2020/06/01 Language Line Services, Inc. W16490417 (3) DocuSign Envelope ID:42048F6E-18EE-4924-B750-AE413F1 BFA44 Page I of 1
"' CERTIFICATE OF LIABILITY INSURANCE DATEIMMID
��• 05/19/2020 )
020
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 Willis Towers Watson Certificate Center
NAME:
Willis Towers Watson Northeast, Inc. PHONE 1-877-945-7318 FAX 1-BBB-467-2378
c/o 26 Century Blvd - AIC,.No):
P.O. Box 305191 EMMAlL certificates@willis.Com
DbRE8 .
Nashville, TN 372305191 USA INSURE $AFFORDING COVERAGE NAICU
C1TYf HA CEIFEE INSURER A: Great Northern Insurance Company 20303
INSURED INSURER B• Federal Insurance Company 20281
Language Line Services, Inc.
One Lower Ragsdale Drive �UN U 2 2020 INSURERC: Vigilant Insurance Company 20397
Building 2 INSURER D
Monterey, CA 93940 RECEIVED _INSURERE.-
INSURER
COVERAGES CERTIFICATE NUMBER:W16490417 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
ILTR TYPE OF INSURANCE AnDL SUeR POLICY EFF POLICY EXP
POLIOYNI]MBER MPo!6EYYYY) IMMf0Q:Vyyy1 LIMITS
X I COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000
CLAIMS-MADE OCCUR PREMISEtte_gCplrrgncuV $ 1,000,000
A MED EXP(Any one person) $ 10,000
Y 3595-61-78 06/01/2020 06/01/2021 PERSONAL&ADV INJURY $ 1,000,000
GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY Lam' PRO U LOC PRODUCTS-COMP/OP AGG . $ 2,000,000
JECT
OTHrrt is
AUTOMOBILE LIABILITY COMBINED SIN E LIMI
r (Ea accidornll $ 1,000,000
ANY AUTO BODILY INJURY(Per person) $
B OWNED SCHEDULED , 73576109 06/01/2020 06/01/2021 BODILY INJURY(Peraocldonl)' $
X, AUTOS ONLY AUTOS $
HIRED X{ NON-OWNED PROPER7YI7AMAflE
AUTOS ONLY AUTOS ONLY (Per accident)
B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
EXCESS LIAB CLAIMS-MADE 7987-71-21 06/01/2020 06/01/2021 AGGREGATE $ 5,000,000
DED F-1 RETENTION$ $
WORKERS COMPENSATION X TAT T ERH
AND EMPLOYERS'LIABILITY 1,000,000
C ANYPROPRIETOPJPARTNER/EXECUTIVE Y/N I E.L.EACH ACCIDENT $
OFFICER/MEMBEREXCLUDED? NIA 7174-35-69 06/01/2020 06/01/2021 1,000,Otl0'
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $
II yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below r E.L.DISEASE•POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space is required)
City of Menifee and its officers, employees, agents, and authorized volunteers are included as Additional Insureds as
respects General Liability.
The General Liability policy shall be Primary and Non-Contributory with any other insurance in force for or which may
be purchased by the Additional Insureds.
CERTIFICATE HOLDER 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.
City of Menifee AUTHORIZED REPRESENTATIVE
29844 Road
Menifeee,, C CA 92566
9)1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
sR 1D: 19629514 BATCH: 1684774
202 2060
DocuSign Envelope ID:42048F6E-18EE-4924-B750-AE413F1 BFA44
Dated: 05/20/20
CA848143
7114 7389 6621 3761 0695
CALIFORNIA PRELIMINARY NOTICE
This is not a Lien. Civil Code Sections 8200, et seq., 9300, et seq.
Reputed Owner or Public Entity CI 1 -You are hereby notified that
05/20/20 CA848143 FINANCE FEE REXEL USA INC DBA GEXPRO
CITY OF MENIFEE 2099 S STATE COLLEGE BLVD#200
29844 HAUN RD JUN 0 2 2020 ANAHEIM CA 92806
MENIFEE CA 92586 RECEIUtD
Reputed Construction Lender or Lessee 2-Has furnished or will furnish labor,
services,equipment, or materials of
CO# R-687/BOND#36KO13524 the following general description:
CULBERSTON INS SERVICES INC ELECTR. EQUIPMENT& SUPPLIES
5500 E SANTA ANA CANYON RD
#201/ANAHEIM CA 92807
3 -An estimate of the total price of the
Reputed Direct Contractor labor,services,equipment,or materials
DBX INC furnished or to be furnished is:
ATTN: ACCOUNTS PAYABLE $142,000.00
42024 AVENIDA ALVARADO#A
TEMECULA CA 92590 4-The building,structure or other work of
NOTICE TO PROPERTY OWNER
improvement is located at:EVEN THOUGH YOU HAVE PAID YOUR R-687 TRAFFIC SIGNAL @
CONTRACTOR IN FULL, if the person or firm that has MENIFEE-HOLLAND TS &
given you this notice is not paid in full for labor, MENIFEE/CAMINO CRYSTAL RD
service, equipment or material provided or to be MENIFEE/HOLLAND RD
provided to your construction project, a lien may be MENIFEE CA 92586
placed on your property. Foreclosure of the lien may 5-The party to or for whom the work is provided.
lead to loss of all or part of your property. You may wish
to protect yourself against this by (1) requiring your 1081356/DBX INC
contractor to provide a signed release by the person 42024 AVENIDA ALVARADO#A
or firm that has given you this notice before making TEMECULA CA 92590-3405
payment to your contractor, or(2) any other method that The relationshipa to the p rty(ies)giving this notice is:
is appropriate under the circumstances. This notice is Material Supplier
required by law to be served by the undersigned as a 6-Name and address of Trust Funds to which
statement of your legal rights. This notice is not intended Supplemental Fringe Benefits are payable
to reflect upon the financial condition of the contractor (if applicable):
or the person employed by you on the construction
project. If you record a notice of cessation or completion
of your construction project,you must within 10 days
after recording, send a copy of the notice of completion 7-Federal Public Work Jobsite Title 40 USC Sec.270A-270E
to your contractor and the person or firm that has given Contract#
you this notice. The notice must be sent by registered Bond Co:
or certified mail. Failure to send the notice will extend
the deadline to record a claim of lien.You are not
required to send the notice if you are a residential Authorized Agent I /�
homeowner of a dwelling containing four or fewer units. 1-800-366-5660
This undersigned declares as follows: I am over the age of 18 and employed by Construction Notice Services, Inc.,whose business address is 9520 Padgett St
#208, San Diego,CA 92126. 1 am employed in the County of San Diego,where this mailing occurs, and not a party to this action.On the date shown below,
in the City of San Diego, I served within California Preliminary Notice, sealed and deposited in the mail in the manner prescribed by law, by first class
registered or certified mail, postage fully prepaid,to the person(s)at the address shown thereon. _
Signature: = �— [ � — Date: 05/20/20