2020/12/01 Charles E. Thomas Company, Inc. Certificate of Liability InsuranceAndreini & Company -San Mateo
220 West 20th Ave
San Mateo, CA 94403
46873 1 AB 0.416 46873
CITY OF MENIFEE
29844 HAUN RD
MENIFEE, CA 92586-6539
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Ace CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDD1YYYY)
12,11012020
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 CONTACT
Andreini & Company -San Mateo PHONE Lisa Salciccia
220 West 20th Ave f358IL .378-4238 c • 650-378-4361
San Mateo CA 94403 ADDRESS: Isalciccia0andreiriLcom
INSURED
Charles E- Thomas Company, Inc
13701 So Alma Avenue
Gardena CA 90249
_ INSURER A : Insurance Corr
CHARL-1 INSURER a! Crum &Forster
INSUREAC FederalInsural
INSURER E :
F:
Ins Cc
COVERAGES CERTIFICATE NUMBER- 17rr;an1e:t3 R1=Vlclnnl n111MR1lz• i
NAIL #
27847
44520
20281
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.
ILTR TYPE OF INSURANCE j,d $tJL�1SU13ft'4 PO{1,,ICY EFF POLICY EXP
II WV f POLICY NUMBER MM+QDlYYYY) I fMW0DfYYYYJ LIMITS
B
X COMMERCIAL GENERAL LIABILITY
Y
EPK133210
12/1/2020 12/1/2021
EACH OCCURRENCE
$2.000,000
PREMISES Ta 000wrgrlce)__
$100,000
CLAIMS -MADE MOCCUR
VIED EXP (Any oneperson)
$ 10,000
X
CPL-Pollution
PERSONAL & ADV INJURY
$ 2,000,000
GEto'LAGi3REGATELIMIT APPLIES PER;
POLICY X I JECT L� LOC
GENERAL AGGREGATE
$2.000,000
PRODUCTS-COMP;OPAGG
$2,000,000
CPL - per Occurence
$ 2,000,000
01 HER:
C
AUTOMOBILE LIABILITY
73612365 12/1/2020
12/1/2021
rMSiNEO&1N E MIS
_ 5 .d_du±.n1.
$1,000,000
X ANY AUTO
BODILY INJURY (Per person)
_
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per acciden0
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
P acc_k lj
$ .
X Cam $1 000 X Coll $1,0m
$
B
UMBRELLA LIAB X OCCUR
EFX114106
12/1/2020
12/1/2021
EACH OCCURRENCE
$4.000,000
X
AGGREGATE
$4,000,000
EXCESS LIAB f CLAIMS MADE
➢ED X RETENTION$
_
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
N / A
WPL504465502
12/1/2020
12/1/2021
XPER
STATUTE ER
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
— _
$1,000,000
(Mandatory In NH)
II yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$1,000 000
B
Errors&Omisslons
Claims Made
EPK133210
12/1/2020
12/1/2021
Occurrence
Aggregate
$2.000,000
$2,000,000
DESCRIPTION OF OPERATIONS ! LOCATIONS r VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
"This revised certificate updates policy numbers far General Liability and Excess Liability"
City of Menifee and its officials, officers, employees, and volunteers are included as Additional Insured with respects to General Liability where required by
written contract per the attached blanket endorsement.
CERTIFICATE HOLDER CANCELLATION
City of Menifee
29844 Haun Road
Menifee CA 92586
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
0 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
2 of 3 46873
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - STATE OR GOVERNMENTAL
AGENCY OR SUBDIVISION OR POLITICAL
SUBDIVISION - PERMITS OR AUTHORIZATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
CONTRACTORS POLLUTION LIABILITY COVERAGE PART
ERRORS AND OMISSIONS LIABILITY COVERAGE PART
THIRD PARTY POLLUTION LIABILITY COVER PART
ONSITE CLEANUP COVERAGE PART
SCHEDULE
State Or Governmental Agency Or Subdivision Or Political Subdivision:
here Required By Written Contract.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Under the Common Provisions, Section III —
Who Is An Insured is amended to include as an
insured any state or governmental agency or
subdivision or political subdivision shown in the
Schedule, subject to the following provisions:
1. This insurance applies only with respect to
operations performed by you or on your be-
half for which the state or governmental
agency or subdivision or political subdivision
has issued a permit or authorization.
2. This insurance does not apply to:
a. "Bodily injury" "property damage" "per-
sonal and advertising injury", a "pollution
condition" or a "wrongful act" arising out of
operations performed for the federal gov-
ernment, state or municipality; or
b. "Bodily injury" or "property damage" in-
cluded within the "products -completed op-
erations hazard".
EN0145-1111
Includes copyrighted material of Insurance Service Office, Inc. with its permission.
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