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2021/07/30 CVS Health Corporation0000949 SP 0321-001-P00949-1 05267-01 City of Manifee Attn: City Manager 2974 Haum Road Menifee, CA 92586 0321-01-00-0000949-0001-0002837 Her A�y DATE (MMIDD/YYYY) �f6LJ EVIDENCE OF PROPERTY INSURANCE 08/04/2021 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PHONE No. NE COMPANY Exty. Marsh USA Inc. - See attached for a list of additional insurers 99 High Street Boston, MA 02110 Attn: CVSCaremark.certrequest@Marsh I Fax: 212-948-5338 CN 101226639-STORE-PROP-21- CODE: I SUB CODE: I INSURED LOAN NUMBER POLICY NUMBER CVS HEALTH CORPORATION See Acord 101 For Full List ONE CVS DRIVE MC2180 WOONSOCKET, RI 02895 EFFECTIVE DATE EXPIRATION DATE 07/30/2021 .07/30/2022 CONTINUED UNTIL TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION IDESC R I PTIO N CVS Store #05267-01, Located: 26973 Newport Road, Menifee, CA 92584 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION PERILS INSURED I I BASIC BROAD X SPECIAL COVERAGE / PERILS I FORMS AMOUNT OF INSURANCE DEDUCTIBLE PERILS: "All Risk" of direct physical loss or damage to real property on a replacement cost basis. 50.000,000 40,000,000 Coverage Includes, but is not limited to fire, extended perils such as vandalism, malicious mischief, flood, and earthquake PROP COVERED: Real & Personal Property, Extra Expense, Improvements and Betterments, Structures in the Course of Construction, Newly Acquired Locations, Ordinance or Law and as more fully in the policy(ies). PROPERTY VALUATION: Real and Personal Property, Extra Expense, Improvements and Betterments Structures in the Course of Construction, Newly Acquired Locations and as more fully described in the policy(ies). The Perils of Terrorism and Mold are excluded. Plate Glass damages are covered. Rental Value is included on an actual loss sustained basis but only to the extent required by the lease. Various deductibles apply as per the policy terms and conditions KtMAKKb tincivaing apeciao t:Onamon8 City of Manifee is/are named as an Additional Insured as their interests may appear, as respects the leased premises, but only to the extent required under the lease of the premises or under any other written contract or agreement CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST NYC-008645684-20 NAME AND ADDRESS X ADDITIONAL INSURED LENDER'S LOSS PAYABLE u LOSS PAYEE MORTGAGEE 05267-01 City of Manifee LOAN # Attn: City Manager 2974 Haum Road Menifee, CA 92586 AUTHORIZED REPRESENTATIVE ACORD 27 (2016/03) @ 1993-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101226639 LOC #: Boston ACaRICJ°° ennirilntiei D=UAD Q Qf%LJ=ni ii Pone 7 of Z AGENCY Marsh USA Inc. POLICY NUMBER CARRIER NAIC CODE NAMED INSURED CVS HEALTH CORPORATION ONE CVS DRIVE MC2180 WOONSOCKET, RI 02895 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 27 FORM TITLE: Evidence of Property Insurance PARTICIPATING INSURERS: Factory Mutual Insurance Company Policy# 1083993 ACE American Insurance Company Policy # MAUD37869995007 "Allied World Assurance Company, Ltd Policy # P010154/014 Chubb European Group SE (Lloyd's CGM) Policy # BOWPN2151255 2623 /0623 AFB Lloyd's Syndicate (Beazley) Policy # BOWPN2151221 0033 HIS Lloyd's Syndicate Policy # BOWPN2151256 1183 TAL Lloyd's Syndicate Policy # BOWPN2150709 1458 RNR Lloyd's Syndicate Policy # BOWPN2150709 1200 AMA Lloyd's Syndicate Policy # BOWPN2150709 2010 MMX Lloyd's Syndicate Policy # BOWPN2150709 Ironshore Specialty Ins. Co. Policy # 1000413029-02 Starr Surplus Lines Ins. Co. Policy # SLSTPTY11509821 Hiscox Policy # LMPRP219804105 Everest Indemnity Insurance Company Policy # RP5CF00239-211 Landmark American Ins. Co. (RSUI) Policy # LHD919651 First Specially Insurance Corporation Policy #ESP200423603 Hilltop Specially Insurance Company Policy # HCS103355 `Hamilton Re Ltd Bda Policy # PX21-4405-01 "Liberty Specially Markets Bermuda Limited /Oil Casually Insurance, Ltd# 1-SMAPR159135A Lexington Insurance Company Policy # 11144874 National Fire & Marine Insurance Company Policy # 42-PRP-311785-01 