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2019/04/21 NextRequest Co Certficiate of Liability InsuranceWLTR005 THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 December 12, 2019 City of Menifee and its officers, employees, agents, and authorized volunteers 29844 Haun Rd. Menifee CA 92586 Account Information: Policy Holder Details :NEXTREQUEST CO Contact Us Business Service Center Business Hours: Monday - Friday (7AM - 7PM Central Standard Time) Phone:(866) 467-8730 Fax:(888) 443-6112 Email:agency.services@thehartford.com Website:https://business.thehartford.com Enclosed please find a Certificate Of Insurance for the above referenced Policyholder.Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/12/2019 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 SUBROGATIONIS 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 NUTMEG INSURANCE AGENCY INC/PHS 46508229 The Hartford Business Service Center 3600 Wiseman Blvd San Antonio, TX 78251 CONTACT NAME: PHONE (A/C, No, Ext): (866) 467-8730 FAX (A/C, No): (888) 443-6112 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURED NEXTREQUEST CO 433 BRYANT ST SAN FRANCISCO CA 94107-1302 INSURER A :Hartford Fire and Its P&C Affiliates 00914 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/Y YYY)LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY (Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS- MADE EACH OCCURRENCE AGGREGATE DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/ A 46 WBG AP1337 04/21/2019 04/21/2020 PER STATUTE X OTH- ER Y/N E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION City of Menifee and its officers, employees, agents, and authorized volunteers 29844 Haun Rd. 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD SB-146932-E31 (Ed.06/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED –LIABILITY EXTENSION This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Policy. own acts or omission or those of its1.ADDITIONAL INSURED –BLANKET VENDORS employees or anyone else acting on itsWHOISANINSUREDisamendedtoinclude as an behalf.However,this exclusion does notadditionalinsuredanypersonororganization(referred apply to:to below as vendor)with whom you agreed,because (1)The exceptions contained inof a written contract or agreement to provide Subparagraphs d.or f.;orinsurance,but only with respect to "bodily injury"or "property damage"arising out of "your products"which (2)Such inspections,adjustments,tests oraredistributedorsoldintheregularcourseof the servicing as the vendor has agreed tovendor's business, subject to the following additional make or normally undertakes to make inexclusions:the usual course of business,in connection with the distribution or sale of1.The insurance afforded the vendor does not apply the products.to: 2.This insurance does not apply to any insureda."Bodily injury"or "property damage"for which person or organization,from whom you havethevendorisobligatedtopaydamagesbyacquiredsuchproducts,or any ingredient,part orreasonof the assumption of liability in a container,entering into,accompanying orcontractoragreement.This exclusion does containing such products.not apply to liability for damages that the vendor would have in the absence of the 3.This provision 2.does not apply to any vendorcontractoragreement;included as an insured by an endorsement issued by us and made a part of this Policy.b.Any express warranty unauthorized by you; 4.This provision 2.does not apply if "bodily injury"orc.Any physical or chemical change in the "property damage"included within the "products-product made intentionally by the vendor;completed operations hazard"is excluded eitherd.Repackaging,except when unpacked solely by the provisions of the Policy or by endorsement.for the purpose of inspection,demonstration,2.MISCELLANEOUS ADDITIONAL INSUREDStesting,or the substitution of parts under instructions from the manufacturer,and then WHO IS AN INSURED is amended to include as anrepackagedintheoriginalcontainer;insured any person or organization (called additional insured)described in paragraphs 2.a.through 2.h.e.Any failure to make such inspections,below whom you are required to add as an additionaladjustments,tests or servicing as the vendor insured on this policy under a written contract orhasagreedtomakeornormallyundertakestoagreementbut the written contract or agreement mustmakeintheusualcourseofbusiness,in be:connection with the distribution or sale of the products;1.Currently in effect or becoming effective during the term of this policy;andf.Demonstration,installation,servicing or repair operations,except such operations performed 2.Executed prior to the "bodily injury,""propertyat the vendor's premises in connection with damage"or "personal and advertising injury,"butthesaleof the product;Only the following persons or organizations areg.Products which,after distribution or sale by additional insureds under this endorsement andyou,have been labeled or relabeled or used coverage provided to such additional insureds isasacontainer,part or ingredient of any other limited as provided herein:thing or substance by or for the vendor;or a.Additional Insured –Your Workh."Bodily injury"or "property damage"arising out of the sole negligence of the vendor for its SB-146932-E31 Page 1of5 (Ed.06/11) Pol No. 6020843282 SB-146932-E31 (Ed.06/11) That person or organization for whom you do behalf for which the state or political work is an additional insured solely for liability subdivision has issued a permit. due to your negligence specifically resulting This insurance does not apply to "bodilyfromyourworkfortheadditionalinsuredinjury,""property damage"or "personal andwhichisthesubjectof the written contract or advertising