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2020/09/28 Dennis Janda, Inc. 12935 DocuSign Envelope ID:2D796F2D-B2CB-4BE4-9C6E-B9991097063D DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 09/29/2020 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 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 NAME: Strachota Insurance Agency, Inc. PHONE FAX 27710 Jefferson Ave., Ste. 100 Alc No Ext: (951) 676-2229 plc No:(951) 676-7391 E-MAIL melonee@strachota.com Temecula CA 92590 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Colony Insurance Company 39993 INSURED INSURER B:California Automobile Ins Co. 38342 Dennis Janda Inc. INSURER C:Ohio Security Insurance Company 24082 42164 Remington Avenue INSURERD:Landmark American Insurance Co. 33138 Temecula CA 92590 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 12935 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMACLAIMS-MADE � OCCUR Y 103GL002584402 09/28/2020 09/28/2021 PREMISES ETORENTED PREMISES Ea occurrence) ccurrence $ 100,000 MED EXP(Any one person) $ excluded PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE� LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident 1,000,000 B ANY AUTO Y BA040000055531 11/08/2019 11/08/2020 BODILY INJURY(Per person) $ X ALL OWNED rx SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C AND EMPLOYERS'LIABILITY WORKERS COMPENSATION Y/N XWS56173896 07/03/2020 07/03/2021 X STATUTE OERH ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D Professional Liability LHR840112 05/08/2020 05/08/2021 Each Claim $ 1,000,000 Aggregate $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Menifee, its officers, agents and employees are an Additional Insured with respects to the General Liability per the attached CG20100413 endorsement. Also an Additional Insured with respects to the Commercial Automobile per the attached MCA85100817CA endorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Menifee ACCORDANCE WITH THE POLICY PROVISIONS. 29714 Haun Road AUTHORIZED REPRESENTATIVE Menifee CA 92586 k��� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Page 1 of 1 DocuSign Envelope ID:2D796F2D-B2CB-4BE4-9C6E-B9991097063D POLICY NUMBER: 103 GL 0025844-02 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations All persons or organizations as required by written As designated in written contract with the Named contract with the Named Insured Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for"bodily injury", "property This insurance does not apply to "bodilyinjury" or damage" or "personal and advertising injury" property damage occurring ng after: y caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 DocuSign Envelope ID:2D796F2D-B2CB-4BE4-9C6E-B9991097063D C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III — Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1 . Required by the contract or agreement; or Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 DocuSign Envelope ID:2D796F2D-B2CB-4BE4-9C6E-B9991097063D POLICY NUMBER: 103 GL 0025844-012. COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations All persons or organizations as required by written As designated in written contract with the Named Insured contract with the Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II —Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III— Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage"caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 DocuSign Envelope ID:2D796F2D-B2CB-4BE4-9C6E-B9991097063D From: Margarita Corneio To: Paula Muratore Subject: FW:Agreement Review Request: Professional Services Agreement with Dennis Janda for CIP 21-14 for Topographical Survey Date: Wednesday,October 21,2020 11:12:49 AM Attachments: 2021 PW-ENG-PROFESSIONAL SERVICES AGREEMENT(DENNIS JANDA)(CIP 21-14 SURVEY).docx From: Margarita Cornejo Sent: Wednesday, October 21, 2020 11:12 AM To:Jeffery T. Melching<jmelching@rutan.com> Subject:Agreement Review Request: Professional Services Agreement with Dennis Janda for CIP 21- 14 for Topographical Survey Good Afternoon Jeff, Attached for your review is the proposed Professional Services Agreement with Dennis Janda for Topographic Survey for CIP 21-14 (Ashdale Way Drainage). This agreement request is from the City's Public Works/Engineering Department. Can you please review and advise if this is ok to start routing for signatures or will require any changes? Thank you again! Margarita Cornejo i Financial Services Manager Finance Department City of Menifee 1 29844 Haun Road I Menifee, CA 92586 (*Please note our new location!) Direct: (951) 723-3716 1 City Hall: (951) 672-6777 1 Fax: (951) 679-2568 mcornejo@cityofinenifee.us 1- C q MENIFEE New. Better. Best. �► ii �n Connect with us on social media: