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2020/02/06 Hospice of the Valleys SC Certificate of Liability InsuranceClient#: 430474 HOSPIVALLEI DATE (MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 12/10/2020 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 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 NANTA T Chelsea Lindow Marsh & McLennan Agency LLC � a mot, 858-587-7162 A!X No: 858-452-7530 Marsh & McLennan Ins Agncy LLC CHY V MI Ni l_E EMAIL Chelsea.Lindow@MarshMMA.com PO Box 85638; CA Lic #OH18131 L i3(;C ADDREss: San Diego, CA 92186 INSURERS AFFORDING COVERAGE NAIC # INSURER A: American Alternative Insurance 19720 INSURED INSURER B Hospice of the Valleys SC �� �, I INSURER C : _ 25240 Hancock Ave, Suite 120 1-3 E G F V E D INSURER D : Murrieta, CA 92562 - INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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. INR TYPE OF INSURANCE f AODL SUBR POLICY EFF POLICY EXP LIMITS L INSR WVD POLICY NUMBER MM/DD MMIDD A X COMMERCIAL GENERAL LIABILITY X VHNUHG0004733 32/06/2020 02/06/2021 EACH OCCURRENCE $1 000000 X CLAIMS -MADE OCCUR PREMISESOEaoccurrDence $1 000000 MED EXP (Any one person) $ 50 000 PERSONAL & ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEI° ❑. LOC GENERAL AGGREGATE s3,000,000 PRODUCTS - COMP/OP AGG $ 3 000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accfdent BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTYDAMAGE PeraccIdert $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED F RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOMPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N I A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: City of Menifee named as an additional insured per the attached endorsement. L#—I@L"mI4llitsE1111Lol City of Menifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29714 Haun Road ACCORDANCE WITH THE POLICY PROVISIONS. Sun City, CA 92586 AUTHORIZED REPRESENTATIVE Gmµ- ��w-- © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S4672027/M4671978 WSCAT INSURED: Hospice of the Valleys SC POLICY #: VHNUHG0004733 POLICY PERIOD: 02/06/2020 TO 02/06/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: HOSPICE AND HOME HEALTH CARE LIABILITY COVERAGE FORM SCHEDULE Name of Person(s) or Organ izatio n (s): City of Menifee 29714 Haun Road Sun City, CA 92566 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations ) A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organ;zation(s) shown in the Schedule, but only with respect to liability for injury or damagecaused, in whole or in pa,-t, by your acts or omissions or the acts or omissions of those acting on your bahalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 acontract or agreement, the insurance afforded to such additional insured will not he 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 is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by acontract 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. HGL307 (04/13) Copyright 2012Ameriesui Atlernaliye Insurance Corporatron• Page 1 of 1 All rig hls reserved. 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