injury"arising out of operationswrittenagreement.No coverage applies to performed for the state or municipality.liability resulting from the sole negligence of the additional insured.c.Controlling Interest The insurance provided to the additional Any persons or organizations with a insured is limited as follows:controlling interest in you but only with respect to their liability arising out of:(1)The Limits of Insurance applicable to the additional insured are those specified in (1)Their financial control of you;or the written contract or written agreement (2)Premises they own,maintain or controlorintheDeclarationsofthis policy,while you lease or occupy thesewhicheveris less.These Limits of premises.Insurance are inclusive of,and not in addition to,the Limits of Insurance shown This insurance does not apply to structuralintheDeclarations.alterations,new construction and demolition operations performed by or for such additional(2)The coverage provided to the additional insured.insured by this endorsement and paragraph F.9.of the definition of "insured d.Managers or Lessors of Premisescontract"under Liability and Medical A manager or lessor of premises but only withExpensesDefinitionsdo not apply to respect to liability arising out of the ownership,"bodily injury"or "property damage"maintenance or use of that specific part of thearisingout of the "products-completed premises leased to you and subject to theoperationshazard"unless required by the following additional exclusions:written contract or written agreement. This insurance does not apply to:(3)The insurance provided to the additional insured does not apply to "bodily injury,"(1)Any "occurrence"which takes place after"property damage,"or "personal and you cease to be a tenant in that premises;advertising injury"arising out of the orrenderingorfailuretorenderany (2)Structural alterations,new construction orprofessionalservices. demolition operations performed by or onb.State or Political Subdivisions behalf of such additional insured. A state or political subdivision subject to the e.Mortgagee,Assignee or Receiverfollowingprovisions: A mortgagee,assignee or receiver but only(1)This insurance applies only with respect with respect to their liability as mortgagee,to the following hazards for which the assignee,or receiver and arising out of thestateorpoliticalsubdivisionhasissuedaownership,maintenance,or use of a premisespermitinconnectionwithpremisesyoubyyou.own,rent,or control and to which this This insurance does not apply to structuralinsuranceapplies: alterations,new construction or demolition(a)The existence,maintenance,repair,operations performed by or for such additionalconstruction,erection,or removal of insured.advertising signs,awnings,canopies, f.Owners/Other Interests –Land is Leasedcellarentrances,coal holes, driveways,manholes,marquees,An owner or other interest from whom landhoistawayopenings,sidewalk vaults,has been leased by you but only with respectstreetbanners,or decorations and to liability arising out of the ownership,similar exposures;or maintenance or use of that specific part of the (b)land leased to you and subject to the followingTheconstruction,erection,or additional exclusions:removal of elevators;or (2)This insurance does not apply to:This insurance applies only with respect to operations performed by you or on your SB-146932-E31 Page 2of5 (Ed.06/11)20020005260206684522029 SB-146932-E31 (Ed.06/11) (1)Any "occurrence"which takes place after A.Under B.Exclusions,1.Applicable to Business you cease to lease that land;or Liability Coverage,Exclusion k.Damage To Property,isreplaced by the following:(2)Structural alterations,new construction or demolition operations performed by or on k.Damage To Property behalf of such additional insured."Property damage"to: g.Co-owner of Insured Premises 1.Property you own,rent or occupy, A co-owner of a premises co-owned by you including any costs or expenses incurred and covered under this insurance but only by you,or any other person,organization with respect to the co-owners liability as co-or entity,for repair,replacement, owner of such premises.enhancement,restoration or maintenance of such property for any reason,includingh.Lessor of Equipment prevention of injury to a person or damage to another's property;Any person or organization from whom you lease equipment.Such person or organization 2.Premises you sell,give away or abandon,are insureds only with respect to their liability if the "property damage"arises out of anyarisingout of the maintenance,operation or part of those premises;use by you of equipment leased to you by such person or organization.A person's or 3.Property loaned to you; organization's status as an insured under this 4.Personal property in the care,custody orendorsementendswhentheirwrittencontractcontrolof the insured;or agreement with you for such leased equipment ends.5.That particular part of any real property on which you or any contractors orWithrespectto the insurance afforded these subcontractors working directly oradditionalinsureds,the following additional indirectly in your behalf are performingexclusionsapply:operations,if the "property damage" This insurance does not apply:arises out of those operations;or (1)To any "occurrence"which takes place 6.That particular part of any property that after the equipment lease expires;or must be restored,repaired or replaced because "your work"was incorrectly(2)To "bodily injury,""property damage"or performed on it."personal and advertising injury"arising out of the sole negligence of such Paragraph 2ofthis exclusion does not apply if additional insured.the premises are "your work"and were never occupied,rented or held for rental by you.Any insurance provided to an additional insured designated under paragraphs b.through h.above Paragraphs 1, 3, and 4, of this exclusion do does not apply to "bodily injury"or "property not apply to "property damage"(other than damage"included within the "products-completed damage by fire or explosion)to premises: operations hazard."