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2020/08/28 Dudek Certificate of Liability Insurance (3)ACOR"° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 8/28/2021 8/17/2020 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(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 Lockton Companies 444 W. 471h Street, Suite 900 Kansas Cityy MO 64112-1906 (816) 960-9000 CONTACT NAME: PHONE No. Ext : FAX INC. No E-MAIL ADDRESS: FORDING CQVERAGE NAIC 0 INSURER A: Zurich American Insurance Company 16515 INSURED DUDEK 1477058 605 THIRD STREET ENCINITAS CA 92024 INSURER B : Continental Casual Company 20441 INSURER C : American Guarantee and Liab. Ins. Co. 26247 INSURER INSURER E : INSURER F, COVERAGES CERTIFICATE NUMBER: 1675377d RI=VISInm N1IMRFR• YYYYYYY 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 LTR TYPE OF INSURANCE ADOL IN SUBR POLICY NUMBER E F POLICYLIMITS POLICY EXP A k COMMERCIAL GENERAL LIABILITY Y Y GLOO146311 8/28/2020 8/28/2021 EACH OCCURRENCE 1,000,000 CLAIMS -MADE OCCUR QRRE41GSES(Ea NTED oggyrren 10000 MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY $ 1,000 000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000 000 POLICY ECT X❑ LOC PRODUCTS - COMP/OP AGG $ 2.000 000 OTHER: $ A AUTOMOBILE LIABILITY Y Y BAP0146329 8/28/2020 8/28/2021 COMBINED SINGLE LIMIT Ea a ides $ 1 000 000 X ANY AUTO BODILY INJURY (Per person) $ XXXXXXX AUTOS ONLY SCHEDULED BODILY INJURY (Per accident $ X�yyM AUTOS ONLY AUUTOS ONLDY Pe0acE6RidTR AH}AGE $ xxx � � $ XXxxxxx C X UMBRELLA LIAB X OCCUR N Y AUC0146407 8/28/2020 8/28/2021 EACH OCCURRENCE $ 5,000,000 ,AGGREGATE $ 5,000,000 EXCESS LIAB CLAMS -MACE DED I I RETENTION $ $ XxXXXXX A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN Y WC0146330 8/28/2020 8/28/2021 PER OTH X STATUTE IE L EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? FNI N / A E.L. DISEASE - EA EMPLOYEE Is 1,000,000 (Mandatory in NH) IF yes, describe under DESCRIPTION OF OPERATIONS below EL. 0I15E51SE • POLICY LIMIT is 1,000,000 B PROFESSIONAL N N EEH591932835 8/28/2020 8/28/2021 PER CLAIM $1,000,000 LIABILITY AGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: ANNUAL ON CALL PROFESSIONAL SERVICES. THE CITY OF MENIFEE ITS CO INCILMEMBERS, OFFICERS AGENTS AND EMPLOYEES ARE ADDITIONAL INSURED ON GENERAL AND AUTO LIABILITY COVERAGE, ON A PRIMARY, RON-CONNIBUI)ORY BASIS, IF REQUIRED BY WRITTEN CONTRACT, WAIVER OF SUI3ROGATTON IN FAVOR OF THE ADDITIONAL INSPIRED APPLIES ON GENERAL AUTO, AND UMBRELLA LIABILITY COVERAGE, IF REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. COVERAGE IS SUBJECT TO TIIE TERMS AN1) CONDITIONS OF THE POLICY. CERTIFICATE HOLDER CANCELLATION 16753224 CITY OF MENIFEE 29714 HAUN ROAD MENIFEE CA 92586 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) f -e-7 lei Az-� ©199&2015 ACORD CORPORATION_ All rights reserved The ACORD name and logo are registered marks of ACORD .4coRo CERTIFICATE OF LIABILITY INSURANCE 8/28/2021 DATE(MMIDD!YYYY) 1 8/17/2020 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(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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas Cityy MO 64112-1906 (816)960.9000 NTACT ME: LPAHIC01,. Ext : AIC, No): EMAIL ADDRESS. SU S) AFFORDING COVERAGE NAIC a INSURER A: Zurich American Insurance Company 16535 INSURED DUDEK 1477058 605 THIRD STREET ENCINiTAS CA 92024 INSURER B : Continental Casualty COm anv 20443 INSURER C : American Guarantee and Liab. Ins. Co. 26247 INSURER D INSURER E - IN U COVERAGES CERTIFICATE NUMBER: 16753211 REVISION NUMBER: XXXXXXX 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. N5R