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2019/01/01 Bureau Veritas North America, Inc. Certificate of Liability Insurance (6)1 ® ,4� o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/21/2018 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 Aon Risk Services Northeast, Inc. Aon Risk Services Northeast, Inc. NY NY Office City of Menifee One Liberty Plaza 165 Broadway, Suite 3201 City Clerk CONTACT NAME: PHONE 866-283-7122 FAX 800-363-0108 (AfC, No. Ext): A,C, Ha ; E-MAIL ADDRESS: New York NY 10006 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED AN ® 7 2019 INSURERA: Hartford Fire Insurance Co, 19682 Bureau Veritas North America, Inc. a 180 Promenade Circle, Suite 150 Sacramento CA 95834 USA INSURER B: Twin City Fire Insurance Company 29459 INSURERC: Hartford Ins Co of the Midwest 37478 INSURERD: Hartford Accident & Indemnity Company 22357 Received INSURERE: Sentinel Insurance Company, Ltd 11000 INSURERF: Hartford Underwriters Insurance Company 30104 COVERAGES CERTIFICATE NUMBER: 570074337036 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDlYYYY POLICY EYY LIMITS X COMMERCIAL GENERAL LIABILITY USL U EACH OCCURRENCE $2,000,000 CLAIMS -MADE �X OCCUR IIAPREMISES Ea REN occurrence $1,000,000 MED EXP (Any one person) $10 , 000 PERSONAL &ADV INJURY $2,000,000 GEMLAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2,000,000 JECT 9 POLICY 1E PRO FX� LOC PRODUCTS - COMP/OPAGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY 10 AB S41202 ADS 01/01/2019 01/01/2020 COMBINED SINGLE LIMIT Ea $2,000,000 BODILY INJURY ( Per person) A X ANYAUTO 10 AB s41203 01/01/2019 01/01/2020 OWNED SCHEDULED AUTOS ONLY AUTOS HI RED AUTOS NON -OWNED ONLY AUTOS ONLY HI BODILY INJURY (Per accident) PROPERTYDAMAGE fPer accident UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS -MADE AGGREGATE •DED RETENTION I C WORKERS EMPLOYERSOLIABIL TYTION AND YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? N NIA AOSIOWN541200 1OWNS41200 Ul Ol/2019 01/01/2019 Ol/ 1/2020 01/01/2020 X PTATUTE OTH• FIR E. L EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) AK ID NY If yes, describe under DESCRIPTION OF OPERATIONS below E L. DISEASE -POLICY LIMIT $1,000,000 K Archit&Eng Prof USF00248019 01/01/2019 01/01/2020 Each Claim $1,000,000 SIR applies per policy terns & conditions Aggregate $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is included as Additional Insured in accordance with the policy provisions of the Business Auto Coverage & General Liability Coverage policy. 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 Meni fee AUTHORIZED REPRESENTATIVE 29714 Haun Road Menifee CA 92586 USA C0 0 r` M 0 0 0 r` L0 AL a :R ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000048582 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk services Northeast, Inc. Bureau Veritas North America, Inc. POLICY NUMBER see Certificate Number: 570074337036 CARRIER NAIC CODE see certificate Number: 570074337036 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER K :Allianz Global Risks us insurance Co. 35300 INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFFECTIVE DATE MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD LIMITS ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks ofACORD