2019/10/27 SymbolArts, LLC Certificate of Liability InsuranceSYMBART-01
CERTIFICATE OF LIABILITY INSURANCE DATE3 3120D1YYYY)
I3/2020
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 sortifloale holder Is an ADDITIONAL INSURED, the pefley(ies) must have ADDITIONAL wounCD pravisians 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).
PRODUCER License 4 92472
�WjAcT Carolyn Lyon
Seohiva Insurance Agancy
302 Wost WO South #1 Of
PHONE FAX
(AIC. No. E>ajl 6897 (A/C, Nol:
Salt Lake Clty, UT 84107.8225
Reiss; clyon@beehiveinsurance.com
INSURER(5) AFFORDING COVERAGE NAir it
INSURER A :ACu)ty 14184
INSURED
INSURERB:Utah Business Insurance CO (URIC) 12520
SymbolArts LLC
INSURER C :
6083 S 1550 E
INSURER D :
Ogden, UT 04405
INSURER E.
INSURER F :
COVEGES 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 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 ADOL SOUR POLICY EFF POLICY EXP
IN SO. WWVV POLICYNUMBER VAM/OOf __1MMAMO2 YYI
LIMITS
A X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE S
1,000.000
CLAIMS -MADE X OCCUR X82298 10/27/2019 10/27/2020
X
DAMAGE TO RENTED
PREMISES (Ea ecurrronco) S
100,000
MED EXP (Any one person) - S
5,00D
PERSONAL dAOVINJURY S
1,000.000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $
2,000.000
X POLICY JE�7 LOC
PRODUCTS -COMPIOPAGG S
2'000'000
OTHER.
g
A AUTOMOBILE LIABILITY
{EUMBINI,S !iL'r3LE LIMIT S
1,000,000
X ANY AUTO X82298 10127/2019 10/27/2020
BODILY INJURY (Per person) S
OWNEDSCHEDULED
AUTOS ONLY
BODILY INJURY (Per accident), $
AUTOS ONLY A�TOS
)�iuOP�E'oRdc+s} SAGE
S
pY
,
A X UMBRELLA LIAB X OCCUR
EACH OCCURRENCE $
5'000,000
EXCESS LIAO CLAIMS -MADE X82298 10/27/2019 10/27/2020
AGGREGATE $
5,000,000
DED X RETENTION $ 0
$
WORKERSMPEN ATION
B COMPENSATION
X
AND EMPL
YIN
STArUTL EOTH.
ANY WC0025732019A 10/27/2019 10/27@020
N NIA
E L EACH ACCIDENT $
1,000,000
CcPR[�O�PRIIETgOERRIPARTNER/EXECUTIVE
(mi 5EPM In NH) EXCLUDED?
1,000,000
If yea describe under
E L DISEASE - EA EMPLOYEE $
1'000'900
_ RIPTION OF OPi:RA; ION$eiow _
E L OISEASE . POLICY LIMIT S
DESCRIPTION OF OPERATI DNS r LOCATIONS I VEHICLES (ACORD 101. A 0 d IIIonal Remarks Sehadu re, may be attached If more space Is raquiletl�he General Liability which is primary and
City of Menlfee and lie officers, employees, agenr_y and authorized volunteers Is Additional Insured with regard to
non-contributory as required by contract or agreement. Subject to the terms and conditions of the policy forms.
CERTIFICATE HOLDER CANCELLATION
City of Menifee and its officers, employees, agency and
authorized volunteers
298" Haun Rd
Menifee, CA 92586
ACORD 25 (2016103)
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
01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTO- CG-7194(5-13)
MATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH
YOU - PRIMARY AND NONCONTRIBUTORIr
This endorsement modifies insurance provided under
the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. Section II - Who Is An Insured is amended to
include as an additional insured:
a. Any person or organization for whom you are
performing operations when you and such
person or organization have agreed in
writing in a contract or agreement that such
person or organization be added as addi-
tional insured on your policy; and
b. Any other person or organization you are
required to add as an additional insured
under the contract or agreement described in
paragraph a above.
Such person or organization is an additional
insured only with respect to liability for bodily
injury, property damage or personal and ad-
vertising injury caused, in whole or in part, by:
a. Your acts or omissions; or
b. The acts or omissions of those acting on
your behalf;
in the performance of your ongoing operations
for the additional insured.
A person's or organization's status as an addi-
tional insured under this endorsement ends
when your operations for that additional insured
are completed.
2. With respect to the insurance afforded to these
additional insureds, the following additional ex-
clusions apply:
This insurance does not apply to:
a. Bodily injury, property damage or personal
and advertising injury arising out of the ren-
dering of, or the failure to render, any pro-
fessional architectural, engineering or sur-
veying services, including:
(1) The preparing, approving or failing to pre-
pare or approve maps, shop drawings,
opinions, reports, surveys, field orders,
change orders or drawings and spec-
ifications; or
(2) Supervisory, inspection, architectural or
engineering activities.
b. 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 addi-
tional insured(s) at the location of the
covered operations has been com-
pleted; 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 con-
tractor or subcontractor engaged in per-
forming operations for a principal as a
part of the same project.
The insurance provided by this endorsement is
primary and noncontributory.
CG-7194(5-13) Includes copyrighted material of Insurance Services Office, Inc, with its permission Page 1 of 1