2018/11/29 Qless, Inc. Certicate of Liability Insurance DATE(MM/DDNYYY)
ACC" CERTIFICATE OF LIABILITY INSURANCE 5/30/2019
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 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 endorsemeni(s).
PRODUCER CONTACT NAME: Nancy Rose
ROSEWOOD INSURANCE SERVICES, INC. pHONE 526-844-5100 FAXNo: 626-844-9222
564 N LAKE AVE ADDAIL
RESS: 2rosewood@sbcglobal.net
INSURERS AFFORDING COVERAGE NAIC N
PASADENA CA 91101 INSURII EVANSTON INSURANCE COMPANY 35378
INSURED INSURER 8:NATIONAL UNION FIRE INSURANCE CO 19445
INSURERC:UNDERWRITERS AT LLOYD'S
QLESS, INC- INSURER D:
150 S. LOS ROBLES #900 INSURER E:
PASADENA CA 91001 INSURER F:
COVERAGES CERTIFICATE NUMBER: 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 OTHFR 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.
tNSR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDY EFF MMLDCDY EXP
LTR LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
2AA314$32 5/20/2019 5/20/2020 DAMAGE TO RENED
CLAIMS-MADE � OCCUR PREMISESEaoccTurrence $ 100,000
MED EXP(Any one parson) $ 5,000
A x PERSONAL&ADV INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
V POLICY PRO-
JECT LOC PRODUCTS-CDMPlOPAGG $ 2,000,000
OTHER: $
AUTOMOBILE LIABILITY 2AA314832 5/20/2019 5/20/202 Ea aBadeptSINGLE LIMIT $
ANY AUTO BODILY INJURY(Per person) $ 11000,000
A ALL OWNED SCHEDULED X BODILY INJURY(Per accident} $ 1,000,000
AUTOS AUTOS
HIRED AUTOS
NON-OWNED PHOPE.7 DAMAGE $
AUTOS Per accident
UMBRELLA LIAR OCCUR EBU060676440 5/2 0/2 019 5/20/2020 EACH OCCURRENCE $ 81000,000
$ EXCESS LIAR HCLAIMS-MADE X AGGREGATE $ 8,000,000
DED RETENTION$ 500 $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY Y'N STATUTE I ER
ANY PROP RIETOR/PARTN ERIEXECUTIVE ❑ N f A E.L.EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under '
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
2019 11 218 29 209 C CYBER AND PROFESSIONAL X 1113246 11/ / / / $2,500,000 / $2,500,000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD IDi,Additional Remarks Schedule,may be attached if more space is required)
CITY OF MENIFEE AND ITS OFFICERS, EMPLOYEES, AGENTS, AND AUTHORIZED VOLUNTEERS,
29714 HAUN ROAD, MENIFEE, CA 92586, ARE NAMED AS ADDITIONAL INSURED WITH
PRIMARY AND NON-CONTRIBUTORY WORDING.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION SATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITR THE POLICY PROVISIONS.
CITY OF MENIFEE
29714 H.A7]N ROAD AUTHORIZED II PRESENI
MENIFEE CA 92566 / __
1988-2014 ACORD C RPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered"Marks of ACORD
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
2AA314832 AND
EBU060676440
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - PRIMARY AND NONCONTRIBUTORY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Additional Insured Person(s) or Organization(s):
CITY OF MENIFEE AND ITS OFFICERS, EMPLOYEES,AGENTS,AND AUTHORIZED VOLUNTEERS
29714 HAUN RD., MENIFEE, CA 92586
Location(s) of Covered Operations:
CITY OF MENIFEE
Description of Work Performed for the Additional Insured:
COMMERCIAL WORK
A. Section 11 - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s)
shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and
advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured at the location(s) designated in the
Schedule, but only for occurrences or coverages not otherwise excluded in the policy to which this
endorsement applies.
B. With respect to the insurance afforded to the additional insured, the following additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
1. All work, including materials, parts or equipment furnished in connection with such work, on the project
(other than service, maintenance or repairs) to be performed by or on behalf of the additional insured at the
location of the covered operations has been completed; or
2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any
person or organization other than another contractor or subcontractor engaged in performing operations
for a principal as a part of the same project.
C. The following is added to 4.a. of Other Insurance of Section IV-Commercial General Liability Conditions:
If required in a written contract, your policy is primary and noncontributory in the event of an occurrence
caused, in whole or in part, by your acts or omissions, or the acts or omissions of those acting on your behalf
that occurs while performing ongoing operations for the additional insured at the location(s) designated in the
Schedule.
All other terms and conditions of this policy remain unchanged.
L803(oelo7) Includes copyrighted material of Insurance Services Office,Inc.,with its permission.