2020/05/08 Dennis Janda, Inc. Certificate of Liability Insurance (15) ACC>R1D0 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYY"
11/04/2020
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 ATE
BELOW- THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE BY THE POLICIES
AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les)must be endorsed- It SUBROGATfON 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 endarsemunt(s).
PRODUCER CONTACT
Strachota Insurance Agency, Inc. NAME: mallonse Pettis
27710 Jefferson Ave., Ste. 100 PHONE (951) 476-2229
E#!A!L FAX No (951) 676-7391
Temecula CA 92590 ESS: meloneel3stTrachcta.rom
INSURERIMAIFFORDING COVERAGE RIUC 0
—--- -- [INSURER A:Col Insurance 39993INSURED
Dennis Janda Inc. SURER$.California Automobile Ins Co. 38342
SURERC:Qbio Securi Insurance an 24082
42164 Remington Avenue SURERO:Larx�ark 1lmrrican firssurance Ca. 33138
Temecula CA 92590 SURERE7
BlSURER F
COVERAGES CERTIFICATE NUMBER,Cert ID 13107 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE KEN 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 ADOL LTR TYPE OF INSURANCE S POLICY NUMaER max EFF wYYY MP pY-E%P LIMITS
1MMffYM
A X COMMERCIAL GENERAL UASIUYY
CLAIMS-MADEoccuR Y 103GL002584402 09/2e/2020 09 2a 20 EACH Oo OReNTFA
Rr.NCr• ; 1,000,000
FIRFMISF-SIr-marruagincell $ 100,000
MED EXP(Any uric PmGn) $ excluded
PERSONAL&ADV INJURY $ 1,000,000
GENT AGCREGA7E.LIMIT APPLIES PER GENERALAGUILGAIL $ 2,000,000
POl,1CY J RCT LOC
PROMICTS•COMPW AGO $ 2,000,000
OTl iF.R
$
AUTOMOBILE LIABILITY S70MBIN}_D$NGEE LIMIT $ 1,000,000
H ANY AUTO Y BA040000055531 11/09/202011/oB/2021 BODILY INJURY(Per person) $
ALL D
X OWNED SCHEDULE
AUTOS X AUTOS BODILY INJURY(Per nmd") $
X HIREDAUTOS X NON-OWNED PROVIllFYOAMAGL
AUTOS I�_aoodoni I $
UMBRELLA LIAR OCCUR I'-ACI I OCCURRI:NCf. $
EXCESS LIAR _ CLAIMS
,MADF A¢QiZ{=GJIIE _ 5
WORKERS COMPENSATION
C AND EMPLOYERS'LIABILITY YIN xws:56173896 07/03/2020 07/03/2021 E PER
OFt I-
ANY PROPRIETORIPAR1NERIEXECUIIVE
OFFICERIMEMBEREXCLUDED? ❑Y NIA EL EACH ACCIDENT ¢ 1000 000
(Mandatory in NH) LL DISEASE-LA L'MF4 0YE 1,000 000
rc yes,desalt under r
❑F:ECHIPIIONOF 0111-RAITONS below E L DISEASE-POLICY LIMIT 6 1,000,000
D Professional Liability LHR840112 05/08/2020 05/0e/20ZIEach Clain $ 1,000,000
Aggregate $ 2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS;VEHICLES (ACORD 101,Additional Remarks Schedule,may be■14chcd it mac space is required)
Certificate Bolder is an Additional Insured with respects to the Gcngral Liability per the attached
CC20100413 endorsement. Also an Additional Insured with respects to the Commercial Automobile per
the attar-hod bICA85100817CA endorsement_
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Manifest ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
29714 Haun Rd. � - I =( �rrdys
>senifee CA 92586
I 6
01988-2014 ACORD CORPORATION. All rights reserved.
