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2020/08/01 NextRequest Co 2578
DocuSign Envelope ID:234E9D9F-B37F-4EDB-ABE6-15DE6D3E75CF DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 10/23/2020 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: Melissa Rivera The Cody Group, Inc. PHONE FAX 150 W 28th Street A/c No Ext: (212) 641-0429 A/C No), E-MAIL rou n melissa@cod New York NY 10001 ADDRESS: Y9 p Y•com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Continental Casualty Company 20443 INSURED INSURER B:Valley Forge Insurance Company 20508 NextRequest Co INSURER c:Beazley Insurance Company 37540 433 Bryant St. INSURER0: San Francisco CA 94107 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 2578 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 B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE To RENTED CLAIMS-MADE IX I OCCUR Y Y 6020843282 11/24/2019 11/24/2020 PREMISES(Ea occurrence) ccurence) $ 300,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY❑ PRO- P ❑ LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident 1,000,000 A ANY AUTO 6020843282 11/24/2019 11/24/2020 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ /M OFFICEREMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Professional Liability & W24157200301 08/01/2020 08/01/2021 Per $ 3,000,000 occurrence/agg Cyber/Network Liability Retro Date 8/1/18 Retention $ 25,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Menifee, and its officers, employees, agents, and authorized volunteers are included as additional insured as required and confirmed by written contract or agreement. Coverage is primary and non-contributory as required and confirmed by written contract or agreement. Waiver of subrogation applies as required and confirmed by written contract or agreement. Thirty (30) Day notice of cancellation; Ten (10) Day notice of cancellation in the event of non-payment of premium. 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. 29844 Haun Road AUTHORIZED REPRESENTATIVE Menifee CA 92586 t ©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:234E9D9F-B37F-4EDB-ABE6-15DE6D3E75CF THE HARTFORD BUSINESS SERVICE CENTER THE 3600 WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 October 26, 2020 City of Menifee and its officers, employees,agents and authorized volunteers 29844 HAUN RD MENIFEE CA 92586 Account Information: Contact Us Policy Holder Details : NEXTREQUEST CO Business Service Center Business Hours: Monday- Friday (7AM -7PM Central Standard Time) Phone: (866)467-8730 Fax: (888)443-6112 Email: agency.services(@_thehartford.com Website: https://business.thehartford.com Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team WLTRO05 DocuSign Envelope ID:234E9D9F-B37F-4EDB-ABE6-15DE6D3E75CF CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/26/2020 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 SUBROGATIONIS 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 NUTMEG INSURANCE AGENCY INC/PHS NAME: 46508229 PHONE (866)467-8730 FAX (888)443-6112 (A/C,No,Ext): (A/C,No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio,TX 78251 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Hartford Fire and Its P&C Affiliates 00914 NEXTREQUEST CO INSURER B: 460 BRANNAN ST UNIT 77208 INSURER C SAN FRANCISCO CA 94107 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE❑OCCUR DAMAGE TO RENTED PREMISES Ea occurrence MED EXP(Any one person) PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY❑PRO ❑LOC PRODUCTS-COMP/OP AGG JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) HIRED NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE DED RETENTION$ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY YIN E.L.EACH ACCIDENT $1,000,000 A PROPRIETOR/PARTNER/EXECUTIVE N/A 46 WBG AP1337 04/21/2020 04/21/2021 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION City of Menifee and its officers, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED employees,agents and BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED authorized volunteers IN ACCORDANCE WITH THE POLICY PROVISIONS. 29844 HAUN RD AUTHORIZED REPRESENTATIVE MENIFEE CA 92586 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:234E9D9F-B37F-4EDB-ABE6-15DE6D3E75CF CNA� � � SB-1(Ed. 06E 1) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - LIABILITY EXTENSION This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Policy. 1. ADDITIONAL INSURED—BLANKET VENDORS own acts or omission or those of its employees or anyone else acting on its WHO IS AN INSURED is amended to include as an behalf. However, this exclusion does not additional insured any person or organization (referred apply to: to below as vendor) with whom you agreed, because of a written contract or agreement to provide (1) The exceptions contained in insurance, but only with respect to "bodily injury" or Subparagraphs d. or f.; or "property damage" arising out of"your products"which (2) Such inspections, adjustments, tests or are distributed or sold in the regular course of the servicing as the vendor has agreed to vendor's business, subject to the following additional make or normally undertakes to make in exclusions: the usual course of business, in 1. The insurance afforded the vendor does not apply connection with the distribution or sale of to: the products. a. "Bodily injury" or "property damage" for which 2. This insurance does not apply to any insured the vendor is obligated to pay damages by person or organization, from whom you have reason of the assumption of liability in a acquired such products, or any ingredient, part or contract or agreement. This exclusion does container, entering into, accompanying or not apply to liability for damages that the containing such products. vendor would have in the absence of the 3. This provision 2. does not apply to any vendor contract or agreement; included as an insured by an endorsement issued b. Any express warranty unauthorized by you; by us and made a part of this Policy. c. Any physical or chemical change in the 4. This provision 2. does not apply if"bodily injury" or product made intentionally by the vendor; "property damage" included within the "products- completed operations hazard" is excluded either d. Repackaging, except when unpacked solely by the provisions of the Policy or by endorsement. for the purpose of inspection, demonstration, testing, or the substitution of parts under 2. MISCELLANEOUS ADDITIONAL INSUREDS instructions from the manufacturer, and then WHO IS AN INSURED is amended to include as an repackaged in the original container; insured any person or organization (called additional e. Any failure to make such inspections, insured) described in paragraphs 2.a. through 2.h. adjustments, tests or servicing as the vendor below whom you are required to add as an additional has agreed to make or normally undertakes to insured on this policy under a written contract or make in the usual course of business, in agreement but the written contract or agreement must connection with the distribution or sale of the be: products; 1. Currently in effect or becoming effective during the f. Demonstration, installation, servicing or repair term of this policy; and operations, except such operations performed 2. Executed prior to the "bodily injury," "property at the vendor's premises in connection with damage"or"personal and advertising injury," but the sale of the product; Only the following persons or organizations are g. Products which, after distribution or sale by additional insureds under this endorsement and you, have been labeled or relabeled or used coverage provided to such additional insureds is as a container, part or ingredient of any other limited as provided herein: thing or substance by or for the vendor; or a. Additional Insured—Your Work h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its SB-146932-E31 Page 1 of 5 (Ed. 06/11) DocuSign Envelope ID:234E9D9F-B37F-4EDB-ABE6-15DE6D3E75CF SB-146932-E31 (Ed. 06/11) That person or organization for whom you do behalf for which the state or political work is an additional insured solely for liability subdivision has issued a permit. due to your negligence specifically resulting from your work for the additional insured This insurance does not apply to "bodily which is the subject of the written contract or injury," "property damage" or 'personal and written agreement. No coverage applies to advertising injury" arising out of operations liability resulting from the sole negligence of performed for the state or municipality. the additional insured. c. Controlling Interest The insurance provided to the additional Any persons or organizations with a insured is limited as follows: controlling interest in you but only with respect (1) The Limits of Insurance applicable to the to their liability arising out of: additional insured are those specified in (1) Their financial control of you; or the written contract or written agreement or in the Declarations of this policy, (2) Premises they own, maintain or control whichever is less. These Limits of while you lease or occupy these Insurance are inclusive of, and not in premises. addition to, the Limits of Insurance shown This insurance does not apply to structural in the Declarations. alterations, new construction and demolition (2) The coverage provided to the additional operations performed by or for such additional insured by this endorsement and insured. paragraph F.9. of the definition of"insured d. Managers or Lessors of Premises contract" under Liability and Medical Expenses Definitions do not apply to A manager or lessor of premises but only with "bodily injury" or "property damage" respect to liability arising out of the ownership, arising out of the "products-completed maintenance or use of that specific part of the operations hazard" unless required by the premises leased to you and subject to the written contract or written agreement. following additional exclusions: (3) The insurance provided to the additional This insurance does not apply to: insured does not apply to "bodily injury," (1) Any "occurrence" which takes place after "property damage," or "personal and advertising injury" arising