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2021/01/01 Bureau Veritas North America, Inc. Certificate of Liability Insurance1 A�a�o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) , 2/22/2020 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 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). PRODUCER AOn Risk services Northeast, Inc. Aon Risk Services Northeast, Inc. NY NY Office One Liberty Plaza CONTACT NAME' PHONE (XC.ND.Exl): 866-283-7122 FAX No : 800-363-0105 E-MAIL ADDRESS: 165 Broadway, Suite 3201 New York NY 10006 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Hartford Fire Insurance Co. 19682 Bureau Veritas North America, Inc. 180 Promenade Circle, suite 150 Sacramento CA 95834 USA INSURER8: Hartford underwriters Insurance Company 30104 INSURERC: AllianZ Global Risks US Insurance Co. 35300 INSURER D: Trumbull Insurance Company 27120 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570085339729 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A50VE 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WV❑ POLICY NUMBER MhErD01YYY MMIDOIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY USL EACH OCCURRENCE $2 , 000, 000 CLAIMS -MADE OCCUR PREMISES _.occurrence $1,000,000 MED EXP (Any one person) $10 , 000 PERSONAL& ADV INJURY $2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2 , 000, 000 POLICY X PRO % LOC �JECT PRODUCTS - COMP/OPAGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY 10 AS 541202 AOS 01/01/2021 01/01/2022 COMBINED SINGLE LIMIT !G n $2 , 000 , 000 BODILY INJURY( Per person) B X ANYAUTO 10 AB s41203 01/01/2021 01/01/2022 OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY HI BODILY INJURY (Per accident) PROPERTY DAMAGE iParaccident UMBRELLA LIAB EACH OCCURRENCE EXCESS LAB HOOCUR CLAIMS -MADE AGGREGATE DED I RETENTION D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA 10WNs412uu See State Policy Addendum 01/01/2021 1 I X PER STATUTE OTH- A E.L. EACH ACCIDENT $1, 000 , 000 E.L•DISEASE-EA EMPLOYEE $1,000,000 (Mandatory in NH) If as, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1. 000 , 000 C Archit&Eng ProfUSF 4 1 01/01/2021 01/01/2022 Each Claim $1,000,000 Claims Made Aggregate $1,000,000 SIR applies per policy ter as & condi ions DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additlonsl Ram6rka ScMdule, may be attached if more space is required) Certificate Holder is included as Additional Insured in accordance with the policy provisions of the Business Auto Coverage & General Liability Coverage policy. iL d N t` rn M 0 0 LO LO CERTIFICATE HOLDER CANCELLATION Z SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Menifee AUTHORIZED REPRESENTATIVE 29714 Haun Road Menifee CA 92586 USA J4'osa ��r�rM.s�rd �sd� ✓sars ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000048582 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMEDINSURED Aon Risk Services Northeast, Inc. Bureau Veritas North America, Inc. POLICY NUMBER see Certificate Number: 570085339729 CARRIER I NAIC CODE See Certificate Number: 570085339729 1 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation/Employers Liability 10WNs41200 01/01/21-01/01/22 Trumbull Insurance AR,DC,IN,LA,RI,UT 1OWNS41200 01/01/21-01/01/22 Twin City Fire Insurance Company FL,ND,OH,WA,WY 1OWNS41200 01/01/21-01/01/22 Hartford Insurance Company of the Midwest AK,ID 10WNs41200 01/01/21-01/01/22 Hartford Casualty Insurance Company MO,TX IOWNS41200 01/01/21-01/01/22 Nutmeg Insurance Company CT,IL 10WNs41200 01/01/21-01/01/22 Hartford Fire Insurance Company NH,OR,PA 10WNs41200 01/01/21-01/01/22 Hartford Accident and Indemnity Company AL,GA,KY,ME,MI,MT,NE,NY,TN,VT 10WNs41200 01/01/21-01/01/22 Property /Casualty Insurance Company of Hartford CA,CO3DE,MN,MS,SC 10WNs41200 01/01/21-01/01/22 Hartford Insurance Company of Illinois WV 1OWNS41200 01/01/21-01/01/22 Hartford Insurance company of the southeast KS,MD 10WNs41200 01/01/21-01/01/22 Hartford Underwriters Insurance Company AZ,HI,MA,NC,NJ,SD,VA 10WNs41200 01/01/21-01/01/22 sentinel Insurance Company, Limited IA,NM,NV,OK 10WBRs41201 01/01/21-01/01/22 Twin City Fire Insurance Company WI 1OWBRS41201 01101121-01101122 Hartford Fire Insurance Company PR ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD