2021/04/01 Howroyd Wright Employment Agency, Inc. dba AppleOne~1 HOWRGEN-01 aQR
,4` vRo CERTIFICATE OF LIABILITY INSURANCE DATE4/212 D/YYYY)
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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
MG Skinner 8: Associates
11030 Santa Monica Blvd., Suite 207
Los Angeles, CA 90025
INSURED
Howroyd Wright Employment Agency, Inc. dba AppleOne
P.O. Box 29048
Glendale, CA 91209-9048
COVERAGES
CERTIFICATE NUMRFR,.
INSURER F :
Phil
478-5041
RF11lgTr1N NIIVkRPPt
10) 479-8707
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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
ITRA
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE EKOCCUR
Contractual Liab.
X
IPHPK2256316
4/1/2021
4/1/2022
EACH OCCURRENCE
$ 3,000,000
DAMAGE TO RENTED 01—
$ 100,000
X
MED EXP iAny one erson
5,000
PERSONAL& ADV INJURY
31000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY E] PEO LOC
GENERAL AGGREGATE
3,000,000
PRO UCTS•COMP/OPAG
3'���'���
COMBINER SINGLE LIMIT
1 000 000
OTHER
A
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY _ AUTOS
X
PHPK2256316 4/1/2021
4/1/2022
X
BODILY INJURY IPerperson)
BODILY INJURY Peraccident
X
PERTY GE
r a Ident
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
I
EACH OCCURRENCE
$ 155000,000
A
X I
UMBRELLA LIAB
X
OCCUR
AGGREGATE
15,000,000
EXCESS LIAB
CLAIMS -MADE
IPHUB762438 4/1/2021
4/1/2022
DED I X I RETENTIONS 10,000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
[�p�
leratoryin NH) EXCLUDED?
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA A
WVLRC67816493
4/1I2021
I
4/1/2022
X PERI OTH-
E.L. EACH ACCIDENT
1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.I.. DISEASE - POLICY LIMIT
$ 1,000,000
A
Crime (3rd Party)
PHSD1619067 4/1/2021 4/1/2022
Occurrence/Aggregate
3,000,000
A
E&O/Prof. Liability
PHPK2256316 4/112021 4/1/2022
Occurrence/Aggregate
3,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Job ID: 00951349
Ciry of Menifee and its offices, employeees, agents and authorized volunteers are additional insureds. Primary and non-contributory coverage applies.
Separation of Insureds (cross liability) clause applies under General Liability. Notice of Cancellation under applicable policies: 30 days / 10 days for
non-payment of premium. General Liability and Auto Liability deductible: $0
City of Menifee
298" Haun Road
Menifee, CA 92586
ACORD 25 (2016/03)
SHOULD ANY OF THE ABOVE DESCRIBED POLII
THE EXPIRATION DATE THEREOF, NOTIC
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
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