2020/07/01 Habitat for Humanity Inland Valley Certificate of Liability InsuranceCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY)
5/30/2020
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 CONTACT
NAME
Arthur J. 6ailagner & Uo. — — PHONE FAx
Insurance Brokers of CA, Inc. LIC #0726293 we Ho
1255 Battery Street, Suite 450 AanREse:
San Francisco CA 94111 INSURER(S) AFFORDING COVERAGE I NAIC a
INSURED
Habitat for Humnaity Inland Valley (2170)
41615 Winchester Road, Suite 214
Temecula, CA 92590
A: NonProfits' United Ins
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER- 13755G4497 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.
INSR _ - - litiDi.� PIA POLICY EFF POLICY EXP
LTR ! TYPEOFINSURANCE I POLICY NUMBER MM431CP YYY MM/ODIYYYY . LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
1
CLAIMS -MADE 71 OCCUR
PAEMISES (Ea gcc�rr�nce)
$
MED EXP (Any oneperson)
$
PERSONAL & ADV INJURY
$
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
(�EN'L.
POLICY EI MR �J LOG
PRODUCTS - COMP!OP AGG
1111
$
UTHEFL
A
AUTOMOBILE
_
LIABILITY
Y
NPUlD00-20
7/1/2020
7/1/2021
COMBINED SINGLE LIMIT
i�_ _
(Ea accH)__ -_
$2,000,000
—
X
ANY AUTO
BODILY INJURY (Per person)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
PROPERTYDAMAGE
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA LIAB
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LAB CLAIMS_ -MADE
__HOCCUR
DED RETENTIONS
_
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
PER OTH-
STATUTE ER
ANYPROPRIETORiPARTNER/EXECUTIVE
E,L. EACH ACCIDENT
$
OFFICER/MEMBEREXCLUDED? ❑
N / A
_
T
(Mandatory In NH)
E.L- DISEASE • EA EMPLOYEE
$
II yes, describe under
DESCRIPTION OF OPERATIONS below
E.L.-O SEASP- POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required)
Any Auto means any covered auto under the NPU Vehicle Insurance Program.
ADDITIONAL INSURED(S); City of Menifee, its officers, agents and employees
CERTIFICATE FIOI.-DFR CANCFI I ATION
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 Meniee
29844 Haun Road
AU HORIIEDREPRESENTATIVE
fey
Menifee CA 92586
IA lu
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
2` of 3 38558
NONPROFITS
UNITED
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AIAM0V0%Q6l9 I I—.6—A 11-6—IA IMMI - D..AI
111V111 IV111.0 Vis111vu VVIVIVi�i lii�iiipilV�i i OO!
Automobile Liability Coverage
ADDITIONAL COVERED PARTY ENDORSEMENT
This endorsement modifies insurance provided under the following
BUSINESS AUTO COVERAGE FORM
BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
The "Who is an Insured" section of your Automobile Liability Insurance is changed by adding the
following:
Who is covered includes any person or organization from whom you have leased an auto, from
which you have received funding for your operations, or for who you provide services. These
persons or organization are protected, if they require to be named, and you agree to name them,
as an additional insured, if indicated on the attached Certificate of Coverage, but only with respect
to liability arising out of the ownership, use, maintenance, loading or unloading of a covered auto.
Cancellation:
Should any of the above described policies be cancelled before the expiration date thereof, the issuing
insurer will endeavor to mail 30 days written notice to the certificate holder named on the certificate, but
failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or
representatives.
Premium Payments:
Those persons or organizations are not responsible for paying premiums for your coverage.
Insured:
Policy Number:
Effective Date:
Authorized Representative:
NPU-VIP
As shown on the Certificate of Insurance attached.
N P U 1000-20
July 1, 2020 to July 1, 2021 (or otherwise indicated)
2020-2021
Page 1 of 1 3` of 3 38558
Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc.
1255 Battery Street #450
San Francisco, CA 94111
38558 1 AB 0.416 38558
IIII�����IIIII���I�I�I�I'IIIII�IIII��IIIIIIIIIII�I�IIIII�II��IIII
CITY OF MENIEE
29844 HAUN RD
MENIFEE, CA 92586-6539
C1ty of Menifee
F1na nce
IJUN 16 2020
Received
1• of 3 38558