ACORO 25(2014101) The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: 103 GL 0025844-02 COMMERCIAL GENERAL LIABILITY
CG 20 10 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following-
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location(s) Of Covered Operations
All persons or organizations as required by written As designated in written contract with the Named
contract with the Named Insured Insured
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 B. With respect to the insurance afforded to these
include as an additional insured the person(s) or additional insureds, the following additional
organization(s) shown in the Schedule, but only exclusions apply:
with respect to liability for"bodily injury", "property This insurance does not apply to"bodily injury" or
damage" or "personal and advertising injury" ng y y
caused, in whole or in part, by:
"property damage occurring after:
1. Your acts or omissions; or 1. All work, including materials, parts or
equipment furnished in connection with such
2. The acts or omissions of those acting on your work, on the project (other than service,
behalf; maintenance or repairs) to be performed by or
in the performance of your ongoing operations for on behalf of the additional insured(s) at the
the additional insured(s) at the location(s) location of the covered operations has been
designated above. completed; or
However: 2. That portion of "your work" out of which the
injury or damage arises has been put to its
1. The insurance afforded to such additional intended use by any person or organization
insured only applies to the extent permitted by other than another contractor or subcontractor
law;and engaged in performing operations for a
2. If coverage provided to the additional insured is principal as a part of the same project.
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2
C. With respect to the insurance afforded to these 2. Available under the applicable Limits of
additional insureds, the following is added to Insurance shown in the Declarations;
Section III—Limits Of Insurance: whichever is less.
If coverage provided to the additional insured is This endorsement shall not increase the
required by a contract or agreement, the most we applicable Limits of Insurance shown in the
will pay on behalf of the additional insured is the Declarations.
amount of insurance:
1. Required by the contract or agreement;or
Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 10 04 13
I
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Business Auto Broadening Endorsement
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
I. NEWLY ACQUIRED OR FORMED ENTITY (BROAD FORM NAMED INSURED)
II. EMPLOYEES AS INSUREDS
III. AUTOMATIC ADDITIONAL INSURED
IV. EMPLOYEE HIRED AUTO LIABILITY
V. SUPPLEMENTARY PAYMENTS
VI. FELLOW EMPLOYEE COVERAGE
VII. ADDITIONAL TRANSPORTATION EXPENSE
VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE
IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE
X. LOAN/LEASE GAP COVERAGE
XI. GLASS REPAIR- DEDUCTIBLE WAIVER
XII. TWO OR MORE DEDUCTIBLES
XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS
XIV. WAIVER OF SUBROGATION
XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS
XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE
XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT
XVIII, HIRED AUTO-COVERAGE TERRITORY
XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH
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BUSINESS AUTO COVERAGE FORM
I. NEWLY ACQUIRED OR FORMED ENTITY(Broad Form Named Insured)
SECTION II - LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added:
d. Any business entity newly acquired or formed by you during the policy period
provided you own 50%or more of the business entity and the business entity is not
separately insured for Business Auto Coverage. Coverage is extended up to a
maximum of 190 days following acquisition or formation of the business entity.
Coverage under this provision is afforded only until the end of the policy period.
Coverage does not apply to an "accident" which occurred before you acquired or
formed the organization.
II. EMPLOYEES AS INSUREDS
SECTION II-LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added:
e. Any "employee"of yours is an "insured" while using a covered "auto"you don't
own, hire or borrow in your business or your personal affairs.
III. AUTOMATIC ADDITIONAL INSURED
SECTION II-LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added:
f. Any person or organization that you are required to include as additional insured
on the Coverage Form in a written contract or agreement that is signed and
executed by you before the "bodily injury" or"property damage" occurs and that is
in effect during the policy period is an "insured"for Liability Coverage, but only for
damages to which this insurance applies and only to the extent that person or
organization qualifies as an "insured" under the Who Is An Insured provision
contained in Section Il.
IV. EMPLOYEE HIRED AUTO LIABILITY
SECTION II - LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added:
g. An "employee"of yours is an "insured" while operating an "auto" hired or rented
under a contract or agreement in that"employee's" name,with your permission,
while performing duties related to the conduct of your business.
