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2018/03/12 Social Work Action Group Certicate of Liability Insurance CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/16/2018 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 NAME: Hiscox Inc.d/b/a/Hiscox Insurance Agency in CA AICNNo Ell: (888)202-3007 AIC No: 520 Madison Avenue E-MAIL ADDRESS: contact@hiscox.com 32nd Floor INSURERS AFFORDING COVERAGE NAIC# New York,NY 10022 INSURERA: Hiscox Insurance Company Inc 10200 INSURED INSURER B: Social Work Action Group INSURER C: 4055 Jurupa Ave Rm 25 INSURER D: INSURER E: Riverside CA 92506 INSURERF: 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 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 I ADDL SUBR LTR TYPE OF INSURANCE p POLICY NUMBER MM/POLICY EFF MM/DD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 X CGL is on BOP Form MED EXP(Any one person) $ 5,000 A Y UDC-2198811-BOP-18 03/12/2018 03/12/2019 PERSONAL&ADV INJURY $ S/T Each Occ. GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑ PRO- JECT LOC PRODUCTS-COMP/OP AGG $ S/T Gen.Agg. OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL p AUTOS AUTOS AUTOSSCHEDULED UDC-2198811-BOP-18 03/12/2018 03/12/2019 BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Homeless Outreach Services CERTIFICATE HOLDER CANCELLATION City of Menifee 29714 Haun Rd SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Menifee,CA 92586 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AC®® CERTIFICATE OF LIABILITY INSURANCE DATE{MNUDDfYYYY) 11/13/18 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 s 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 NAME Hiscox Inc. PHONE 888-202-3007 FA No Ftl- X Nn: r 520 Madison Avenue,32nd Floor E-MAIL contact@hiscox.com New York,NY 10022 INSURERMAFFORDING COVERAGE NAIL 0 INSURER A: Hiscox Insurance Company Inc. 10200 INSURED INSURER B: _ Social Work Action Group INSURER C: 4055 Jurupa Ave Rm 25 INSURER D: _ Riverside,CA 92506 INSURER E: 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 E INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS z 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY) (MM1DDNYYYJ LIMITS g GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY PREMISES Ee occurrence S G CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ ) GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG S POLICY EO LOC S d AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S ANY AUTO BODILY INJURY(Par person)_ $ ALL OWNED SCHEDULED BODILY INJURY(Per $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE 5 HIRED AUTOS AUTOS Peraccide $ nl S a UMBRELLA LIARHCLAIMS-MADE OCCUR EACH OCCURRENCE $ EXCESS LIAB AGGREGATE $ I DED RETENTIONS g WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNEIVEXECUTIVE YIN E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLu0E02 NIA UDC-0000141WC00 03/09/18 03/09/19 - (MandatM In NH)If yes,describe under E.L.DISEASE-EA EMPLOYEE 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 1 8 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) e i II a z z s CERTIFICATE HOLDER CANCELLATION 1 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City ofMenifee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29714 Haun Rd ACCORDANCE WITH THE POLICY PROVISIONS. Menifee,CA 92586 AUTHORIZED REPRESENTATIVE ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD 'S