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2020/08/11 Visionaries Image Company, LLC (4)
ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 3/17/2021 License # 0633339 (310) 373-6441 244 (310) 378-5336 11000 Visionaries Image Company LLC 4263 South Glacier Trail Ontario, CA 91762 35076 18058 A 1,000,000 X 72SBABA6242 8/11/2020 8/11/2021 1,000,000 10,000 1,000,000 2,000,000 2,000,000 1,000,000A 72SBABA6242 8/11/2020 8/11/2021 B 9277351 7/1/2020 7/1/2021 1,000,000 1,000,000 1,000,000 C Professional Liab.X PHSD1566716 8/11/2020 PER CLAIM 1,000,000 City and its officers, employees, agents, and authorized volunteers are GL additional insured on primary non-contributory basis with waiver of subrogation as required by written contract or agreement per policy form SS00080405 & Professional liability additional insured applies per policy form PI-PLSP-179-09/11. *Policy Terms Apply. City of Menifee 29714 Haun Road Menifee, CA 92586 VISIIMA-01 VLUNA Olson Duncan Insurance Service Inc. 25550 Hawthorne Blvd. Suite 203 Torrance, CA 90505 Vanessa Luna vanessa@olsonduncan.com Sentinel Insurance Company LTD State Comp Ins Fund Philadelphia Indemnity Ins Co X 8/11/2021 X X X X X PI-PLSP-179 (09/11) Page of This endorsement modifies and is subject to the insurance provided under the following: The policy is amended as follows: shall include the person(s)/entity(ies) named in the endorsement , but only for the wrongful acts of the or any . It is agreed that the insurance provided to the person(s)/entity(ies) listed in the endorsement shall be primary and non-contributory, but only with respect to caused, in whole or in part, by: The or acts or omissions; or The acts or omissions of those acting on the or behalf; In the performance of ongoing operations for the person(s)/entity(ies) listed in the endorsement . BUSINESS LIABILITY COVERAGE FORM 3.Additional Insured -Grantor Of FranchiseF.OPTIONAL ADDITIONAL INSURED C.WHO IS AN INSURED under Section isCOVERAGES amended to include as an additional insuredIf listed or shown as applicable in the Declarations,the person(s)or organization(s)shown in theoneormoreofthefollowingOptionalAdditionalDeclarationsasanAdditionalInsured-Insured Coverages also apply. When any of these Grantor Of Franchise,but only with respect toOptionalAdditionalInsuredCoveragesapply,their liability as grantor of franchise to you.6.Paragraph (Additional Insureds When Required 4.Additional Insured -Lessor Of LeasedbyWrittenContract,Written Agreement or Permit)EquipmentC.of Section ,Who Is An Insured,does not apply to the person or organization shown in the a.C.WHO IS AN INSURED under Section isDeclarations.These coverages are subject to the amended to include as an additionaltermsandconditionsapplicabletoBusinessinsuredtheperson(s)or organization(s)Liability Coverage in this policy,except as shown in the Declarations as an Additionalprovided below:Insured –Lessor of Leased Equipment, but only with respect to liability for "bodily1.Additional Insured -Designated Person Or injury","property damage"or "personalOrganization and advertising injury"caused,in whole orC.WHO IS AN INSURED under Section is in part,by your maintenance,operation oramendedtoincludeasanadditionalinsureduseofequipmentleasedtoyoubysuchtheperson(s)or organization(s)shown in the person(s)or organization(s).Declarations,but only with respect to liability b.With respect to the insurance afforded tofor"bodily injury","property damage"or these additional insureds,this insurance"personal and advertising injury"caused,in does not apply to any "occurrence"whichwholeorinpart,by your acts or omissions or takes place after you cease to lease thattheactsoromissionsofthoseactingonyour equipment.behalf: 5.Additional Insured -Owners Or Othera.In the performance of your ongoing Interests From Whom Land Has Beenoperations; or Leasedb.In connection with your premises owned a.C.WHO IS AN INSURED under Section isbyor rented to you. amended to include as an additional2.Additional Insured -Managers Or Lessors insured the person(s)or organization(s)Of Premises shown in the Declarations as an Additionala.C.WHO IS AN INSURED under Section is Insured – Owners Or Other Interests FromamendedtoincludeasanadditionalinsuredWhomLandHasBeenLeased,but onlythe person(s) or organization(s)shown in the with respect to liability arising out of theDeclarationsasanAdditionalInsured-ownership, maintenance or use of that partDesignatedPersonOrOrganization;but only of the land leased to you and shown in thewithrespecttoliabilityarisingoutoftheDeclarations.ownership,maintenance or use of that part of b.With respect to the insurance afforded tothe premises leased to you and shown in the these additional insureds,the followingDeclarations.additional exclusions apply:b.With respect to the insurance afforded to This insurance does not apply to:these additional insureds,the following (1)Any "occurrence"that takes placeadditionalexclusions apply: after you cease to lease that land;orThisinsurancedoes not apply to: (2)Structural alterations,new(1)Any "occurrence"which takes place construction or demolition operationsafteryouceasetobeatenantinthatperformedbyoronbehalfofsuchpremises; or person or organization.(2)Structural alterations,new 6.Additional Insured -State Or PoliticalconstructionordemolitionoperationsSubdivision–Permitsperformedbyoronbehalfofsuch a.C.WHO IS AN INSURED under Section ispersonor organization. amended to include as an additional insured the state or political subdivision shown in the Declarations as an Additional Page 18 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (e)Insured –State Or Political Subdivision -Any failure to make such Permits,but only with respect to inspections,adjustments,tests or operations performed by you or on your servicing as the vendor has agreed behalf for which the state or political to make or normally undertakes to subdivision has issued a permit.make in the usual course of business,in connection with theb.With respect to the insurance afforded to distribution or sale of the products;these additional insureds,the following (f)Demonstration,installation,additional exclusions apply: servicing or repair operations,This insurance does not apply to:except such operations performed(1)"Bodily injury","property