TYPE OF INSURANCE ADDL -IN5D SUER WVD POLICY NUMBER P LICY EFF MMIDD YI POLICY EXP [MMA301YYYY LIMITS A COMMERCIAL GENERAL LIABILITY Y Y GLOO146311 8/28/2020 8/28/2021 EACH OCCURRENCE 1,000,000 CLAIMS -MADE © OCCUR DAMAGET RENTED PREINI E E occurrence 1OO OOO MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y BAP0146329 8/28/2020 8/28/2021 COMBINE❑ SINGLE LIMIT a cceden $ 1 000 000 BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident $ XXXX'XXX AUTOS ONLY NON-OWNED ONLY ,PROPERTY DAMAGE $ X`rXX`r`r`r $ XXXXXXX C X UMBRELLA LIAB X OCCUR N Y AUC0146407 8/28/2020 8/28/2021 EACH OCCURRENCE $ 51000,000 AGGREGATE $ 5,000.000 EXCESS LAB CLAIMS•MADE DED I I RETENTION $ $ XXXXXXX A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXOFFICER/MEMBER EXCLUDED? ECUTIVE � (Myandatory in NH) SCdescribe un DEs der RIPTION OF OPERATIONS below N / A Y WC0146330 8/28/2020 8/28/2021 X I STATUTE I I ER E,L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1.000 000 E.L. DISEASE -POLICY LIMIT 1,000,000 B PROFESSIONAL LIABILITY N N EEH591932835 8/28/2020 8/28/2021 PER CLAIM $1,000,000 AGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) PROJECT: NEWPORT ROAD WIDENING (ANTELOPE AND MENIFEE) CIP 401-13. CITY OF MENIFEE AND ITS OFFICERS, OFFICIALS, EMPLOYEES, AND AUTHORIZED VOLUNTEERS ARE ADDITIONAL INSURED ON GENERAL AND AUTO LIABILITY COVERAGE, ON A PRIMARY, NON-CONTRIBUTORY BASIS, IF REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION IN FAVOR OF THE ADDITIONAL INSURED APPLIES ON GENERAL, AUTO, AND UMBRELLA LIABILITY COVERAGE, IF REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. COVERAGE IS SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. CERTIFICATE HOLDER CANCELLATION 16753211 CITY OF MENIFEE 29714 HAUN ROAD MENIFEE CA 92586 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) "491 wi ©1988-2015 ACORD CORPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD ACOR"® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) �.� 8/28/2021 1 8/17/2020 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(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 Lockton Cornpanies 444 W. 47th Street, Suite 900 Kansas Cityy MO 64112-1906 (816) 960-9000 CUMIRT NAME: aC, NE No, Extl: WC Na EMAIL ADDRESS: INSURER(S) AFFORDJING-OUVERAPE NAIC # INSURER A: Zurich American Insurance Company 16535 INSURED DUDEK 1474534 605 THIRD STREET ENCINITAS CA 92024 INSURER B : Continental Casual Company— 20443 INSURER C : American Guarantee and Liab. Ins. Co. 26247 INSURER D ANSMBERE: NSU F: COVERAGES CERTIFICATE NUMBER: 1675/203 RFVIRI(IN NIIURFR- XXXXXXX 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 LTR TYPE OF INSURANCE ADM IN50 SUBR WVD I POLICY NUMBER POLICY EFF tfdWJQDNYYYI POLICY EXP (MMIDDffYYYILIMITS A X COMMERCIAL GENERAL LIABILITY Y Y GLOO146311 8/28/2020 9/28/2021 EACH OCCURRENCE 1,000,000 CLAIMS -MADE OCCUR X DAMAGE TO RENTED PREMISES Ea occurrence 100,000 MED EXP (Anyoneperson) 10 000 PERSONAL & ADV INJURY s 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 2,000,000 RPOLICY ECT 71 LOC PRODUCTS - COMP/OP AGG s2,000,000 $ OTHER: ,d, AUTOMOBILE LIABILITY Y Y BAP0146329 8/28/2020 8/28/2021 COM INED SINGLE LIMIT acCIden[ $ 1.000.000 BODILY INJURY (Per person) $ XXXXXXX 1 ANY AUTO AUTOS ONLY SCHEDULED BODILY INJURY (Per accident $ XXXXXXX AUTOS ONLY AUTOS ONLY PROPERTY AMAGE $ XXXXXXX $XXXXXXX C X UMBRELLA LIAB X OCCUR N Y AUC0146407 8/28/2020 8/28/2021 EACH OCCURRENCE $ 1000.000 ,AGGREGATE $ 1,000,000 EXCESS LIAB ffi CLAIMS -MADE DED I I RETENTION $ $ XXXXXXX AND EMPLO ERSEL ABILIITY YIN Y WC0146330 8/28/2020 8/28/2021 AlSTATUTE ER IE.L. EACH