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2019/05/01 Lee & Stires, Inc. Certificate of Liability InsuranceDATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCEF1211712019 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). CNACT PRODUCER Patriot Risk & Insurance Services NAME, 2415 Campus Drive, Suite #200 PHO949 486-7900 Fi X No 949 486 7950 Irvine, CA 92612 FAIL www.patrisk.com P INSURED Lee & Stires Inc. PO Box 2124 Montclair CA 91763 OK qF MEfIIFE F111tIi�Ci sw _',�.�.< <:'. �� `-�� wJ RECEIVED r� C E I V E D - - - INSURERA: United Special Insurance Company - 12537 INSURER B: Financial Pacific Insurance Cormpany 31453 INSURER c: vi ators S ecial Insurance Co an 36056 INSURER D.: Insurance CorMAny of The West 27847 INSURER E_ _ INSURERF: COVERAGES CERTIFICATE NUMBER: S90aR177 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 TYPE OF INSURANCE WOOL $UBR POLICY EFF POLICY EXP LIMITS LTR POLICYNUMBER MMODrYY M DIYYYY A COMMERCIAL GENERAL LIABILITY LIG0054500 5/1/2019 5/1/2020 EACH OCCURRENCE $1 000000 PREMISES occur $ 50 000 CLAIMS -MADE LZ OCCUR MED EXP (Any one arson $ 5 000 PERSONAL & ADV INJURY $ 1 000 000 _ GEN'L AGGREGATE LIMIT APPLIES PER: GEN ERAL AGGREGATE $2,000,000 POLICY Q jECT LOC PRODUCTS - COMP/OP AGG s2,000,000 $ QTHER: B AUTOMOBILELWBILITY . 60515882 5/1/2019 5/1/2020 O B! EDSINGLELIMIT$ [€� aoddent 1 000 000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE ,jPatr{3ocldenfl $ $ C UMBRELLA LIAB OCCUR LA19EXCZ01JFYIC 5/1/2019 5/1/2020 EACH OCCURRENCE $5000,000 y/ AGGREGATE $ 5 000 000 I EXCESS LIAR L� CLAIMS -MADE DED I I RETENTION $ D 'WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N OFFICEOR/M EMBER EXCLUDED? ED7 ECUTIVE NIA WSD502254907 11112020 1/1/2021 PER OTH- STATUTE R E.L. EACH ACCIDENT $ OOO OOO E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yyes, desulbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LINT 1 $ 1 000 000 B Marine 60515882 511/2019 5/1/2020 Leased/Rented $100,000 linland Deductible $1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Re: Transportation Permit "30-day notice of cancellation / 10-days for non-payment of premium. L.r-K I11•IL AI t HULULK L;ANL;t=LLAI IVN Cityy of Menifee 29714 Huan Rd. 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 Dave Jacobson U ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 52948372 119/20 - GL/AU/UMB/IM - 20/21 WC I Annette Romero 112/17/2019 9:41:12 AM (PST) I Page 1 of 3 This certificate cancels and supersedes ALL previously issued certificates. Lee & Stires Inc. POLICY NUMBER: LI00054500 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) Locations Of Covered Operations As required by written contract. If required by your agreement with such Additional Insured. Additional Insureds shown in a written contract, or written agreement that includes primary and non- contributory wording where required. If anyone, other than the Additional Insured, provides similar insurance for the Additional Insured, then this insurance will apply as outlined in SECTION IV — COMMERICAL LIABILITY CONDITIONS, paragraph 4. Other Insurance, subparagraph c. Method of Sharing. The inclusion of one or more Insured(s) under the terms of this endorsement does not increase our limits of liability. All other terms and conditions remain unchanged. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to 2. The acts or omissions of those acting on your include as an additional insured the person(s) or behalf; organization(s) shown in the Schedule, but only in the performance of your ongoing operations for with respect to liability for "bodily injury", "property the additional insured(s) at the location(s) damage" or "personal and advertising injury" designated above. caused, in whole or in part, by: However: 1. Your acts or omissions; or CG 20 10 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 52N8372 1 19/20 - GL/AV�U!%B/IM - 7a�21 WC I Annette Romero 1 12/17/2019 9:41:12 AM (PST) I Page 2 of 3 Tibia. Certificate caIiCe1S and supersedes ALL previously issued certificates. 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. 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 Page 2 of 2 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. © Insurance Services Office, Inc., 2012 CG20100413 52949372 19/20 - GL/AUJU"/IM - 20/21 WC I Annette Romero 112/17/2019 9:41:12 AM (PST) I Page 3 of 3 This certificate cancels and supersedea ALL previously issued certificates.