damage"or at the vendor's premises in"personal and advertising injury"connection with the sale of thearisingoutofoperationsperformedforproduct;the state or municipality;or (g)Products which,after distribution(2)"Bodily injury"or "property damage"or sale by you,have been labeledincludedinthe"product-completed or relabeled or used as aoperations"hazard.container,part or ingredient of any 7.Additional Insured –Vendors other thing or substance by or for the vendor; ora.C.WHO IS AN INSURED under Section is amended to include as an additional (h)"Bodily injury"or "property insured the person(s)or organization(s)damage"arising out of the sole (referred to below as vendor)shown in the negligence of the vendor for its Declarations as an Additional Insured -own acts or omissions or those of Vendor,but only with respect to "bodily its employees or anyone else injury"or "property damage"arising out of acting on its behalf. However, this "your products"which are distributed or exclusion does not apply to: sold in the regular course of the vendor's (i)The exceptions contained inbusinessandonlyifthisCoveragePart(d)(f)Subparagraphs or ;orprovidescoveragefor"bodily injury"or (ii)Such inspections,"property damage"included within the adjustments,tests or servicing"products-completed operations hazard".as the vendor has agreed tob.The insurance afforded to the vendor is make or normally undertakessubjecttothefollowingadditionalexclusions:to make in the usual course of (1)This insurance does not apply to:business,in connection with the distribution or sale of the(a)"Bodily injury"or "property products.damage"for which the vendor is obligated to pay damages by (2)This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contract or agreement.whom you have acquired such This exclusion does not apply to products,or any ingredient,part or liability for damages that the container,entering into, vendor would have in the absence accompanying or containing such of the contract or agreement;products. (b)Any express warranty 8.Additional Insured –Controlling Interest unauthorized by you;C.WHO IS AN INSURED under Section is (c)Any physical or chemical change amended to include as an additional insured in the product made intentionally the person(s)or organization(s)shown in the by the vendor;Declarations as an Additional Insured – Controlling Interest,but only with respect to(d)Repackaging,unless unpacked their liability arising out of:solely for the purpose of inspection, demonstration,testing,or the a.Their financial control of you;or substitution of parts under b.Premises they own,maintain or controlinstructionsfromthemanufacturer,while you lease or occupy these premises.and then repackaged in the original container; Form SS 00 08 04 05 Page 19 of 24 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural The limits of insurance that apply to additional D.alterations,new construction and demolition insureds are described in Section –Limits Of operations performed by or for that person or Insurance. organization.How this insurance applies when other insurance 9.Additional Insured –Owners,Lessees Or is available to an additional insured is described in Contractors –Scheduled Person Or E.the Other Insurance Condition in Section – Organization Liability And Medical Expenses General Conditions.a.C.WHO IS AN INSURED under Section is amended to include as an additional G.LIABILITY AND MEDICAL EXPENSESinsuredtheperson(s)or organization(s)DEFINITIONSshown in the Declarations as an Additional 1."Advertisement"means the widespread publicInsured–Owner,Lessees Or Contractors,dissemination of information or images thatbutonlywithrespecttoliabilityfor"bodily has the purpose of inducing the sale of goods,injury","property damage"or "personal products or services through:and advertising injury"caused,in whole or in part,by your acts or omissions or the a.(1)Radio; acts or omissions of those acting on your (2)Television;behalf:(3)Billboard;(1)In the performance of your ongoing (4)Magazine;operations for the additional (5)Newspaper;insured(s);or b.The Internet,but only that part of a web(2)In connection with "your work"site that is about goods,products orperformedforthatadditionalinsuredservicesforthepurposesofinducingtheandincludedwithinthe"products-sale of goods, products or services; orcompletedoperationshazard",but c.Any other publication that is givenonlyifthisCoveragePartprovides widespread public distribution.coverage for "bodily injury"or "property damage"included within the However, "advertisement"does not include:"products-completed operations a.The design,printed material,informationhazard".or images contained in,on or upon theb.With respect to the insurance afforded to packaging or labeling of any goods ortheseadditionalinsureds,this insurance products;ordoesnotapplyto"bodily injury","property b.An interactive conversation between ordamage"or "personal an advertising among persons through a computer network.injury"arising out of the rendering of,or 2."Advertising idea"means any idea for anthefailuretorender,any professional "advertisement".architectural,engineering or surveying services,including:3."Asbestos hazard"means an exposure or threat of exposure to the actual or alleged(1)The preparing,approving,or failure to properties of asbestos and includes the mereprepareorapprove,maps,shop presence of asbestos in any form.drawings,opinions,reports,surveys, field orders, change orders, designs or 4."Auto"means a land motor vehicle,trailer ordrawings and specifications; or semi-trailer designed for travel on public roads,including any attached machinery or(2)Supervisory,inspection,architectural equipment.But "auto"does not includeorengineering activities. "mobile equipment".10.Additional Insured –Co-Owner Of Insured 5."Bodily injury" means physical:Premises a.Injury;C.WHO IS AN INSURED under Section is amended to include as an additional insured b.Sickness; ortheperson(s)or Organization(s)shown in the c.DiseaseDeclarationsasanAdditionalInsured–Co-sustained by a person and,if arising out of theOwnerOfInsuredPremises,but only with above, mental anguish or death at any time.respect to their liability as co-owner of the premises shown in the Declarations.6."Coverage territory"means: Page 20 of 24 Form SS 00 08 04 05