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2019/11/08 Dennis Janda, Inc. Certificate of Liability InsuranceDocuSign Envelope ID: 2D796F2D-B2CB-4BE4-9C6E-B9991097063D / A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 09/29/2020 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 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 Strachota Insurance Agency, Inc. 27710 Jefferson Ave., Ste. 100 CONTACT NAME: PHONE FAX Alc No Ext: (951) 676-2229 plc No: (951) 676-7391 E-MAIL melonee@strachota.com ADDRESS: Temecula CA 92590 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Colony Insurance Company 39993 INSURED Dennis Janda Inc. INSURER B: California Automobile Ins Co. 38342 INSURER C: Ohio Security Insurance Company 24082 INSURERD:Landmark American Insurance Co. 33138 42164 Remington Avenue INSURERE: Temecula CA 92590 INSURER F : COVERAGES CERTIFICATE NUMBER: Cert ID 12935 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 � OCCUR Y 103GL002584402 09/28/2020 09/28/2021 ETORENTED DAMACLAIMS-MADE PREMISES ccurrence PREMISES Ea occurrence) $ 100,000 MED EXP (Any one person) $ excluded PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE� LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO Y BA040000055531 11/08/2019 11/08/2020 ALL OWNED X SCHEDULED AUTOS AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ C AND EMPLOYERS' LIABILITY WORKERS COMPENSATION Y/N XWS56173896 07/03/2020 07/03/2021 X STATUTE OERH ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 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 D Professional Liability LHR840112 05/08/2020 05/08/2021 Each Claim $ 1,000,000 Aggregate $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Menifee, its officers, agents and employees are an Additional Insured with respects to the General Liability per the attached CG20100413 endorsement. Also an Additional Insured with respects to the Commercial Automobile per the attached MCA85100817CA endorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Menifee 29714 Haun Road AUTHORIZED REPRESENTATIVE Menifee CA 92586 k��� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Page 1 of 1 DocuSign Envelope ID: 2D796F2D-B2CB-4BE4-9C6E-B9991097063D POLICY NUMBER: 103 GL 0025844-02 COMMERCIAL GENERAL LIABILITY CG20100413 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. 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(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is 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. With respect to the insurance afforded to these additional insureds, 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(s) 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. CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 DocuSign Envelope ID: 2D796F2D-B2CB-4BE4-9C6E-B9991097063D C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 DocuSign Envelope ID: 2D796F2D-B2CB-4BE4-9C6E-B9991097063D POLICY NUMBER: 103 GL 0025844-012 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations All persons or organizations as required by written As designated in written contract with the Named Insured contract with the Named 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is 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. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 DocuSign Envelope ID: 2D796F2D-B2CB-4BE4-9C6E-B9991097063D From: Margarita Corneio To: Paula Muratore Subject: FW: Agreement Review Request: Professional Services Agreement with Dennis Janda for CIP 21-14 for Topographical Survey Date: Wednesday, October 21, 2020 11:12:49 AM Attachments: 2021 PW-ENG -PROFESSIONAL SERVICES AGREEMENT (DENNIS JANDA) (CIP 21-14 SURVEY).docx From: Margarita Cornejo Sent: Wednesday, October 21, 2020 11:12 AM To: Jeffery T. Melching <jmelching@rutan.com> Subject: Agreement Review Request: Professional Services Agreement with Dennis Janda for CIP 21- 14 for Topographical Survey Good Afternoon Jeff, Attached for your review is the proposed Professional Services Agreement with Dennis Janda for Topographic Survey for CIP 21-14 (Ashdale Way Drainage). This agreement request is from the City's Public Works/Engineering Department. Can you please review and advise if this is ok to start routing for signatures or will require any changes? Thank you again! Margarita Cornejo Financial Services Manager Finance Department City of Menifee 1 29844 Haun Road I Menifee, CA 92586 (*Please note our new location!) Direct: (951) 723-3716 1 City Hall: (951) 672-6777 1 Fax: (951) 679-2568 �NhFEE, r-., A& MENIFEE New. Better. Blest. Connect with us on social media: f '0191in