2019/12/04 Andrea Reza Certificate of Liability Insurance•-'-''�� DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 12/03/2019
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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS 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
NUTMEG INS AGENCY INC/PHS =
76210775 PHONE (800) 925-3137 Fax (000) 443 611
(A/C, No, Ext): (A/C, No):
The Hartford Business Service Center
3600 Wiseman Blvd E-MAIL
San Antonio, TX 78265 ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC#
INSURED INSURER A: Sentinel Insurance Company Ltd. 11000
Andrea Reza DBA Silver Drop Cakes INSURER B :
3365 BUFFALO RD
INSURER C
PERRIS CA 92570-5571
INSURER D
INSURER E :
INSURER F :
f`AVCQ Af=CC fr-RT1=f ATF MI HIM RFR• RRV•IglnN NIIMRI=R•
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
LTR
TYPE OF INSURANCE
ADDL
INSH
SUBR
WVD
POLICY NUMBER
POLICY EFF
/DD/YYYY
POLICY EXP
M/DD/Y YY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$1,000,000
CLAIM5•MADEMOCCUR
DAMAGETORENTEDn
PREMISES (Ea
$1,000,000
MILD EXP (Any one person)
$10,000
X
General Liability
A
X
76 SBW BG3179
12/04/2019
12/04/2020
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
POLICY ❑ PRO LOU
JECT El
PRODUCTS - COMP/OP AGG
$2,000,000
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
fLiif accident)
BODILY INJURY (Per person)
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
PROPERTY DAMAGE
HIRED NON -OWNED
I
AUTOS AUTOS
(Per accident)
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
AGGREGATE
EXCESS LIAB
CLAIMS-
MADE
E
RETENTION .$
WORKERS COMPENSATION
PER
OTH-
AND EMPLOYERS' LIABILITY
STATU E
I— JEJR
E.L. EACH ACCIDENT
ANY Y/N
PROP R IETOR/PARTNER/EXECUTI VE
OFFICER/MEMBER EXCLUDED?
A
E.L DISEASE -EA EMPLOYEE
(Mandatory In NH)
If yes, describe under
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPEnATIONS below
DESCRIPTION OF OPERATIONS/LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Those usual to the Insureds Operations. City �or), Its Councilmembers, Officers, Agents, and Employees are additional insureds per
the Business Liability Coverage Form SS000 his policy.
City of Menifee
29714 HAUN RD
SUN CITY CA 92586-6540
ACORD 25 (2016/03)
fifi SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
i' IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Rac®iVed
C 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
I