V. SUPPLEMENTARY PAYMENTS
SECTION II—LIABILITY COVERAGE,A. Coverage, 2.Coverage Extensions, a. Supplementary
Payments, Subparagraphs (2) and (4)are replaced by the following:
(2) Up to$3,000 for cost of bail bonds(including bonds for related traffic law
violations) required because of an "accident" we cover. We are not obligated to
furnish these bonds.
(4) All reasonable expenses incurred by the "insured" at our request, including
actual loss of earnings up to$500 a day because of time off from work.
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VI. FELLOW EMPLOYEE COVERAGE:
SECTION II—LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee
This exclusion does not apply if you have workers'compensation insurance in-force covering all of
your"employees". Coverage is excess over any other collectible insurance.
VII. ADDITIONAL TRANSPORTATION EXPENSE
SECTION III- PHYSICAL DAMAGE COVERAGE,A. Coverage, 4. Coverage Extensions, a.Transportation
Expenses, is replaced with the following:
We will pay up to$50 per day to a maximum of$1000 for temporary transportation
expense incurred by you because of the total theft of a covered "auto" of the private
passenger type.We will pay only for those covered "autos"for which you carry either
Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary
transportation expenses incurred during the period beginning 48 hours after the theft and
ending, regardless of the policy's expiration,when the covered "auto" is returned to use or
we pay for its"loss". If your business shown in the Declarations is other than an auto
dealership, we will also pay up to$1,000 for reasonable and necessary costs incurred by
you to return a stolen covered auto from the place where it is recovered to its usual
garaging location.
Vill. HIRED AUTO PHYSICAL DAMAGE COVERAGE
SECTION III—PHYSICAL DAMAGE COVERAGE,A.Coverage,4. Coverage Extensions,the following is
added:
C. If Liability Coverage is provided in this policy on a Symbol 1 or a Symbol 8 basis and
Comprehensive,Specified Causes of Loss, or Collision coverages are provided under
this coverage form for any"auto"you own,then the Physical Damage Coverages
provided are extended to "autos"you hire,subject to the following limit:
(1) The most we will pay for"loss"to any hired "auto" is$50,000 or Actual
Cash Value or Cost of Repair, whichever is less
(2) $500 deductible will apply to any loss under this coverage extension,
except that no deductible shall apply to "loss" caused by fire or lightning
Subject to the above limit and deductible we will provide coverage equal to the
broadest coverage applicable to any covered "auto"you own of similar size and
type. This coverage extension is excess coverage over any other collectible
insurance.
IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE
SECTION III- PHYSICAL DAMAGE COVERAGE, B. Exclusions, 3.a., is amended to add the following:
This exclusion does not apply to the accidental discharge of an airbag.
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X. LOAN/LEASE GAP COVERAGE
SECTION III-PHYSICAL DAMAGE COVERAGE C. Limit of Insurance,the following is added:
4. In the event of a "total loss"to a covered "auto" shown in the schedule or declarations for
which Collision and Comprehensive Coverage apply, we will pay any unpaid amount due on
the lease or loan for that covered "auto," less:
a. The amount paid under the Physical Damage Coverage Section of the
policy; and
b. Any:
(1) Overdue lease/loan payments at the time of the "loss";
(2) Financial penalties imposed under a lease for excessive use,abnormal wear
and tear or high mileage.
(3) Security deposits not returned by the lessor;
(4) Costs for extended warranties, Credit Life Insurance, Health,Accident or
Disability Insurance purchased with the loan or lease;and
(5) Carry-over balances from previous loans or leases.
The most we will pay under Auto Loan/Lease Gap Coverage for an insured auto is 2S%of
the actual cash value of that insured auto at the time of the loss.
XI. GLASS REPAIR—DEDUCTIBLE WAIVER
SECTION III - PHYSICAL DAMAGE COVERAGE, D. Deductible,the following is added:
No deductible applies to glass damage if the glass is repaired rather than replaced.
XII. TWO OR MORE DEDUCTIBLES
SECTION III-PHYSICAL DAMAGE COVERAGE, D. Deductible,the following is added:
If two or more"company" policies or coverage forms apply to the same accident:
1. If the applicable Business Auto deductible is the smallest, it will be waived; or
2. If the applicable Business Auto deductible is not the smallest, it will be reduced by
the amount of the smallest deductible; or
3. If the loss involves two or more Business Auto coverage forms or policies the
smallest deductible will be waived.
For the purpose of this endorsement "company" means the company providing this
insurance and any of the affiliated members of the Mercury Insurance Group of companies.
XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM,SUIT OR LOSS
The requirement in SECTION IV, BUSINESS AUTO CONDITIONS,A. Loss Conditions, 2. Duties In The
Event Of Accident, Claim,Suit,Or Loss, a., In the event of"accident",you must notify us of an
"accident" applies only when the "accident" is known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) A member, if you are a limited liability company; or
(4) An executive officer or insurance manager, if you are a corporation.
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XIV. WAIVER OF SUBROGATION
SECTION IV-BUSINESS AUTO CONDITIONS,A. Loss Conditions, 5.Transfer of Rights Of Recovery
Against Others To Us,section is replaced by the following:
5. Transfer Of Rights Of Recovery Against Others To Us
We waive any right of recovery we may have against any person or organization to
the extent required of you by a written contract executed prior to any"accident" or
"loss", provided that the "accident"or"loss" arises out of the operations
contemplated by such contract.The waiver applies only to the person or
organization designated in such contract.
XV. UNINTENTIONAL ERROR,OMISSION,OR FAILURE TO DISCLOSE HAZARDS
SECTION IV- BUSINESS AUTO CONDITIONS, B. General Conditions, 2.Concealment,
Misrepresentation, or Fraud,the following is added:
Any unintentional omission of or error in information given by you,or unintentional failure
to disclose all exposures or hazards existing as of the effective date or at any time during
the policy period shall not invalidate or adversely affect the coverage for such exposure or
hazard or prejudice your rights under this insurance. However,you must report the
undisclosed exposure or hazard to us as soon as reasonably possible after its discovery.
This provision does not affect our right to collect additional premium or exercise our right
of cancellation or non-renewal.
XVL EMPLOYEE HIRED AUTO PHYSICAL DAMAGE
SECTION IV—BUSINESS AUTO CONDITIONS, B.General Conditions, S. Other Insurance, b. For Hired
Auto Physical Damage Coverage, is replaced by the following:
b. For Hired Auto Physical Damage Coverage,the following are deemed to be covered
"autos" you own:
1. Any covered "auto"you lease, hire, rent or borrow; and
2. Any covered "auto" hired or rented by your"employee" under a contract in
that individual "employee's" name,with your permission, while performing
duties related to the conduct of your business.
However,any"auto"that is leased, hired, rented or borrowed with a driver is not a covered
"auto".
XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT
SECTION IV—BUSINESS AUTO CONDITIONS, B. General Conditions, S. Other Insurance,the
following is added and supersedes any provision to the contrary:
e. This insurance is primary to and will not seek contribution from any other insurance
available to an additional insured under your policy provided that:
(1) The additional insured is a Named Insured under such other insurance; and
(2) You have agreed in writing in a contract or agreement that this insurance
would be primary and would not seek contribution from any other
insurance available to the additional insured.
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XVIII. HIRED AUTO-COVERAGE TERRITORY
SECTION IV- BUSINESS AUTO CONDITIONS, B. General Conditions, 7. Policy Period,Coverage
Territory, e. Anywhere in the world if:, is replaced by the following:
e. Anywhere in the world if:
(1) A covered "auto" is leased, hired, rented or borrowed without a driver for a
period of 30 days or less; and
(2) The "insured's" responsibility to pay damages is determined in a "suit"on
the merits, in the United States of America,the territories and possessions
of the United States of America, Puerto Rico,or Canada or in a settlement
we agree to.
XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH
SECTION V—DEFINITIONS, C. "Bodily Injury" is amended by adding the following:
"Bodily injury" also includes mental anguish but only when the mental anguish arises from
other bodily injury, sickness,or disease.
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