Loading...
2019/12/31 RSI COmmunities LLC Certicate of Liability Insurance -�1 ,�►coRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/31/2020 12/27/2019 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 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). CONTACT PRODUCER Lockton Insurance Brokers,LLC oAm 19800 MacArthur Blvd.,Suite 1250 A/C.No.Et): WG.Na CA License#OF15767 E-MAIL Irvine 92612 ADDRESSz 949-252-4400 INSURERIS)AFFORDING COVERAGE NAIC INSURER A: Navigators SEecialty Insurance Company— 36056 INSURED RSI Communities LLC INSURER B: Underwriters at Lloyds of London 10736 1065979 680 Newport Center Drive,3rd Floor INSURER C: Huston Casualty Cornvany42374 Newport Beach CA 92660 N RER D• Evanston Insurance Company 35378 N URE COVERAGES W11.1Y(12 CERTIFICATE NUMBER: 16 97634 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ADDL SURR POLICY NUMBER POLICY EFF AOUCYEXP LIMITS LTRA X COMMERCIAL GENERAL LIABILITY Y N CE19CGLZ03UJVIC 12/31/2019 12/31/2020 EACH OCCURRENCE s 2,000,000 CLAIMS-MADE FRIOCCUR OAIIA E r1,R EN7EL7 Excluded srr. X SIR:S250-000 INED EXP(Any oneperson) Excluded PERSONAL&ADV INJURY s 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY SEC LOC PRODUCTS-COMP/OP AGG $ 2000,000 OTHER:SIR$500k $ AUTOMOBILE LIABILITY COMSiNED SINGLE LIMIT $ XXXXXXX ANY AUTO NOT APPLICABLE 130DILY INJURY(Per person) $ XXX'XXN_X AUTOS ONLY SCHEDULED 130DILY INJURY(Per accident $ XXXXXXX AUTOS ONLY NON-OWNED OS ONLY PROPERTY DAMAGE II $ XIXXX= $ _ B UMBRELLA LIAB X OCCUR N N B0595XN6134019 12/31/2019 12/31/2020 EACH OCCURRENCE $ 3,000,000 X EXCESS LIAR CLAIMS-MADE .AGGREGATE $ 3,000,000 DED I X I RETENTION$500,000 $ XXXXXXX WORKERS COMPENSATION PEA 01H- AND EMPLOYERS'LIABILITY Y/N NOT APPLICABLE STATUTE FR ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A IE.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? pv�p (Mandatory in NH) IE XXXXXXX -L.DISEASE-EA EMPLOYEE If yes,describe under XXXXXXX DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT C 2nd Excess N N H19XC51236-00 12/31/2019 12/31/2020 $5M Occ/$5M Agg D 3rd Excess MKLV6XL30000200 12/31/2019 12/31/2020 $5M Occ/$5M Agg C 4th Excess H19XC51237-00 12/31/2019 12/31/2020 $51V Occ/$5M Agg DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Encroachment permit.City of Menifee is an Additional Insured(s)as per the attached endorsement or policy language. CERTIFICATE HOLDER CANCELLATION See Attachment city/ een1-71 ,,,, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 16397634 AUTHORIZED REPRESENTATIVE City of Menifee 29714 Haun Road Receivedf� Menifee CA 92586 IAM?,�Al— ACORD 25(2016/03) @1A8.201&-AC0f1D C RPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD Attachment Code :D516084 Certificate ID : 16397634 POLICY NUMBER: CE19CGLZ03UJVIC COMMERCIAL GENERAL LIABILITY CG20120413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any State Or Political Subdivision where required by written contract. 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 2. This insurance does not apply to: include as an additional insured any state or a. "Bodily injury", "property damage"or governmental agency or subdivision or political "personal and advertising injury"arising —_ subdivision shown in the Schedule, subject to out of operations performed for the the following provisions: federal government, state or 1. This insurance applies only with respect to --- municipality; or operations performed by you or on your b. "Bodily injury"or"property damage" —_ behalf for which the state or governmental included within the"products-completed agency or subdivision or political subdivision operations hazard". has issued a permit or authorization. C. With respect to the insurance afforded to these However: additional insureds,the following is added to a. The insurance afforded to such Section III -Limits Of Insurance: additional insured only applies to the If coverage provided to the additional insured is extent permitted by law; and required by a contract or agreement, the most b. If coverage provided to the additional we will pay on behalf of the additional insured is insured is required by a contract or the amount of insurance: agreement,the insurance afforded to 1. Required by the contract or agreement; or such additional insured will not be 2. Available under the applicable Limits of broader than that which you are Insurance shown in the Declarations; required by the contract or agreement whichever is less. to provide for such additional insured. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1