2019/03/13 Disability Access Consultants, LLC Certificate of Liability Insurance '4`QRO0 CERTIFICATE OF LIABILITY INSURANCE DATE /
12/1919/2019 Y)
019
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 CONTACT Cell Provo
NAME:
AssuredPartners of Minnesota LLC PHONE (651)644-7200 nrC No: (651)644-9137
2361 Hwy 36 W E-MAIL, cprovo@apminnesota.com
INSURER(S)AFFORDING COVERAGE NAIC#
St.Paul MN 55113 INSURERA: Continental Cas Co 20443
INSURED INSURER B: American Casualty Cc Reading 20427
Disability Access Consultants,LLC INSURER C: Transportation Ins Cc 20494
2862 Olive Highway INSURER D: The Hartford 00914
INSURER E: Philadelphia Insurance Company 251
Oroville CA 95965 INSURER F
COVERAGES CERTIFICATE NUMBER: 20/21 Master 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIDDIYYYY
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
DAMAGE TO RENTE17-
CLAIMS-MADE � OCCUR PREMISES Ea occurrence $ 300,000
MED EXP(Any one person) $ 10,000
A Y B6020052587 01/01/2020 01/01/2021 PERSONAL&ADV INJURY $ 2,000,000
GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000
X POLICY ECT F LOC PRODUCTS-COMP/OPAGG $ 4,000,000
OTHER: Employee Benefits $ 1,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
Ea accident
X ANYAUTO BODILY INJURY(Per person) $
B OWNED SCHEDULED Y 6020004782 01/01/2020 01/01/2021 BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROP E RTY OA MAC E $
AUTOS ONLY AUTOS ONLY Per accident)
Medical payments $ 5,000
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
C EXCESS LIAB CLAIMS-MADE Y B6020052637 01/01/2020 01/01/2021 AGGREGATE $ 5,000,000
DED I X RETENTION$ 0 $
ER
WORKERS COMPENSATION X PTTLITE ERH
AND EMPLOYERS'LIABILITY YIN 1,000,000
D ANY PROPRIETOR/PARTNER/EXECUTIVE NIA 41WBAC5W3P 01/08/2020 01/08/2021 E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E-L.DISEASE-POLICY LIMIT $
Professional Liability
E PHSD1429572 03/13/2019 03/13/2020 Limit $5,000,000
Deductible $10,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
City of Menifee ADA Self Evaluation and Transition Plan are listed as additional insured
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 and its officers,employees,agents ACCORDANCE WITH THE POLICY PROVISIONS.
29714 Haun Road
AUTHORIZED REPRESENTATIVE (�
Menifee CA 92586 A,
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD