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2018/07/03 Dennis Janda, Inc. Certificate of Liability Insurance AC[]R CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDIYYYYI 05/08/2019 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 nndorsed, If SUBROGATION 15 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 andorsomont(s). PRODUCER CONTACT Strachota Insurance Agency, Inc. NAME:_ LawKence E Patter 27710 Jefferson Avenue, Suite 100 cityof Menifee PHONE F]� {RICIll. Sl; I951J 676-2229 �( pl_(951) 67G-7391 City Clerk E MRIL Temecula CA 92590 Y ADDRESS: L'ary"9t:L'aCl7[3taa.Ca1R -MAY ((��44ee INSURER YERAO S)AFFORAING CgE _ FtAtC tl — —MH7_,1 3_21t.17._ fNSURERA:Cow any Insurance Comp 39993 INSURED INSURER B:AmQU"D Islatasanae Dennis Janda Inc. 2L)nWany 42390 iNSURERC:Ohio Security Insurance "_ y 24aA1 42164 Remington Avenue Received 1NSURERD:Landmark ,iLmeri,cam Tnsurallmoo Co. 33136 Temecula CA 92590 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER;Cart ID 9622 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE AFEN 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, Wait LTR TYPE OF INSURANCE AOOL SUER Pp1,ICY'EFF F'GLICY 6.r gamjiffin— POLICY NUMBER N1M10WYYri MMII10lYy LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ S 11000,000 CLAIMS-MADE I X 1 OCCUR y 103GLOO2584400 09/28/2018 100�09/28/2019 pf 1RMAO I1�ROl�)`ED S t}00. - - MEDF,.Xp�ADyone(IBflbbJ S --hided PERSONAL&ADV INJURY S i f(O.000 GEN'L AG4REG/ITE LIMIT APPLIES PER: GENERAL AGGREGATE S_ )1 r 000.004 POLICY� JEo I A LOG PRODLX;TS.CON PiOAAGC, S "includad OTHER: $ AUTOMOBILE LIABILITY COMBiN O i L LIMIT tl=3armmu $ 11000,000 B ANYAUTO y DEAU936781 11/08/2018 11/08/2019 BODILY INJURY(Per person) S ALL OWNED X SCHEDULED — AUTOS _ AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROAl1C ._ AUTOS $ $ UMBRELLA LIAB — OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE j D RE7EHT1 WORIiERBCOMPENSATIO C TI S AND EMPLOYERS'LIABILITY YIN XWS56173896 07/03/201807/03/2019.x.aRf.ACUT —_ ANY PROP RIETOWPARTNERIFXECUTiVE OFFlCERwEMBER EXCLUDED? ❑Y NIA _EL EACFL ACCIDENT $ 1,000,000NH) _ IMendatcry an and EL DISEASE-EAEMPLpY _ 6 1,000,000 If yas,dascrine under _ DESCRIPTION OF OPERATIONStv;cw EL DISEASE.POLICY LIMIT S 1,000,000 D Professional Liability LHR837440 05/08/2019 05/08/2024Bach Claim S 1,000,000 Aggregate S 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Certificate Holder is an Additional Insured with respects to the General Liability per the attached CG20100413 endorsement. Also an Additional Insured with respects to the Commercial Automobile per the attached BA99040618 endorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Menifee ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 29714 Haun Rd. i Menifee CA 92586 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Page 1 of 1 103 GL 0025844-00 POLICY NUMBER: 103 GL 0025844-00 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations All persons or organizations as required by written As designated in written contract with the Named contract with the Named Insured Insured 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 B. With respect to the insurance afforded to these include as an additional insured the persons) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to"bodily injury"or damage" or "personal' and advertising injury" "property damage"occurring after: caused,in whole or in part, by: 1. Your acts or omissions; or 1. All work, including materials, parts or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs)to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the IhP additional insureds) at the Inceilion(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the 1. The insurance afforded to such additional injury or damage arises has been put to its insured only applies to the extent permitted by intended use by any person or organization other than another contractor or subcontractor law;and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. 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 CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 103 GL 0025844-00 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following Is added to Insurance shown in the Declarations; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the roquirad by a aontraot or agreement, the most wo applicable Limits of Insurance shown In the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement;or Page 2 of 2 0 Insurance Services Office, Inc.,2012 CG 20 10 0413 COMMERCIAL AUTO BA 99 04 06 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED WHEN REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. This provision does not apply in regard to any ownership, maintenance or use of the additional insured's"autos." Additional Insured When Required by Contract (a) The limits of insurance specified in (1) Paragraph A.1. — WHO IS AN INSURED — the written contract or written of Section II — Liability Coverage is agreement; or amended to add: (b) The Limits of Insurance shown in d. When you have agreed, in a written the Declarations. contract or written agreement, that a Such amount shall be a part of and not person or organization be added as an in addition to Limits of Insurance shown additional insured on your business auto in the Declarations and described in this policy, such person or organization is an Section. "insured", but only to the extent such person or organization is liable for (3) Additional Insureds Other Insurance "bodily injury" or "property damage" If we cover a claim or "suit" under this caused by the conduct of an "insured" Coverage Part that may also be covered under paragraphs a. or b. of Who Is An by other insurance available to an Insured with regard to the ownership, additional insured, such additional maintenance or use of a covered "auto." insured must submit such claim or"suit" The insurance afforded to any such to the other insurer for defense and additional insured applies only if the indemnity. "bodily injury" or "property damage" However, this provision does not apply occurs: to the extent that you have agreed in a (1) During the policy period, and written contract or written agreement that the insurance is primary and non- (2) Subsequent to the execution of such contributory with the additional insured's written contract, and own insurance. (3) Prior to the expiration of the period (4) Duties in The Event Of Accident, Claim, of time that the written contract Suit or Loss requires such insurance be provided to the additional insured. If another person or organization is added as an additional insured on your (2) How Limits Apply policy, the additional insured shall be If you have agreed in a written contract required to comply with the provisions in or written agreement that another A. Loss Conditions 2.— Duties In The person or organization be added as an Event Of Accident, Claim, Suit Or additional insured on your policy, the Loss — of SECTION IV — BUSINESS most we will pay on behalf of such AUTO CONDITIONS, in the same additional insured is the lesser of: manner as the Named Insured. BA 99 04 06 18 Includes copyrighted material or Insurance Services office, Inc.,with its permission. Page 1 of 1