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2018/05/08 Dennis Janda, Inc. Certificate of Liability Insurance AC'�® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 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 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 CONTACT Strachota Insurance Agency, Inc. - Temec NAME: HONE 27710 Jefferson Ave., Ste. 100 A/CC' 0 Ext: (951) 676-2229 FAX No:(951) 676-7391 E-MAIL Temecula CA 92590 City of Menifee ADDRESS: City Clerk INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Colony Ins Co 39993 INSURED Dennis Janda Inc. NOV 0 7 2018 INSURERB:Amguard Insurance Company 142390 INSURERC:Ohio Security Insurance Compan I24082 42164 Remington Avenue INSURER D:Admiral Insurance Co 1 24856 Temecula CA 92590 Received INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 8729 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. ILTR TYPE OF INSURANCE AI DDD SWVDUBR� POLICY NUMBER MM/D//YYYYPOLICY EFF MMLDDIIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE OCCUR Y 103GL002584400 09/28/2018 09/28/2019 PREMSES(Eaoccu aDAMAGE TO RENTED nte S 100,000 MED EXP(Any one person) S excluded PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 HOTHER PRO- ❑ ECT F7 LOC PRODUCTS-COMP/OPAGG IS included IS AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident �S 1,000,000 B ANY AUTO Y DEAU936781 11/08/2018 11/08/2019 BODILY INJURY(Per person) S ALL OWNED X SCHEDULED BODILY INJURY Per accident S AUTOS AUTOS ( )I X HIREDAUTOS X AUTOS NON-OWNED PROPERTY DAMAGE S AUTOS Per accident S 4UMBRELLA LIAB HOCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERS COMPENSATION PER OTH- C AND EMPLOYERS'LIABILITY Y/N XWS56173896 07/03/2018 07/03/2019 STATUTE ER I ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? El N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEES 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S 1,000,000 I D E&O - Architects & Engine LHR834663 05/08/2018 05/08/2019Per Claim S 1,000,000 Ded: 5,000 Per Claim Aggregate $ 1,000,000 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. It-«� Menifee CA 92586 - I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) 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 person(s) 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 the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by 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 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 (3) Additional Insureds Other Insurance person or organization is liable for "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 If another person or organization is to the additional insured. 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 manner as the Named Insured. additional insured is the lesser of: BA 99 04 06 18 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 1 of 1