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2019/01/01 Bureau Veritas North America, Inc. Certificate of Liability Insurance CERTIFICATE OF LIABILITY INSURANCE 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 L' certificate does not confer rights to the certificate holder in lieu of such endorsement(s). m PRODUCER CONTACT � Aon Risk Services Northeast, Inc. PHONE VAX Aon Risk Services Northeast, Inc. WC-Ne.Esl): 666-293-7122 IAlC we,No.: 800-363-0105 d NY NY Office City of Menifee E'awL o One Liberty Plaza ADDRESS: _ 165 Broadway, suite 3201 City Clerk New York NY 10006 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED JAN 07 2019 INSURER A: Hartford Fire Insurance Co. 19682 Bureau Veritas North America, Inc. INSURERB: Twin City Fire Insurance Company 29459 180 Promenade Circle, suite 150 Sacramento CA 95834 USA INSURERC: Hartford Ins Co of the Midwest 37478 Received INSURER D: Hartford Accident & Indemnity Company 22357 INSURERE: sentinel insurance Company, Ltd 11000 INSURER F: Hartford Underwriters Insurance Company 130104 COVERAGES CERTIFICATE NUMBER:570074337036 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. Limits shown are as fequested INSR LTR TYPE OF INSURANCE - WV0 POLICY NUMBER yly�pD LIMITS ^ X COMMERCIAL GENERAL LIABILITY USL00159319 Ul/U1/LUl9 UL/vl/tutu EACHOCCURRENCE $2,000,000 DAMAGE TO RENTED $1'QOO'000 CLAIMS-MADE X OCCUR PREMI Ea occurrence MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER I GENERAL AGGREGATE $2,000,000 M POLICY X PRO X LOC JECT PRODUCTS-COMP/OP AGG $2,000,000 r OTHER: 0 - A AUTOMOBILE LIABILITY 10 AB s41202 01/01/2019 U110112020 COMBINED SINGLE LIMIT $2,000,000' AOS A X ANYAUTO 10 AB S41203 01/01/2019 01/01/2020 BODILY INJURY(Per person) 0 OWNED SCHEDULED HI AUTOS ONLY AUTOS BODILY INJURY(Per accident) a) HIREDAUTOS NON-OWNED PROPERTY DAMAGE U ONLY AUTOS ONLY Per accident) t N UMBRELLALIAB OCCUR EACH OCCURRENCE V EXCESS LIAB CLAIMS-MADE AGGREGATE DEO I RETENTION 1 WORKERS COMPENSATION AND 10WNS41200 01/01/201901/01/2020 PER pTH- EMPLOYERS'LIABILITY YIN ADS X14TATUTFZ C ANY PROPRIETOR I PARTNER)EXECUTIVE N E-L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A 10WNs41200 01/01/2019 01/01/2020 (Mandatory in NH) AK ID NY E.L-DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under CESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $1,000,000 K Archit&Eng Prot USFOOL48UI9 01/01/2019 01701j2020 Each Claim $1,000,000 SIR applies per policy terns & condi ions Aggregate $1,000,600 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached 4 more space is required) Certificate Holder is included as Additional Insured in accordance with the policy provisions of the Business Auto Coverage & - General Liability Coverage policy. rr s CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE - POLICY PROVISIONS. City Of Menifee 29714 Haun Road AUTHORIZED REPRESENTATIVE _ Menifee CA 92586 USA ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000048582 LOC#: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGFw%GY NAMED INSURED Aon Risk services Northeast, Inc. Bureau Veritas North America, Inc. POLICY NUMBER See Certificate Number: 570074337036 CARRIER NAIC CODE see Certificate Number: 570074337036 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Llabrfili Insurance INSURER(S)AFFORDING COVERAGE NAIC# INSURER K :Allianz Global Risks us Insurance Co. 35300 INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORN certificate form for policy limits. INSR ADDL SUER POLICY POLICY I,TR TYPE OF INSURANCE INSD WVD POLICY NUMBER EFFECTIVE EXPIRATION LIMITS DATE DATE fA1 Al/DDlYYVY MM/DDlYYV 1 I ACORD 101(2008I01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD