2021/03/01 Rutan & Tucker, LLPpage 2 of 5
Client#: 1257796 305RUTANTUC
DATE (MM/DDNYYY)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 13/01/2021
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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCERNTACT
ANME: LOCI McNay _
McGrlff Insurance Services oNE 714 941 -2815 KA5[
2400 E Katella Ave Suite 1100 E, E")` 1A{D, No):
ADDRESS: LMeNay@Mcgilff•com
Anaheim, CA 92806 - I ---
INSURER(S) AFFORDING COVERAGE NAIC q
714 941-2800 Federal Insurance Company INSURER p : P Y 20281
INSURED
INSURER B.-
Rutan & Tucker LLP
18575 Jamboree Rd., 9th Floor
Irvine, CA 92612-1998
INSURER C:;
INSURER D
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES
INDICATED. NOTWITHSTANDING ANY REQUIREMENT.
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
EXCLUSIONS AND CONDITIONS OF SUCH
]NSft
LTR TYPE OF INSURANCE
A X COMMERCIALGENERALLIABILITY
CLAIMS -MADE n OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
_ POLICY Li SECT I� LOC
_ OTHER: _ _
A AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY _ AUTOS
HIRED NON -OWNED
X AUTOS ONLY X AUTOS ONLY
A x UMBRELLA LIAB X OCCUR
EXCESS LIAB CLAIM ADE
OF
POLICIES.
INSURANCE
THE
LISTED BELOW HAVE BEEN
TERM OR CONDITION OF ANY
INSURANCE AFFORDED BY THE
LIMITS SHOWN MAY HAVE BEEN
ISSUED TO
CONTRACTOR
POLICIES
REDUCED
THE INSURED
OTHER DOCUMENT
DESCRIBED
BY PAID CLAIMS.
NAMED ABOVE FOR THE POLICY PERIOD
WITH RESPECT TO WHICH THIS
HEREIN IS SUBJECT TO ALL THE TERMS,
A
.1.10L
_
$R
N(VD
_
_POLICY NUMBER _ _
36001486WCE
735583261
79890486
POLICY
MWDD/YYYY
POLICY
k1WDD/YYYY _
LIMITS
EACH OCCURRENCE $1 000000
3/01/2021
_
33/01 /2021
)3/01/2021
03101/2022
Io�Tu rD,anu�_.,
MED EXP (Any one person)
$1 000 000
�`
$1 0 000
PERSONAL & ADV INJURY
$1 000,000
GENERAL AGGREGATE
$ 2r000,000
$Included
PRODUCTS -COMP/OP AGG
$
03/01/202
qBI SINGLE LIMIT
_
$1,000,1)OO
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMA13S
acadeaq.
$
EACH OCCURRENCE
$
$1 O 000 000
03/01/202
AGGREGATE
$10 000 000
WORKERS COMPENSATION PER I JOTH-
AND EMPLOYERS' LIABILITY Y / N R -
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? C • N /A
(Mandatory In NH) EL. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below _ _ E.L. DISEASE- POLICY LIMIT $
A Blanket Personal 36001486WCE 33/01/2021 03/01/2022 $20,511,600 Limit
Property SPC,RC/$5,000 Ded
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required)
Certificate Holder is named as Additional Insured with respect to General Liability as contained within
Chubb's endorsement 80-02-2367 05/07, Who Is An Insured, Additional Insured -Scheduled Person or
Organization, per written contract.
CERTIFICATE HOLDER CANCELLATION
City of Menifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
c/o Wendy Welch, Accounting Manager ACCORDANCE WITH THE POLICY PROVISIONS.
29714 Haun Rd
Menifee, CA 92586 AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103) 1 of 1
9754 #S27453484/M27453469
01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
LXMCN
MsI
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9755
page 4 of 5
Liability Insurance
Endorsement
Policy Period 03/01 /2021 to 03/01 /2022
Effective Date 03101/2021
Policy Number 36001486WCE
Insured Rutan & Tucker LLP
This Endorsement applies to the following forms:
GENERAL LIABILTI•Y
Under Who Is An Insured, the following provision is added.
Who Is An Insured
Additional Insured - Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are
Scheduled Person obligated pursuant to a contract or agreementto provide them with such insurance as is afforded by
Or Organization this policy.
However, the person or organizationis an insured only:
if and then only to the extent the person or organization is describedin the Schedule;
to the extent such contract or agreement requires the person or organization to be afforded
status as an insured;
for activities that did not occur, in whole or in part, before the execution of the contract or
agreement; and
with respect to damages, loss, cost or expensefor injury or damage to which this insurance
applies.
No person or organizationis an insured under this provision:
that is more specificallyidentified under any other provision of the Who is An Insured
section (regardless of any limitation applicable thereto).
with respect to any assumption of liability(of another person or organization)by than in a
contract or agreement.This limitation does not apply to the liability for damages, loss, cost or
expense for injury or damage, to which this insurance applies,that the person or organization
would have in the absence of such contractor agreement.
Liabffity Insurance AdMo+to/ Insured- ScI7!Vi& r&n,Rr iza#on continued
Form 80.02-2367 (Rev. 5-07) Endorsement Page 1
9756
page 5 of 5
Liability Endorsement
(continued)
Under Conditions, the following provisionis added to the condition titled Other Insurance.
Conditions
Other Insurance —
If you are obligated, pursuant to a contract or agreement, to provide the person or organization
Primary, Noncontributory
shown in the Schedule with primary insurance such as is affoidedby this policy, then in such case
Insurance - Scheduled
this insuranceis primary and we will not seek contribution fiom insurance availableto such person
Person Or Organization
or organization.
'L4P.�5'3k:. :. j: _ - -1'.:i 4�T Wr'S �!�•-.%r v.. �.7C: Z+$.1
Schedule
Persons or organizations that you are obligated, pursuant to a contract or agreement, to provide with
such insurance as is afforded by this policy.
All other terms and conditions remain unchanged.
Authorized Representative,
Liability Insurance Additional Insured -Sch! e P n ,,—e1nl lastpage
Form 8",2367 (Rev. 5-07) Endorsement Page 2
9757