ACCIDENT $ 1 OOO.00O ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N NIA IE.L. DISEASE - EA EMPLOYEE 1 000 000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below IEL. DISEASE - POI LIMIT 1.000.000 B PROFESSIONAL N N EEH591932835 8/28/2020 8/28/2021 PER CLAIM$1,000,000 LIABILITY AGGREGATE $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) FY201.SII9 ON•CALL CONSTRUC11ON. INSPECTION SERVICES (RECOVERABLE). THE CITY OF MENIFEE AND ITS OFFICER$, EMPLOYEES AGENTS, AND AUTHORIZED VOLUNTEERS. ARE ADDITIONAL INSURED ON GENERAL AND AUTO LIABILITY COVERAGE, ON A PRIMARY, NON•CONTkIBUTOIiY BASIS, IF REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION IN FAVOR OF THE ADDITIONAL INSURED APPLIES ON GENERAL, AUTO, AND UMBRELLA I JABILITY COVERAGE, IF REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. COVERAGE IS SUBJECT TO THE TERMS AND CONDITIONS OF TIC 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. 16753203 AUTHORIZED REPRESENTATIVE CITY OF MENIFEE 29714 HUAN ROAD MENIFEE CA 92586 /__ _4 7 47 �v ACORD 25 (2016/03) ©1998-2015 ACORD CORPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD �1 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 8/28/2021 8/17/2020 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(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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas Cityy MO 64112-1906 (816) 960-9000 INSURED DUDEK 1474534 605 THIRD STREET ENCINITAS CA 92024 Zurich American Insurance INSURERC.. American Guarantee and Liab. Ins. Co. hCV) A7 1 COVERAGES CERTIFICATE NUMBER: 16753187 REVISION NUMBER: XXxxX 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE I SD WVQ POLICY NUMBER MMODIYYYY JMM1DDPMY1 LIMITS • x COMMERCIAL GENERAL LIABILITY Y Y GLOO146311 8/28/2020 8/28/2021 EACH OCCURRENCE 1,000.000 CLAIMS -MADE OCCUR PREM SETS.O RENTED nce 100,000 MED EXP (Any oneperson) 10,000 PERSONAL B ADV INJVRY S 1.000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000.000 POLICY JEC°T LOC PRODUCTS - COMP/OP AGG s 2.000 000 OTHER: $ • AUTOMOBILE LIABILITY Y Y BAP0146329 8/28/2020 8/28/2021 E° BINEDISINGLE LIMIT $ 1,000,000 1AUTO}�' ANY AUTO BODILY INJURY (Per person) $ xxxxxxx OWNED SCHEDULED (Peraaciden! $ XXXXXXX AUTOS ONLY AUTOS BODILY INJURY HIRED NON -OWNED ROPERUTntDAMAflE $ Xxxxxxx S ONLY AUTOS ONLY $XXXXXXX C x UMBRELLA LIAB h OCCUR N Y AUC0146407 8/28/2020 8/28/2021 EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE $ 11000,000 DED I I RETENTION $ $ xxxxxxx WORKERS COMPENSATION A AND EMPLOYERS' LIABILITY Y / N Y WC0146330 8/28/2020 8/28/2021 x S7RATUFE ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? � N / A E.L EACH ACCIDENT S 100 0000 (Mandatory in NH) E.L DISEASE - EA EMPLOYEE 1,000,000 describe under DESCRIPTION OF OPERATIONS below N EL DISEASE - POLICYLAMIT 1,000,000 B PROFESSIONAL N EEH591932835 8/28/2020 8/28/2021 PER CLAIM S1,000,000 LIABILITY AGGREGATE; $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF MENIFEE AND ITS OFFICERS, EMPLOYEES AGENTS AND AUTHORIZED VOLUNTEERS ARE ADDITIONAL INSURED ON GENERAL AND AUTO LIABILITY COVERAGE, ON A PRIMARY NON-CON'i'RIBUTORY BASIS, IF REQUIRED BY WRITTEN CONTRACT, WAIVER OF SUBROGATION IN FAVOR OF THE ADDITIONAL ij ISURED APPLIES ON GENERAL, AUTO AND UMBRELLA LIABILITY COVERAGE, IF REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. COVERAGE 19 SUBJECT TO THE TERMS AND CONDITIONS OF TIME 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. 16753187 AUTHORIZED REPRESENTATIVE CITY OF MENIFEE ATTN: JONATHAN SMITH 29714 HAUN ROAD MENIFEE CA 92586 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD