2019/03/01 Rutan & Tucker, LLP Certificate of Liability Insurancepage 2 of 5
M.
Client#: 1257796 305RUTANTUC
ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY)
02/13/2019
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: It the certificate holder is an ADDITIONAL INSURED, the pciicy(les) 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 my rights to the c iflcate holder In lieu of such endorsement(s).
PRODUCER y NA Lori McNay
BB&T Insurance Services USA_ a0, 714 941-2815 I nx
7 �1�- In/r.. rro1:
of Orange County /,` �¢, qADDREss LMcNay0bbandLeom
2400 E Katella Ave Suite 1100�� It�gUitER(g}AFFORDING COVERAGE NAIC #
Anaheim, CA 92806 -
�(1 INSURER A: Fedwallnsuranwcompany 2=1
INSURED INSURER B:
Rutan &Tucker
P.O. Box 1950
611 Anton Blvd. 14th Floor
Costa Mesa, CA 92626-1998
COVERAGES
CERTIFICATE NUMBER:
INSURER C:
INSURER D:
INSURER E:
INSURER F:
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.
'rLNTSRq ado UEM P&pLV�y EFF POLpp��Y v
TYPE OF INSURANCE INSA WVD POLICY NUMBER (MAA?Df11'rYYY) (MMlDglY Y1 LIMITS
A X COMMERCIAL GENERAL LIABILITY 36001486WCE 33/01/2019 03/01/202C EACHOCCURRENCE$1 000000
] CLAIMS -MADE L^I OCCUR AA E pxTu rau,ca $1,000,000
-A
73583261
D3/01/2019
MED EXP (Any oneperson)
$1
PERSONAL 6 ADV INJURY
$1
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO -
POLICY JECT LOC
OTHER: _
GENERAL AGGREGATE
$i
PRODUCTS - COMP/OPAGG
$
$
A
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
X AUTOS ONLY X AUTOS ONLY
03/01/202
_
(EgaccYa08M9caLEL1MiIT
1
BODILY INJURY (Per person)
$
id Per accent
BODILY INJURY ( )
$
PROPERTYDAMAGE
Paccided
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
79890486
D3/01/2019
03101/202C
EACH OCCURRENCE
$1
AGGREGATE
$1
DED �I. RETENTION $
$
WORKERS COMPENSATION
11TUTE I IOTH-
AND EMPLOYERS' LIABILITY YIN
JFR
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED? C]
N/A
E.L. EACH ACCIDENT $
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
It yes, describe under
DESCRIPTION OF OPERATIONS below
36001486WCE
_
03/01/2019
E.L. DISEASE - POL_ICY LIMIT $
03/01/2020 $10,068,600 Limit
_
A
Blanket Personal
Property
,
I SPC,RC/$5,000 Ded
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required)
Certificate Holder is named as Additional Insured with respect to General Liability as contained within
Chubb's endorsement 80-02-2367 0,5/07, Who Is An Insured, Additional Insured -Scheduled Person or
Organization, per written contract.
City of Menifee
C/O Wendy Welch, Accounting Manager
29714 Haun Rd
Menifee, CA 92586
CANCELLA I ION
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) 1 of 1
1843 #S22945447/M22945434
01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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