2019/01/01 Disability Access Consultants, LLC Certificate of Liability Insurance (3)ACaR1`P CERTIFICATE OF LIABILITY INSURANCE
1114�
DATE (MM/DD/YYYY)
03123/2020
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([es) 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
CONTACT NAME: Ceil Provo
PHONE (651) 644-7200 (651) 644-9137
AJC Na Exl : AlC, Nb
9
AssureclPartners of Minnesota LLC
-MAIL cprovo@apminnesota.com
ADDRESS:
2361 Hwy 36 W
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA: Continental Cas Co
20443
St. Paul MN 55113
INSURED
INSURER B : American Casualty Co Reading
20427
INSURER C : Transportation Ins Cc
20494
Disability Access Consultants, LLC
INSURER D : The Hartford
00914
2862 Olive Highway
INSURER E : Philadelphia Insurance Company
251
Oroville CA 95965
INSURER F:
COVERAGES CERTIFICATE NUMBER: 20121 Master & Pro[ 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 CONTRACTOR 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
AQDL5U5R
INSD
WVD
POLICY NUMBER
POLI Y f
MM/DDIYYYY
POLI Y EXP
MMIDD/YYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
CLAIMS -MADE � OCCUR
PREMISES I Ea occurrence
$ 300,000
M ED EXP (Any one person
$ 10,000
PERSONAL&ADV INJURY
$ 2,000,000
A
Y
B6020052587
01/01/2020
01/01/2021
GEN'LAGGREGATE LIMITAPPLIES PER:
CITY pF MENIFEE
GENERAL AGGREGATE
$ 4,000,000
POLICY ❑ PRO- ❑
JECT LOC
FINANCE
PRODUCTS - COMP/OP AGG
4,000,000
$
Employee Benefits
$ 1,000,000
OTHER:
AUTOMOBILE LIABILITY
ZU�
COMBINED $I NGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY(Per person)
$
BOWNED
IANYAUTO
SCHEDULED
AUTOS ONLY AUTOS
Y
6020004782
RECEIVED
01/01/2020
01/01/2021
BODILY INJURY accident)
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Medical payments
$ 5,000
x
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
C
EXCESSLIyLIAB
CLAIMS -MADE
Y
B6020052637
01/01/2020
01/01/2021
DED /1 RETENTION 5 0
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? FYI (Mandatory in NH)
NIA
41WBAC5W3P
01/08/2020
01/08/202,
SPER TATUTE ERH
E-L. EACH ACCIDENT
1,000,000
$
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
It pas. describa under
DESCRIPTION OF OPERATIONS below
....__�_� .. ..
.--- •----
E-L. DISEASE - POLICY LIMIT
$ 1,000,000
-�
Limit
$5,000,000
- - --
E
Professional Liabilkty
PHSD1531446
03/13/2020
03/13/2021
Deductible
$10,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
City of Menifee ADA Self Evaluation and Transition Plan are listed as additional insured
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Menifee and its officers, employees, agents
ACCORDANCE WITH THE POLICY PROVISIONS.
29714 Haun Road
AUTHORIZED REPRESENTATIVE
Menifee CA 92586
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A ,
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