(1)rented to you; 3.The following is added to Paragraph H.of the (2)temporarily occupied by you with theBUSINESSOWNERSCOMMONPOLICYpermissionof the owner,orCONDITIONS: (3)to the contents of premises rented to youH.Other Insurance for a period of 7 or fewer consecutive 4.This insurance is excess over any other valid days. and collectible insurance naming the A separate limit of insurance applies toadditionalinsuredasaninsuredwhetherDamageToPremisesRentedToYouasprimary,excess,contingent or on any other described in Section D –Liability and MedicalbasisunlessawrittencontractorwrittenExpensesLimitsofInsurance.agreement specifically requires that this insurance be either primary or primary and Paragraphs 3, 4, 5, and 6 of this exclusion do noncontributing.not apply to liability assumed under a sidetrack agreement.4.LEGAL LIABILITY –DAMAGE TO PREMISES Paragraph 6of this exclusion does not apply to "property damage"included in the "products-completed operations hazard." SB-146932-E31 Page 3of5 (Ed.06/11) SB-146932-E31 (Ed.06/11) B.Under B.Exclusions,1.Applicable to Business 7.Bodily Injury Liability Coverage,the last paragraph of 2.Section F.Liability and Medical ExpensesExclusionsisdeletedandreplacedbytheDefinitions,item 3."Bodily Injury"is deleted andfollowing:replaced with the following: Exclusions c,d,e,f,g, h,i,k,l,m,n, and o,do "Bodily injury"means bodily injury,sickness ornotapplytodamagebyfiretopremiseswhilediseasesustainedbyaperson,including death,rented to you or temporarily occupied by you with humiliation,shock,mental anguish or mental injury bypermissionof the owner or to the contents of that person at any time which results as apremisesrentedtoyouforaperiodof 7 or fewer consequence of the bodily injury,sickness or disease.consecutive days.A separate limit of insurance applies to this coverage as described in Section 8.Expanded Personal and Advertising Injury D.Liability And Medical Expenses Limits Of Definition Insurance.a.The following is added to Section F.Liability and C.The first Paragraph under item 5.Damage To Medical Expenses Definitions,item 14. Premises Rented To You Limit of Section D.Personal and Advertising Injury,in the Liability And Medical Expenses Limits Of Businessowners General Liability Coverage Insurance is replaced by the following:Form: The most we will pay under Business Liability for h.Discrimination or humiliation that results in damages because of "property damage"to any injury to the feelings or reputation of a naturalonepremises, while rented to you,or temporarily person,but only if such discrimination or occupied by you,with the permission of the humiliation is based solely on either disparate owner,including contents of such premises rented impact (as opposed to disparate treatment)or to you for a period of 7 or fewer consecutive days,vicarious liability,and: is the Damage to Premises Rented to You limit 1.Not done intentionally by or at theshownintheDeclaration.direction of:5.Blanket Waiver of Subrogation a.The insured;or We waive any right of recovery we may have against:b.Any "executive officer,"director,a.Any person or organization with whom you have a stockholder,partner,member or written contract that requires such a waiver.manager (if you are a limited liability company)of the insured;and6.Broad Knowledge of Occurrence 2.Not directly or indirectly related to theThefollowingitemsareadded to E.Businessowners employment,prospective employment,General Liability Conditions in the Businessowners past employment or termination ofLiabilityCoverageForm:employment of any person or person by e.Paragraphs a.and b.apply to you or to any any insured. additional insured only when such "occurrence,"b.The following is added to Exclusions,Section B.:offense,claim or "suit" is known to: (15)Discrimination Relating to Room,Dwelling(1)You or any additional insured that is an or Premisesindividual; Caused by discrimination directly or indirectly(2)Any partner,if you or an additional insured is related to the sale,rental,lease or sub-leaseapartnership;or prospective sale,rental,lease or sub-lease (3)Any manager,if you or an additional insured of any room,dwelling or premises by or at the is a limited liability company;direction of any insured. (4)Any "executive officer"or insurance manager,(16)Fines or Penalties if you or an additional insured is a corporation;Fines or penalties levied or imposed by a (5)Any trustee,if you or an additional insured is a governmental entity because of trust;or discrimination. (6)Any elected or appointed official, if you or an c.This provision (Expanded Personal and additional insured is a political subdivision or Advertising Injury)does not apply if Personal public entity.and Advertising Injury Liability is excluded either by the provisions of the Policy or byThisparagraphe.applies separately to you and endorsement.any additional insured. SB-146932-E31 Page 4of5 (Ed.06/11)20020005260206684522030 SB-146932-E31 (Ed.06/11) 9.Personal and Advertising Injury Re-defined room dwelling or premises that a person or organization occupies committed by or on behalfSectionF.Liability and Medical Expenses Definitions,of it's owner,landlord or lessor.item 14,Personal Advertising Injury,Paragraph c. is replaced by the following: c.The wrongful eviction from,wrongful entry into,or invasion of the right of private occupancy of a SB-146932-E31 Page 5of5 (Ed.06/11)