out of the you cease to be a tenant in that premises; or rendering or failure to render any professional services. (2) Structural alterations, new construction or b. State or Political Subdivisions demolition operations performed by or on behalf of such additional insured. N A state or political subdivision subject to the e. Mortgagee,Assignee or Receiver following provisions: A mortgagee, assignee or receiver but only (1) This insurance applies only with respect with respect to their liability as mortgagee, to the following hazards for which the assignee, or receiver and arising out of the state or political subdivision has issued a ownership, maintenance, or use of a premises permit in connection with premises you by you. own, rent, or control and to which this insurance applies: This insurance does not apply to structural (a) The existence, maintenance, repair, alterations, new construction or demolition construction, erection, or removal of operations performed by or for such additional advertising signs, awnings, canopies, insured. cellar entrances, coal holes, f. Owners/Other Interests— Land is Leased driveways, manholes, marquees, An owner or other interest from whom land hoistaway openings, sidewalk vaults, has been leased by you but only with respect street banners, or decorations and to liability arising out of the ownership, similar exposures; or maintenance or use of that specific part of the (b) The construction, erection, or land leased to you and subject to the following removal of elevators; or additional exclusions: (2) This insurance applies only with respect This insurance does not apply to: to operations performed by you or on your SB-146932-E31 Page 2 of 5 (Ed. 06/11) DocuSign Envelope ID:234E9D9F-B37F-4EDB-ABE6-15DE6D3E75CF SB-146932-E31 (Ed. 06/11) (1) Any "occurrence" which takes place after A. Under B. Exclusions, 1. Applicable to Business you cease to lease that land; or Liability Coverage, Exclusion k. Damage To (2) Structural alterations, new construction or Property, is replaced by the following: demolition operations performed by or on k. Damage To Property behalf of such additional insured. "Property damage"to: g. Co-owner of Insured Premises 1. Property you own, rent or occupy, A co-owner of a premises co-owned by you including any costs or expenses incurred and covered under this insurance but only by you, or any other person, organization with respect to the co-owners liability as co- or entity, for repair, replacement, owner of such premises. enhancement, restoration or maintenance h. Lessor of Equipment of such property for any reason, including prevention of injury to a person or Any person or organization from whom you damage to another's property; lease equipment. Such person or organization 2. Premises you sell, give away or abandon, are insureds only with respect to their liability if the "property damage" arises out of any arising out of the maintenance, operation or part of those premises; use by you of equipment leased to you by such person or organization. A person's or 3. Property loaned to you; organization's status as an insured under this 4. Personal property in the care, custody or endorsement ends when their written contract control of the insured; or agreement with you for such leased equipment ends. 5. That particular part of any real property With respect to the insurance afforded these on which you or any contractors or additional insureds, the following additional subcontractors working directly or exclusions apply: indirectly in your behalf are performing operations, if the "property damage" This insurance does not apply: arises out of those operations; or (1) To any "occurrence" which takes place 6. That particular part of any property that after the equipment lease expires; or must be restored, repaired or replaced ( ) � ry°2 To "bodilyinjury," "property p y damage"" ro " because "your work" was incorrectly ge or "personal and advertising injury" arising performed on it. out of the sole negligence of such Paragraph 2 of this exclusion does not apply if additional insured. the premises are "your work" and were never Any insurance provided to an additional insured occupied, rented or held for rental by you. designated under paragraphs b. through h. above Paragraphs 1, 3, and 4, of this exclusion do does not apply to "bodily injury" or "property not apply to "property damage" (other than damage" included within the "products-completed damage by fire or explosion)to premises: operations hazard." (1) rented to you; 3. The following is added to Paragraph H. of the BUSINESSOWNERS COMMON POLICY (2) temporarily occupied by you with the CONDITIONS: permission of the owner, or H. Other Insurance (3) to the contents of premises rented to you for a period of 7 or fewer consecutive 4. This insurance is excess over any other valid days. and collectible insurance naming the A separate limit of insurance applies to additional insured as an insured whether Damage To Premises Rented To You as primary, excess, contingent or on any other described in Section D — Liability