Loading...
2015/08/14 DHS Consulting, Inc. Certificate of Liability Insurance (3)ACORD® CERTIFICATE OF LIABILITY INSURANCE /YYYY) =8/3/2016 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). PRODUCER Risk Strategies Company CONTACT NAME: Risk Strategies Com an PHO N E 949 242-9240 AC No: 2040 Main Street, Suite 450 Irvine, CA 92614 E-MAIL ADDRESS: syounq@risk-strategies.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Citizens Insurance Co. of America 31534 www.risk-strategies.com CA DO[ License No. OF06675 INSURED DHS Consulting, Inc. 2000 E. 4th Street, Suite 320 INSURER B : Travelers Property & Casualty Co. of America 25674 INsuRERc: Continental Casualty Co. 20443 INSURERD: Santa Ana CA 92705 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER_ g19nc;1RR 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A V COMMERCIAL GENERAL LIABILITY ✓ OB3A696329 8/14/2015 8/14/2016 EACH OCCURRENCE $ $2,000,000 CLAIMS -MADE 7 OCCUR DAMAGE TO RENTE PREMISES (Ea occur ence) $ $1,000,000 MED EXP (Any one person) $ $5,000 PERSONAL & ADV INJURY $ $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ $4,000,000 POLICY ✓� JERT LOC PRODUCTS - COMP/OP AGG $ $4,000,000 $ OTHER: A AUTOMOBILE LIABILITY OB3A696329 8/14/2015 8/14/2016 INED EOa icccd..,) SINGLE LIMIT $ $2,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOSHIRED BODILY INJURY (Per accident) $ Perr ciPR denDAMAGE $ ✓ AUTOS ONLY ✓ AUOTO ONLDY A ✓ UMBRELLA LIAB OCCUR OB3A696329 8/14/2015 8/14/2016 EACH OCCURRENCE $ $6 000,000 H AGGREGATE $ $6,000,000 EXCESS LIAR CLAIMS -MADE DED I ✓ I RETENTION $0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBEREXCLUDED? (Mandatory in NH) N/A ✓ UB4483T58 8/14/2015 8/14/2016 ,/ STATUTE EERH E.L. EACH ACCIDENT $ $1,000,000 E.L. DISEASE - EA EMPLOYEE $ $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ $1,000,000 C Professional Liability MCH591891686 8/14/2015 8/14/2016 Per Claim: $2,000,000 Aggregate: $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Projects as on file with the insured including but not limited to Newport Road Rehabilitation from Bradley Road to Murrieta Road.. City of Menifee and its officers, officials, employees, and authorized volunteers are named as additional insureds and primary/non-contributory clause applies to the general liability policy and a waiver of subrogation applies to the work comp policy -see attached endorsements. Prof Liab Retro Date: Full Prior Acts; Prof Liab Ded: $10,000 per claim CERTIFICATE HOLDER CANCELLATION Cityy of Menifee 29714 Haun Rd. Menifee CA 92586 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Michael Christian @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 312C5188 1 15-15 GL-HNOA-JL-WC-PL I Sherry Young 1 8/3/20.5 9:47:23 AM (PDT) I Page 1 of 5 POLICY NO.:OB3A696329 INSURED: DHS Consulting, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY SUPPLEMENTARY ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM I. Additional Insured by Contract, Agreement or Permit Under SECTION II — LIABILITY, C. Who Is An Insured, Paragraph 4. is added as follows: a. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract, agreement or permit that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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, but only with respect to: (3) "Your work" for the additional insured(s) at the location designated in the contract, agreement or permit; or (4) Premises you own, rent, lease, control or occupy. This insurance applies on a primary basis if that is required by the written contract, agreement or permit. b. This provision does not apply: (1) Unless the written contract or written agreement has been executed or permit has been issued prior to the "bodily injury", "property damage" or "personal and advertising injury'; (2) To any person or organization included as an insured by an endorsement issued by us and made part of this Policy; (3) To any lessor of equipment: (a) After the equipment lease expires; or (b) If the "bodily injury", "property damage" or "personal and advertising injury" arises out of the sole negligence of the lessor; (4) To any: (a) Owners or other interests from whom land has been leased which takes place after the lease for that land expires; or (b) Managers or lessors of premises if: (i) The occurrence takes place after you cease to be a tenant in that premises; or (ii) The "bodily injury', "property damage" or .personal and advertising injury" arises out of structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor; or (5) To "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services. This includes but is not limited to any professional services as an architect or engineer arising out of any construction agreement or activities under which any insured or anyone acting on any insured's behalf provides or provided service, advice, expertise or work. Construction includes, but is not limited to, the plan, conception, design, build, construct, assembly, development, safety, erection, formation, reconstruct, rehabilitation, repair, or any improvement made to real property. Construction also includes the hiring, supervision or management of any of these activities. However, this exclusion does not apply to liability arising out of an insured's presence at a jobsite that was not caused by professional activities listed in the above paragraph. c. Additional insured coverage provided by this provision will not be broader than coverage provided to any other insured. d. All other insuring agreements, exclusions, and conditions of the policy apply. II. Additional Insured by Contract, Agreement or Permit — Primary and Non-contributory The following is added to SECTION III — COMMON POLICY CONDITIONS: M. Other Insurance 1. Additional Insureds If you agree in a written contract, written agreement or permit that the insurance provided to any person or organization included as an Additional Insured under SECTION II - LIABILITY, Part C — Who is An Insured, is primary and non-contributory, the following applies: 391-1586 02 11 Includes copyrighted material of Insurance Services Offices, Inc., with its permission Page 1 of 3 312C5188 1 15-16 GL-HNGA-:1L-WC-PL I Sherry Young 1 8/3/20:6 8:47:2J AM (PDT) I Page 2 of 5 If other valid and collectible insurance is When this insurance is excess, we will have available to the Additional Insured for a loss no duty under SECTION II — LIABILITY, we cover under SECTION II — LIABILITY, Part A. Coverages, 1. Business Liability to Part A. Coverages, Paragraph 1., Business defend the insured against any "suit" if any Liability our obligations are limited as other insurer has a duty to defend the follows: insured against that "suit". If no other insurer a. Primary Insurance defends, we will undertake to do so, but we will be entitled to the insured's rights against This insurance is primary to other all those other insurers. insurance that is available to the Additional Insured which covers the When this insurance is excess over other Additional Insured as a Named Insured. insurance, we will pay only our share of the amount of the loss, if any, that exceeds the We will not seek contribution from any sum of: other insurance available to the (1) The total amount that all such other Additional Insured except: insurance would pay for the loss in the (1) For the sole negligence of the absence of this insurance; and Additional Insured; (2) The total of all deductible and self - (2) When the Additional Insured is an insured amounts under all that other Additional Insured under another primary liability policy; or insurance. (3) When b.(2) below applies. We will share the remaining loss, if any, with any other insurance that is not described in If this insurance is primary, our this Excess Insurance provision and was not obligations are not affected unless bought specifically to apply in excess of the any of the other insurance is also Limits of Insurance shown in the primary. Then, we will share with all Declarations of this Coverage Part. that other insurance by the method described in b.(3) below. C. Method Of Sharing b. Excess Insurance If all of the other insurance permits contribution by equal shares, we will follow this method also. This insurance is excess over: Under this approach each insurer contributes (1) Any of the other insurance, whether equal amounts until it has paid its applicable limit primary, excess, contingent or on of insurance or none of the loss remains, any other basis: whichever comes first. (a) That is Fire, Extended If any of the other insurance does not permit Coverage, Builder's Risk, contribution by equal shares, we will contribute Installation Risk or similar by limits. Under this method, each insurer's share coverage for "your work"; is based on the ratio of its applicable limit of (b) That is Fire insurance for insurance to the total applicable limits of premises rented to the insurance of all insurers. Additional Insured or III. Aggregate Limit of Insurance (Per Project) temporarily occupied by the a. For purposes of the coverage provided by this Additional Insured with endorsement, D. Liability and Medical permission of the owner; Expenses Limits of Insurance under Section 11 (c) That is insurance purchased by — Liability is amended by adding the following: the Additional Insured to cover The General Aggregate Limit under D. Liability the Additional Insured's liability and Medical Expenses Limits of Insurance as a tenant for "property applies separately to each of "your projects" or damage" to premises rented to each location listed in the Declarations. the Additional Insured or temporarily occupied by the b. For purposes of the coverage provided by this Additional Insured with endorsement F. Liability And Medical permission of the owner; or Expenses Definitions under Section II - Liability is amended by adding the following: (d) If the loss arises out of the maintenance or use of aircraft, a. "Your project" means: "autos" or watercraft to the I. Any premises, site or location at, on, or extent not subject to Exclusion in which "your work" is not yet g. of SECTION II — LIABILITY, completed; and Part A. Coverages, 1. ii. Does not include any location listed in Business Liability. the Declarations. 391-1586 02 11 Includes copyrighted material of Insurance Services Offices, Inc., with its permission Page 2 of 3 312C5188 1 15-16 GL-HNOA-JL-WC-PL I Sherry Young 1 8/3/20:6 8:47:2J AM )PDT) I Page 3 o: 5 IV. Blanket Waiver of Subrogation Paragraph K. Transfer Of Rights Of Recovery Against Others To Us in Section III — Common Policy Conditions is amended by the addition of the following: We will waive any right of recovery we may have against any person or organization when you have agreed in a written contract, permit or agreement to waive any rights of recovery against such person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". 391-1586 02 11 Includes copyrighted material of Insurance Services Offices, Inc., with its permission Page 3 of 3 31205188 1 15-16 GL-HNOA-JL-KC-PL I Sherry Young 1 8/3/20-6 8:47:20 AM (PDT) I Page 4 of 5 TRAVELERS Insured: DHS Consulting, Inc. Policy No.: U64483T58 Effective Date: 8/14/2015 WORKERS COMPENSATION AND EMPLOYERS LIABILITY ENDORSEMENT WC 99 03 76 (00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 5.000% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization ANY PERSON OR ORGANIZATION WITH WHOM YOU AGREE IN WRITING TO WAIVE YOUR RIGHT TO RECOVER AGAINST THEM. YOU MUST AGREE TO THIS WAIVER PRIOR TO THE DATE OF LOSS Job Description: Projects as on file with the insured. Authorized Representative 312C5188 1 15-16 GL-HNGA-JL-NC-PL I Sherry Young 1 8/3/20-6 8:47:2) AM (PDT) I Page 5 of 5