Tokio Marine America Ins. Co US Policy # LCP6481298-01 Velocity Risk Underwriters Policy # 2020-9002589-02 Tidelis Insurance Bermuda Limited Policy# B21 R0226664M Star Stone Specially Insurance Company Policy #H70550210CSP 4444 CNP Lloyd's Syndicate Policy # B72336AAA BERMUDA' THE PROPERTY INSURANCE NUMBERS B21R0226664M„ LSMAPR159135A„P0101541014, AND PX21-4405-01 PLACEMENTS WERE MADE BY MARSH GLOBAL BROKING (BERMUDA), MARSH USA INC. HAS ONLY ACTED IN THE ROLE OF A CONSULTANT TO THE CLIENT WITH RESPECT TO THIS PLACEMENT, WHICH IS INDICATED HERE FOR YOUR CONVENIENCE, EVIDENCE/CERTIFICATES OF INSURANCE Any evidence of insurance issued in connection with this policy, including electronic memorandums of insurance, shall be issued solely as a matter of convenience or information for the addressee(s), holder(s) or viewer(s) of said evidence of insurance, except where under written contract with a third party the Insured is required to provide property insurance for the benefit of a third party and include the interest of such third party under said property policy as either additional insured, loss payee or mortgagee pursuant to said contract. In such event, the interest of such third party as either additional insured, loss payee or mortgagee as its interest may appear shall be covered under this policy as of the inception dale of this policy if the contract had been entered into by the Insured prior to the policy's inception dale, or as of the date the Insured enters into contract with the third party if such date occurs subsequent to the policy's inception, subject otherwise to all of the policy's, terms, conditions and exclusion. Further, the inclusion of such additional interest(s) shall not increase this Company's limit of liability under this policy - It is also agreed [hat in the event of loss or damage to property insured under the Insured's properly policy where the third party has an interest in said property per contract with the Insured as either additional insured, loss payee or mortgagee and is not otherwise specifically named under the policy or made known to the Company prior to loss, such interest will be notified to the ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights The ACORD name and logo are registered marks of ACORD 0321-01-00-0000949-0002-0002838 ipNt�:t AGENCY CUSTOMER ID: CN101226639 LOC #: Boston AC"RO® AnnITInNAI RFMARKS SCHFntjLF Page 3 of 3 AGENCY Marsh USA Inc. POLICY NUMBER CARRIER ADDITIONAL REMARKS NAIC CODE NAMED INSURED CVS HEALTH CORPORATION ONE CVS DRIVE MC2180 WOONSOCKET, RI 02895 EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 27 FORM TITLE: Evidence of Property Insurance Company on the date of the notice of loss per the policy's conditions or as soon as reasonably practicable thereafter. Failure to timely notify the Company in such event will not relieve this Company of any liability for said additional interests, but will be corrected as soon as possible. STANDARD MORTGAGEE CLAUSE Loss or damage, if any, under this policy, shall be payable to any mortgagee, (or trustee) as designated herein by endorsement or certificate of insurance, as interests may appear, under all Present or future mortgages upon the property herein described in which the aforesaid may have an interest as mortgagee(or trustee), in order of precedence of said mortgagees, and this insurance, as to the interest of the mortgagee or trustee only therein, shall not be invalidated by any act or neglect of the mortgagor or owner of the within described property, nor by any foreclosure or other proceedings or notice of sale relating to the property, nor by any change in the title or ownership of the property nor by the occupation of the premises for purposes more hazardous than are permitted by this policy; provided, that in case the mortgagor or owner shall neglect to pay any premium due under this policy. the mortgagee or trustee, shall, on demand, pay the same. Provided also, that the mortgagee (or trustee) shall notify the Companies of any change of ownership or occupancy