and Medical basis unless a written contract or written agreement specifically requires that this Expenses Limits of Insurance. insurance be either primary or primary and Paragraphs 3, 4, 5, and 6 of this exclusion do noncontributing. not apply to liability assumed under a 4. LEGAL LIABILITY—DAMAGE TO PREMISES sidetrack agreement. Paragraph 6 of this exclusion does not apply to "property damage" included in the "products-completed operations hazard." SB-146932-E31 Page 3 of 5 (Ed. 06/11) DocuSign Envelope ID:234E9D9F-B37F-4EDB-ABE6-15DE6D3E75CF SB-146932-E31 (Ed. 06/11) B. Under B. Exclusions, 1. Applicable to Business 7. Bodily Injury Liability Coverage, the last paragraph of 2. Section F. Liability and Medical Expenses Exclusions is deleted and replaced by the Definitions, item 3. "Bodily Injury" is deleted and following: replaced with the following: Exclusions c, d, e, f, g, h, i, k, I, m, n, and o, do "Bodily injury" means bodily injury, sickness or not apply to damage by fire to premises while disease sustained by a person, including death, rented to you or temporarily occupied by you with humiliation, shock, mental anguish or mental injury by permission of the owner or to the contents of that person at any time which results as a premises rented to you for a period of 7 or fewer consequence of the bodily injury, sickness or disease. consecutive days. A separate limit of insurance applies to this coverage as described in Section 8. Expanded Personal and Advertising Injury D. Liability And Medical Expenses Limits Of Definition Insurance. a. The following is added to Section F. Liability and C. The first Paragraph under item 5. Damage To Medical Expenses Definitions, item 14. Premises Rented To You Limit of Section D. Personal and Advertising Injury, in the Liability And Medical Expenses Limits Of Businessowners General Liability Coverage Insurance is replaced by the following: Form: The most we will pay under Business Liability for h. Discrimination or humiliation that results in damages because of "property damage" to any injury to the feelings or reputation of a natural one premises, while rented to you, or temporarily person, but only if such discrimination or occupied by you, with the permission of the humiliation is based solely on either disparate owner, including contents of such premises rented impact (as opposed to disparate treatment) or to you for a period of 7 or fewer consecutive days, vicarious liability, and: is the Damage to Premises Rented to You limit shown in the Declaration. 1. Not done intentionally by or at the direction of: 5. Blanket Waiver of Subrogation a. The insured; or We waive any right of recovery we may have against: b. Any "executive officer," director, a. Any person or organization with whom you have a stockholder, partner, member or written contract that requires such a waiver. manager (if you are a limited liability 6. Broad Knowledge of Occurrence company)of the insured; and The following items are added to E. Businessowners 2. Not directly or indirectly related to the General Liability Conditions in the Businessowners employment, prospective employment, Liability Coverage Form: past employment or termination of N employment of any person or person by e. Paragraphs a. and b. apply to you or to any any insured. additional insured only when such "occurrence," b. The following is added to Exclusions, Section B.: offense, claim or"suit" is known to: (1) You or any additional insured that is an (15)Discrimination Relating to Room, Dwelling individual; or Premises (2) Any partner, if you or an additional insured is Caused by discrimination directly or indirectly a partnership; related to the sale, rental, lease or sub-lease or prospective sale, rental, lease or sub-lease (3) Any manager, if you or an additional insured of any room, dwelling or premises by or at the is a limited liability company; direction of any insured. (4) Any "executive officer" or insurance manager, (16)Fines or Penalties if you or an additional insured is a corporation; Fines or penalties levied or imposed by a (5) Any trustee, if you or an additional insured is a governmental entity because of trust; or discrimination. (6) Any elected or appointed official, if you or an c. This provision (Expanded Personal and additional insured is a political subdivision or Advertising Injury) does not apply if Personal public entity. and Advertising Injury Liability is excluded This paragraph e. applies separately to you and either by the provisions of the Policy or by endorsement. any additional insured. SB-146932-E31 Page 4 of 5 (Ed. 06/11) DocuSign Envelope ID:234E9D9F-B37F-4EDB-ABE6-15DE6D3E75CF SB-146932-E31 (Ed. 06/11) 9. Personal and Advertising Injury Re-defined room dwelling or premises that a person or Section F. Liability and Medical Expenses Definitions, organization occupies committed by or on behalf item 14, Personal Advertising Injury, Paragraph c. is of it's owner, landlord or lessor. replaced by the following: c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a SB-146932-E31 Page 5 of 5 (Ed. 06/11)