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2021/08/15 Rick Engineering Company
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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 THISCERTIFICATE 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY 1/1/2022 Cavignac451AStreet,Suite 1800SanDiegoCA92101 Certificate Department 619-744-0574 619-234-8601 certificates@cavignac.com XL Specialty Company 37885 RICKENG-01 Valley Forge Insurance Company 20508RickEngineeringCompany5620FriarsRoadSanDiego,CA 92110 Continental Casualty Co.20443 Continental Insurance Company 35289 Amer Cas.Co of Reading,PA 1616862130 B X 2,000,000 X 1,000,000 X Contractual Liab 15,000 X Separation of In 2,000,000 4,000,000 X X X Y 6076046485 1/1/2022 1/1/2023 4,000,000 Deductible 0 C 1,000,000 X Y 6076046499 1/1/2022 1/1/2023 D X X 9,000,00060760465041/1/2022 1/1/2023 9,000,000 X 0 E X N WC676046521 1/1/2022 1/1/2023 1,000,000 1,000,000 1,000,000 A ProfessionalLiability DPR9882390 8/15/2021 8/15/2022 Each ClaimAggregate $3,000,000$8,000,000 Re:EDC Southern Gateway Public Engagement Strategy Project.Additional Insured coverage applies to General Liability and Automobile Liability for City ofMenifee,its officers,agents,employees and authorized volunteers per policy form.Primary coverage applies to General Liability and Automobile Liability perpolicyform.Professional Liability -Claims made form,defense costs included within limit.Excess/Umbrella policy follows form over underlying policies:GeneralLiability,Auto Liability &Employers Liability (additional insured and waiver of subrogation apply when afforded on underlying policies).If the insurance companyelectstocancelornon-renew coverage for any reason other than nonpayment of premium they will provide 30 days notice of such cancellation or nonrenewal.Professional Liability retroactive date 9/21/1955.Professional Liability Coverage Deductible $200,000 per claim. City of Menifee29844HaunRoadMenifeeCA92586 DocuSign Envelope ID: 3DE77A68-D99B-46E0-8C8F-FF658AEE5A32 01/01/2022 DocuSign Envelope ID: 3DE77A68-D99B-46E0-8C8F-FF658AEE5A32 01/01/2022 DocuSign Envelope ID: 3DE77A68-D99B-46E0-8C8F-FF658AEE5A32 01/01/2022 DocuSign Envelope ID: 3DE77A68-D99B-46E0-8C8F-FF658AEE5A32 01/01/2022 DocuSign Envelope ID: 3DE77A68-D99B-46E0-8C8F-FF658AEE5A32 :& :& DocuSign Envelope ID: 3DE77A68-D99B-46E0-8C8F-FF658AEE5A32