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2021/12/01 Security Signal Devices, Inc. (10)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 11/30/2021 Bolton Insurance Services LLC 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 (626) 799-7000 (626) 583-2117 www.boltonco.com 6004772 Ron Wanglin Security Signal Devices Inc. 1740 N. Lemon Street Anaheim CA 92801 65228727 3 3 Additional Insured(s): City of Menifee, its officers, agents and employees City of Menifee Attn: Margarita Cornejo 29844 Haun Road Menifee, CA 92586 GL & Auto Additional Insured apply per CG20100413, CG20370413 & ECA045060609 attached, only if required by written contract/agreement. A 1,000,00051GL01408121112/1/2021 12/1/2022 500,000 3 10,000 3 1,000,000 5,000,000 2,000,0003 ERROS OMMISSIO Included B 51CAD00199211 12/1/2021 12/1/2022 1,000,000 3 A 51CC005093211 12/1/2021 12/1/2022 10,000,00033 10,000,000 3 10,000 C UB8S4819632143G 12/1/2021 12/1/2022 3 1,000,000Y 1,000,000 1,000,000 Everest Indemnity Insurance Company 10851 Everest Denali Insurance Company 16044 Travelers Property Casualty Co of Amer 25674 3 65228727 | SECUSIG-C1 | 2021-2022 Master Certificate | Ryan Yamaguchi | 11/30/2021 5:58:51 PM (PST) | Page 1 of 10 DocuSign Envelope ID: 33E95BBE-7122-4A44-95D9-D012B1CCEE39 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: Additional Insured status applies to Premises Liability ONLY SECUSIG-C1 Bolton Insurance Services LLC Security Signal Devices Inc.1740 N. Lemon StreetAnaheim CA 92801 25 Certificate of Liability (03/16) ATTACHMENT HOLDER: ADDRESS: City of Menifee Attn: Margarita Cornejo 29844 Haun Road Menifee, CA 92586 65228727 | SECUSIG-C1 | 2021-2022 Master Certificate | Ryan Yamaguchi | 11/30/2021 5:58:51 PM (PST) | Page 2 of 10 DocuSign Envelope ID: 33E95BBE-7122-4A44-95D9-D012B1CCEE39 51CAD00199211 65228727 | SECUSIG-C1 | 2021-2022 Master Certificate | Ryan Yamaguchi | 11/30/2021 5:58:51 PM (PST) | Page 3 of 10 DocuSign Envelope ID: 33E95BBE-7122-4A44-95D9-D012B1CCEE39 65228727 | SECUSIG-C1 | 2021-2022 Master Certificate | Ryan Yamaguchi | 11/30/2021 5:58:51 PM (PST) | Page 4 of 10 DocuSign Envelope ID: 33E95BBE-7122-4A44-95D9-D012B1CCEE39 65228727 | SECUSIG-C1 | 2021-2022 Master Certificate | Ryan Yamaguchi | 11/30/2021 5:58:51 PM (PST) | Page 5 of 10 DocuSign Envelope ID: 33E95BBE-7122-4A44-95D9-D012B1CCEE39 65228727 | SECUSIG-C1 | 2021-2022 Master Certificate | Ryan Yamaguchi | 11/30/2021 5:58:51 PM (PST) | Page 6 of 10 DocuSign Envelope ID: 33E95BBE-7122-4A44-95D9-D012B1CCEE39 65228727 | SECUSIG-C1 | 2021-2022 Master Certificate | Ryan Yamaguchi | 11/30/2021 5:58:51 PM (PST) | Page 7 of 10 DocuSign Envelope ID: 33E95BBE-7122-4A44-95D9-D012B1CCEE39 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 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 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 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. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 51GL014081211 Blanket Where Required by Written Contract 65228727 | SECUSIG-C1 | 2021-2022 Master Certificate | Ryan Yamaguchi | 11/30/2021 5:58:51 PM (PST) | Page 8 of 10 DocuSign Envelope ID: 33E95BBE-7122-4A44-95D9-D012B1CCEE39 Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 65228727 | SECUSIG-C1 | 2021-2022 Master Certificate | Ryan Yamaguchi | 11/30/2021 5:58:51 PM (PST) | Page 9 of 10 DocuSign Envelope ID: 33E95BBE-7122-4A44-95D9-D012B1CCEE39 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 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 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 include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 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. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 51GL014081211 Blanket Where Required by Written Contract 65228727 | SECUSIG-C1 | 2021-2022 Master Certificate | Ryan Yamaguchi | 11/30/2021 5:58:51 PM (PST) | Page 10 of 10 DocuSign Envelope ID: 33E95BBE-7122-4A44-95D9-D012B1CCEE39