or increase of hazard which shall come to the knowledge of said mortgagee, (or trustee) and, unless permitted by this policy, it shall be noted [hereon and the mortgagee (or trustee) shall, on demand, pay the premium for such increased hazard for the term of the use thereof; otherwise this policy shall be null and void. The Company reserves the right to cancel this policy at any time provided by its terms, but in such case this policy shall continue in force for the benefit only of the mortgagee (or trustee) for 90 days after notice to the mortgagee (or trustee) of such cancellation and shall then cease and the Companies shall have the right, on like notice, to cancel this agreement. Whenever the Companies shall pay the mortgagee (or trustee) any sum for loss or damage under this policy and shall claim that, as to the mortgagor or owner, no liability therefore existed, the Companies shall, to the extent of such payment, be thereupon legally subrogated to all rights of the party to whom such payment shall be made under all securities held as collateral to the mortgage debt, or may, at its option, pay to the mortgagee (or trustee) the whole principal due or to grow due on the mortgage with interest accrued thereon to the date of such payments, and shall receive a full assignment and transfer of the mortgage and of all such other securities; but no subrogation shall impair the right of the mortgagee (or trustee) to recover the full amount of said mortgagee's (or trustee's) claim. CANCELLATION A, This policy may be canceled at any time at the request of the Insured or it may be canceled by the Company by mailing to the Insured at Director of Risk Management One CVS Drive Woonsocket, RI 02895 and to the additional insureds/loss payees or mortgagee indicated on the certificates of insurance issued during the term of this policy, written notice slating when, not less than 90 days thereafter, such cancellation shall be effective- The earned premium shall be computed on a pro-rata basis. B,The mailing of notice as aforesaid shall be sufficient proof of notice and the effective date and hour of cancellation stated in the notice shall become the end of the policy period. Delivery of such written notice either by the Insured or by the Company shall be equivalent to mailing. C.Cancellalion shall not affect coverage on any shipment in transit on the dale of cancellation. Coverage will continue in full force until such property is safely delivered and accepted at place of final destination. D.In the event of non-payment of premium this policy may be canceled by the Company by mailing to the Insured at the address shown in A. above stating when, not less than 10 days thereafter, such cancellation shall be effective. Reinstatement of coverage shall be effective immediately upon receipt of premium by the Company ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Dear Certificate Holder: As many companies have moved to a remote working environment, mailing Certificates of Insurance to a physical address can cause unnecessary delays in providing you goof of insurance. To streamline deliveryand in an effort to support o€arfirm's commitment to sustainability, going forward,, we would like to distribute your Certificates of Insurance electronicallyif possible. We are kindly requesting Certificate Molders provide us an email address where we can deliver your COI in the future. Please sere your response to: U50peFations.ema'il@marsh.com and provide the following information so that we can expedite your C01 delivery: • Certificate # (Showery below Insured Name — e, .: ABC-12 5 78 -t11) ■ -Mail for feature delivery: For- undeliverable email addresses, our systern is configured to automatically redirect the Certificate for dellveryvia LISPS. Lastly, if you no longer need this C0I please respond to US©perat.ions.ernail(@rnarsh.com with the Certificate number and we will inactive the record in our system to avoid future automatic delivery, "rhank. you. US Operations, Marsh USA, Inc. u �S 0321-01-00-0000949-0003-0002839