2018/11/08 Dennis Janda, Inc. Certificate of Liability InsuranceCERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
10/07/2019
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 CONTACT
Strachota Insurance Agency, Inc.
NAM(r:-
27710 Jefferson Ave., Ste. 100 A1C �F�i9 (951) 676-2229 �.(ArC,No)_(951) 676-7391
Temecula CA 92590
INSURED
Dennis Janda Inc.
42164 Remington Avenue
Temecula CA 92590
E-MAIL
ADDRESS: taryn®strachota.com
INSi]RER a :Copp, Insurance
INSURER B: AmGUARD Insurance
INSURERC: Ohio Securitx Ins
INSURER D: Landmark American
INSURER E :
INSURER F :
Co
COVERAGES CFRTIFICATF NIIMRFR- rarr Tn 1 t,Arg oo1101nu K111RR00o.
39993
42390
24082
33138
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 TYPE OF INSURANCE AD&L POLICY EFF A01-iCY EXP
LTR POLICYNUMBER iMMMDNYYY1 (MVdDDNYYVILIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
Y
103GL0025B4401
09/28/20i9
09/28/2020
_ EACH OCCURRENCE
i5AM GET6WEI_t'E
pREMI,$F�[EBpppuRBrlcp
$ 1,000,000
$ 100,000
$ excluded
MED EXP oneperson)
PERSONAL & ADV INJURY
$ 1,000,000
GEML
AGGREGATE LIMIT APPLIES PER :
POLICY l I PR
ECOT- LOC
GENERAL AGGREGATE
$ 2 000 000
PRODUCTS -Ci7llVP10PAGG
$ 2,000.000
$
OTHER'
AUTOMOBILE
LIABILITY
COMBINEDSINGLE LIMIT
aa�yfdenl
$ 1,000,000
BODILY INJURY (Per person)
$
B
ANY AUTO
Y
DEAU936781 11/08/2018 11/08/2019
ALL OWNED SCHEDULED
AUTOS X AUTOS
BODILY INJURY Per accident
( )
$
HIRED AUTOS X NON-OWNEDT
X
PROPERTY DAMAGE
gyp.
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
S
EXCESS LIAB
CLAIMS -MADE
DED I I RET£NTIgNS
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEM8ER EXCLUDED?
N / A
XWS56173896
07,01,2019
07/03/20a0
X P F,.R
E.L. EACH ACCIDENT
$ 1, BOO r 000
E.L DISEASE -EA_EM_P1OYE
S 1,000,000
(MandatMIn NH)
I! ea describe
DEOFF OPERATIONS below describe O
E L. DISEASE - POLICY LIMIT
S 1,000,000
D
Professional Liability
LHR837440 05/08/2019
F/08/2020kach
Claim $ 11000,000
Aggregate $ 2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate Holder is 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 BA99040618 endorsement.
l.Clt I11•II,:A I t FIULULK 1:ITY nr MFNIFFF (-AMr.FI I ATInfd
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
OCT 17 2019 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Menifee
ACCORDANCE WITH THE POLICY PROVISIONS.
RECEIVEDAUTHORIZED REPRESENTATIVE
29714 Haun Rd.
Menifee CA 92586
9 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
103 GL 0025844-01
POLICY NUMBER: 103 GL 0025844-01
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) I 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
Intormation required to complete this Schedule, it not shown above, will be shown in the Declarations, I
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", "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.
B. 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
103 G L 0025844-01
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 C Insurance Services Office, Inc., 2012 CG 20 10 04 13
COMMERCIAL AUTO
BA 99 04 06 18
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED WHEN REQUIRED BY CONTRACT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
This provision does not apply in regard to any ownership, maintenance or use of the additional insured's "autos."
Additional Insured When Required by Contract
(1) Paragraph A.1. — WHO IS AN INSURED —
of Section II — Liability Coverage is
amended to add:
d. When you have agreed, in a written
contract or written agreement, that a
person or organization be added as an
additional insured on your business auto
policy, such person or organization is an
"insured", but only to the extent such
person or organization is liable for
"bodily injury" or "property damage"
caused by the conduct of an "insured"
under paragraphs a. or b. of Who Is An
Insured with regard to the ownership,
maintenance or use of a covered "auto."
The insurance afforded to any such
additional insured applies only if the
"bodily injury" or "property damage"
occurs:
(1) During the policy period, and
(2) Subsequent to the execution of such
written contract, and
(3) Prior to the expiration of the period
of time that the written contract
requires such insurance be provided
to the additional insured.
(2) How Limits Apply
If you have agreed in a written contract
or written agreement that another
person or organization be added as an
additional insured on your policy, the
most we will pay on behalf of such
additional insured is the lesser of:
(a) The limits of insurance specified in
the written contract or written
agreement; or
(b) The Limits of Insurance shown in
the Declarations.
Such amount shall be a part of and not
in addition to Limits of Insurance shown
in the Declarations and described in this
Section.
(3) Additional Insureds Other Insurance
If we cover a claim or "suit" under this
Coverage Part that may also be covered
by other insurance available to an
additional insured, such additional
insured must submit such claim or "suit"
to the other insurer for defense and
indemnity.
However, this provision does not apply
to the extent that you have agreed in a
written contract or written agreement
that the insurance is primary and non-
contributory with the additional insured's
own insurance.
(4) Duties in The Event Of Accident, Claim,
Suit or Loss
If another person or organization is
added as an additional insured on your
policy, the additional insured shall be
required to comply with the provisions in
A. Loss Conditions 2. — Duties In The
Event Of Accident, Claim, Suit Or
Loss — of SECTION IV — BUSINESS
AUTO CONDITIONS, in the same
manner as the Named Insured.
BA 99 04 06 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1