2017/07/01 Sun City Investments, LLC Certificate of Liability InsuranceCERTIFICATE NO.
ISSUF DATF IMM/nnfYYYY1
GL1-6718 AlF
CERTIFICATE OF COVERAGE
12/20/2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
CSAC Excess Insurance
CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUTE A
Authority
CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE
CERTIFICATE HOLDER.
C/O ALLIANT INSURANCE SERVICES, INC.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED and/or requesting a WAIVER OF
PO BOX 6450
NEWPORT BEACH, CA 92658-6450
SUBROGATION, the Memorandums of Coverage must be endorsed. A statement on this certificate does
not confer rights to the certificate holder in lieu of such endorsement(s).
PHONE (949) 756-0271 / FAX (619) 699-0901
COVERAGE A - CSAC Excess Insurance Authority
y
LICENSE #OC36861
Member:
COVERAGE
PUBLIC AGENCY RISK SHARING AUTHORITY OF
AFFORDED B
CALIFORNIA (PARSAC)
COVERAGE
1525 RESPONSE ROAD, SUITE 1
AFFORDED C
SACRAMENTO, CA 95815
COVERAGE
AFFORDED D
Coverages
THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR
THE 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 COVERAGE AFFORDED BY THE MEMORANDUMS
DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUMS. LIMITS SHOWN MAY
HAVE BEEN REDUCED BY PAID CLAIMS.
CO
TYPE OF COVERAGE
MEMORANDUM
COVERAGE EFFECTIVE
COVERAGE EXPIRATION
LIABILITY LIMITS
LTR
NUMBER
DATE (MM/DD/YYYY)
DATE (MM/DD/YYYY)
A
�X General Liability
EIA-PE 17 EL-76
07/01/2017
07/01/2018
$2,000,000
Limits inclusive of the
Members Self -Insured
Retention of $1,000.000
Description of Operations/Locations/Vehicles/Special Items:
AS RESPECTS ACCESS AND INDEMNIFICATION AGREEMENT BETWEEN CITY OF MENIFEE AND SUN CITY INVESTMENTS, LLC FOR
TEMPORARY ACCESS TO PROPERTY AT 28401 BRADLEY ROAD, MENIFEE, CA FOR ACCESS TO AND FROM AND PARKING FOR THE
CELEBRATION OF THE GRAND OPENING OF FIRE STATION #7 ON JANUARY 10, 2018.
SUN CITY INVESTMENTS, LLC IS INCLUDED AS AN ADDITIONAL COVERED PARTY, BUT ONLY INSOFAR AS THE OPERATIONS UNDER THIS
CONTRACT ARE CONCERNED.
CITY OF MENIFEE IS A MEMBER OF PUBLIC AGENCY RISK SHARING AUTHORITY OF CALIFORNIA (PARSAC)
Certificate Holder
Cancellation
SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIL BE DELIVERED IN ACCORDANCE
WITH THE MEMORANDUMS OF COVERAGE PROVISIONS.
SUN CITY INVESTMENTS, LLC
ATTN: SHAHARAM RAY GOLBARI
AUTHORIZED REPRESENTATIVE
1300 W. OLYMPIC BLVD NO. 500
LOS ANGELES, CA 90015
CSAC EXCESS INSURANCE AUTHORITY PAGE 1 OF 2
ENDORSEMENT NO. U-1
CSAC EXCESS INSURANCE AUTHORITY
GENERAL LIABILITY 1
ADDITIONAL COVERED PARTY AMENDATORY ENDORSEMENT
It is agreed that the "Covered Party, Covered Persons or Entities" section of the Memorandum is amended
to include the person or organization named on the Certificate of Coverage, but only with respect to liability
arising out of premises owned by or rented to the Member, or operations performed by or on behalf of the
Member or such person or organization so designated.
Coverage provided under this endorsement is limited to the lesser of the limits stated on the Certificate of
Coverage or the minimum limits required by contract.
__ _._ V_ _
ADDITIONAL COVERED PARTY —�- -- - - --
NAME OF PERSON OR ORGANIZATION SCHEDULED PER ATTACHED CERTIFICATE OF COVERAGE
AS RESPECTS:
PER ATTACHED CERTIFICATE OF COVERAGE
It is further agreed that nothing herein shall act to increase the Authority's limit of liability.
This endorsement is part of the Memorandum and takes effect on the effective date of the
Memorandum unless another effective date is shown below. All other terms and conditions
remain unchanged.
Effective Date:
Memorandum No.: PER ATTACHED CERTIFICATE OF COVERAGE
Issue Date: June 26, 2017
Authorized Representativ
CSAC Excess Insurance Lthority
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