i OCCUR
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
G_E_N'L
AGGREGATE LIMIT APPLIES PER:
POLICY u PE� I� LOC
GENERAL AGGREGATE
PRODUCTS COMP!OP AGG
S
S
OTHER
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident
S
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED AUTOS ONLY AUTOS
BODILY INJURY (Per accidenll
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
accident)
S
-!Per
_
5
UMBRELLALIAB I i OCCUR
EACHOCCURRENCE
S
AGGREGATE
$
EXCESS LIAB CLAIMSMADE
DED 1 I RETENTION S
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETORPARTNER%EXECUTIVE
OFFICERiMEMBEREXCLUDED7 ❑
N/A
PER OTH.
STATUTE I R
E.L. EACH ACCIDENT_
$
E.L. DISEASE - EA EMPLOYEE
S
(Mandatory In NH)
II yes. describe under
E.L. DISEASE - POLICY LIMIT I
S
DESCRIPTION OF OPERATIONS below
A
Professional Liability
CLAIMS -MADE
I
OPL0022630
1 D1/2018
10/31/2019
Per Claim/Aggregate
$1.000.000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more space Is required)
12848A - Project Description: 2016/2017 Menifee On Call Eng. 8r Supp Svcs
City of Menifee
29714 Haun Road
Menifee CA 92586
USA
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
91988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
5 of 6 14968
ACORD"' CERTIFICATE OF LIABILITY INSURANCE
F DATE(MMIDDIYYYY)
1 10/29/2018
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
Arthur J. Gallagher Risk Management Services, Inc.
250 Park Avenue, 5th Floor
New York NY 10177
CONTACT AJG Service Team
NAMEPHONE
A+ N . t : 212-981-2485 n.No:212-994 7074ro
ADDRESS: GGB.WSPUS.CertRequests@ajg.com
INSURERS AFFORDING COVERAGE
NAIC#
INSURER A: QBE Specialty Insurance Company
11515
INSURED WSPGLOS-01
WSP USA Inc.
INSURER B
INSURER C:
One Penn Plaza
New York, NY 10119
INSURER D :
------------ -------------------
INSURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBER:1934914677 REVISION NUMBER:
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.
IWSR ADOL SUBR _ —
LTR TYPE OF INSURANCE INSD WVPOLICY NUMBER MMDDIYYYY MMDD/YYYP LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE "I OCCUR
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES (Ea occurrence)S
MED EXP (Any one person)
$
PERSONAL& ADV INJURY
S
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO.
F] LOC
El
GENERAL AGGREGATE
S
PRODUCTS -COMPrOPAGG
_
S
S
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
i
BODILY INJURY Per accident
1 1
S
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
i
PROPERTY DAMAGE
(Per accident)
S
$
UMBRELLA LIAR OCCUR
EXCESS LIAR I CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
S
I
DED RETENTION S
S
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y e N
ANYPROPRIETOR+PARTNER%EXECUTIVE
OFFICERIMEMBER EXCLUDED?
N / A
I
STATUTE I EERH
E.L. EACH ACCIDENT
— -
$
-
E.L. DISEASE - EA EMPLOYEE
—.-_
S
(MandatoryIn NH)
it yes. describe under
E.L. DISEASE - POLICY LIMIT
S
DESCRIPTION OF OPERATIONS below
A
Professional Liability
CLAIMS -MADE
OPL0o22630
11/112018
I
I
10i31r2019
Per Claim/Aggregate
S2,000,000
DESCRIPTION OF OPERATIONS ! LOCATIONS ! VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required)
THIRTY (30) DAYS NOTICE OF CANCELLATION
12799A - Professional Services Traffic Engineering
City of Menifee
29714 Haun Road
Menifee CA 92586
USA
I, MMICLLH I IUIV
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
V 19BB-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
6 of 6 14968
Arthur J. Gallagher Risk Management Services, Inc.
250 Park Avenue, 5th Floor
New York, NY 10177
14968 2 AB 0.405 14968
I'I1I1IIII'll'I11ll ll111111111111111111111111111Jill
CITY OF MENIFEE
29714 HAUN RD
MENIFEE, CA 92586-6540
1 of 6 14968
Acorao� CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DDIYYYY)
1 10/29/2018
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(les) 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
Arthur J. Gallagher Risk Management Services, Inc.
250 Park Avenue, 5th Floor
New York NY 10177
CONT CT
NAME: AJG Service Team
PHONE : 212-981-2485 arc Na: 212-9947074
EMAIL
ADDRESS: GGB,WSPUS.CertRequests@ajg.com
INSURERS AFFORDINGCOVERAGE
NAIC#
INSURER A: QBE Specialty Insurance Company
11515
INSURED WSPGLOB-01
W.S. P USA Inc.
INSURER B
INSURER C :
One Penn Plaza
New York, NY 10119
INSURER D :
INSURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBER:?R1599n7R RRvictwim nittenoco.
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.
i
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBRi
WVD
POLICY NUMBER
MM/DDYYYYY
MWDD/Y YP
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
5
DAMAGE TO rED
PREMISES Ea occurrence
$
MED EXP (Any one person)
S
PERSONAL& ADV INJURY
S
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY u PRO. ❑
JECT LOC
GENERAL AGGREGATE
$
PRODUCTS-COMP/OPAGG
- ---
S
$
OTHER.
AUTOMOBILE
LIABILrTY
COMBINED SINGLE LIMIT
(Ea accident
5
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident )
S
HIRED NON OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
(Per accidentl-
$
UMBRELIALIAB a
OCCUR
I
EACHOCCURRENCE
5
AGGREGATE
S
EXCESS LIAR
CLAIMS -MADE
I
DED RETENTIONS
$
j
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AN YPROPRI ETOR+PARTNER; EXECUTIVE
OFFICERIMEMBER EXCLUDED?
N / A
j
H
STATUTE I ER
E.L. EACH ACCIDENT
S
_
E.L. DISEASE - EA EMPLOYEE
S
(Mandatory in NH)
If yes. describe under
E.L. DISEASE •POLICY LIMIT
$
DESCRIPTION OF OPERATIONS below
A
Professional Liability
CLAIMS -MADE
TI
OPL0022630
11/1/2018
10131/2019
Per Claim/Aggregate
S1.000.000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
12837A - Menifee Project Management -On - Call
City of Menifee
29714 Haun Road
Menifee CA 92586
USA
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
U 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
2 of 6 14968