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2020/01/01 Habitat for Humanity Inland Valley Certificate of Liability Insurance C� DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 1211612019 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: It the certificate holder Is an ADDITIONAL INSURED,the policy(les) 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 I WCT Arthur J. Gallagher&Co. PHONE Insurance Brokers of California, Inc. LIC#0726293 EMAIL 1255 Battery Street#450 ARE ' San Francisco CA 94111 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: NonProflts'United Workers'Compensation GroupI INSURED NONPUNI-01 INSURERS: Great American E&S Insurance Company 37532 Habitat for Humanity Inland Valley 27475 Ynez Road#390 INsuRERc: Safety National Casually Corporation 15105 Temecula, CA 92591 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 138295/507 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 r Awl.l$l1HRi — - ._ .-... - Pai]CY EFF ' PaLI YMy) hxP i' -- ---- LTR I TYPEOFINSURANCE i WV POLICY NUMBER MMrDX YYY MMrb IYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s _ CLAIMS-MADE OCCUR ppEK3 f9a otr cncoL $_ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO u JECT LOG PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ .(Ea xc+dontl- . ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED RETENTIONS $ A WORKERS COMPENSATION NPU-WCG 00 1-2020 1 1/1/2020 1/112021 X AND EMPLOYERS'LIABILITY STATUTE ER ANYPROPRIETORIPARTNER/EXECUTIVE Ya N/A E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 B XSWC-Buffer Layer 12032019-00 j 1/112020 111/2021 XS of$500,000 250,000(EL&WC) C XSWC SP4061660 1/1/2020 1/112021 XS of$750.000 2,000,000(EL) Xs of$750,000 Statutory(WC) DESCRIPTION OF OPERATIONS/LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CRY o CANCELLATION I V 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 29844 Haun Road Menifee CA 92586 AU YIORIZEDREPRESENTATIVE 'r1;, V ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 2'of 2 38675