2021/03/26 Uncharted Software Inc.AUTHORIZED REPRESENTATIVE
c 2016, Centre for Study of Insurance Operations. All rights reserved.
This certificate is issued as a matter of information only and confers no rights upon the certificate holder and imposes no liability on the insurer.
CERTIFICATE OF LIABILITY INSURANCE
TYPE OF INSURANCE
COMMERCIAL GENERAL LIABILITY
POSTAL
CODE
BROKER CLIENT ID:
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 requirements, terms
or conditions 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 terms, exclusions and conditions of such policies.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSURANCE COMPANY
AND POLICY NUMBER
EFFECTIVE
DATE
EXPIRY
DATE
LIMITS OF LIABILITY
(Canadian dollars unless indicated otherwise)
NON-OWNED AUTOMOBILES
HIRED AUTOMOBILES
AUTOMOBILE LIABILITY
DESCRIBED AUTOMOBILES
ALL OWNED AUTOMOBILES
LEASED AUTOMOBILES **
** ALL AUTOMOBILES LEASED IN EXCESS OF
30 DAYS WHERE THE INSURED IS REQUIRED
TO PROVIDE INSURANCE
EXCESS LIABILITY
UMBRELLA FORM
OTHER LIABILITY (SPECIFY)
BODILY INJURY AND PROPERTY
DAMAGE COMBINED
BODILY INJURY (PER PERSON)
BODILY INJURY (PER ACCIDENT)
PROPERTY DAMAGE
Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail ________ days written notice to the certificate
holder named above, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives.
AUTHORIZED REPRESENTATIVE
ISSUER
DATE
EACH OCCURRENCE
AGGREGATE
This certificate does not amend, extend or alter the coverage afforded by the policies below.
NON-OWNED AUTOMOBILES
POSTAL
CODE
POSTAL
CODE
1. CERTIFICATE HOLDER - NAME AND MAILING ADDRESS 2.INSURED’S FULL NAME AND MAILING ADDRESS
DESCRIPTION OF OPERATIONS/LOCATIONS/AUTOMOBILES/SPECIAL ITEMS TO WHICH THIS CERTIFICATE APPLIES (but only with respect to the operations of the Named Insured)3.
4. COVERAGES
5. CANCELLATION
6. BROKERAGE/AGENCY FULL NAME AND MAILING ADDRESS
ADDITIONAL INSURED NAME AND MAILING ADDRESS
(Commercial General Liability- but only with respect to the operations of the Named Insured)
8. CERTIFICATE AUTHORIZATION
COMMERCIAL GENERAL LIABILITY
- GENERAL AGGREGATE
MEDICAL PAYMENTS
TENANTS LEGAL LIABILITY
PRODUCTS AND COMPLETED OPERATIONS
AGGREGATE
- EACH OCCURRENCE
DED.AMOUNT OF
INSURANCECOVERAGE
BODILY INJURY AND PROPERTY DAMAGE
LIABILITY
YYYY/MM/DD YYYY/MM/DD
POSTAL
CODE
PERSONAL INJURY LIABILITY
PERSONAL AND ADVERTISING INJURY
LIABILITY
OR
POLLUTION LIABILITY EXTENSION
7.
CONTACT NUMBER(S)
TYPE
TYPE
NO.
NO.
TYPE
TYPE
NO.
NO.
EMAIL ADDRESSSIGNATURE OF
CSIO - Certificate of Liability Insurance CA4301e 201609
HIRED AUTOMOBILES
CLAIMS MADE OR OCCURRENCE
PRODUCTS AND / OR COMPLETED OPERATIONS
EMPLOYER’S LIABILITY
CROSS LIABILITY
WAIVER OF SUBROGATION
TENANTS LEGAL LIABILITY
POLLUTION LIABILITY EXTENSION
City of Menifee
29844 Haun Road
Menifee CA 92586
Uncharted Software Inc., Uncharted Field Services Corp.
2 Berkeley Street Suite 600
Toronto Ontario M5A 4J5
Development of software and custom solution for business visualization systems and any other computer related services provided for others.
4
4
4
4
4
4
4
Victor Canada - TGL569280
Victor Canada - TGL569280
2021/03/26 2022/03/26
2022/03/262021/03/26
$1,000
$3,000,000
$3,000,000
$3,000,000
4
$5,000
$1,000 $500,000
$1,000,000
Mitchell Sandham Inc.
1375 North Service Road East, Suite 103
Oakville ON L6H 1A7
UNCHA-1
City of Menifee, its officers, agents and employees
Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavour to mail 30 days written notice to the certificate holder,
but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representative
December 21, 2021 tmederick@mitchellsandham.com
(416) 862-1750 (416) 862-1360
Tricia Mederick
Mitchell Sandham Inc.Main Fax
JZ
Victor Canada - TGL569280 2022/03/262021/03/26 $500 $50,000
DocuSign Envelope ID: 56836D30-85DE-47ED-AA20-07AD429F6627