2021/10/03 Interwest Consulting Group (3)CORif
COVERAGES
CERTIF]CATE OF LIABILITY INSURANCE
CERTIFICATE NUMBER:74 9071856
DATE (UI{/DDIYYM
9t2A12021
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312-856 9400 312-856-9425
swhite rbninsutanco.com
AFFOR D'NG COVERAG E
PRODUCER
RBN lnsurance Services303 E Wacker Dr Ste 650Chicago lL 6060'l
19682Hartford Ftre lnsurance Co.
lnsurance Co 29424rNsuRERs I Hartford casua
37532IGreal American E&S lns Co.
Fire lnsurance Co 29459
lnsutance 124A9nINSURERE: B
INSUREO
Interwest Consultino GrouoP.O. Box 18330
Boulder CO 80308
SAFELLC,Ol
NSIJ Na lns- Co 36056lors S e
REVISION NUMBERTHSSCETORTTHTHTEPOLcESoNURANSECLDSTEELBHAEENBESSEUTODTHENSUNEDMEDABOVE THFORE PO cLI roDERNDtcATEDOTWNTHTsNDN6EUTEMoREMNTEORNcoDTIONoANONcTRACTORROTHEUDOCEt,1 NT TH RES CTE To HI HC STHCERTrcAi,4ATE Bt S EDSU OR TER ETH NN RANCESU OR EDo B THE cPOL E DESSC EDB HE E SSUBJ TECTo T TEHE [,lsEXCUSNoANSDCONTDoNSoSHUCPOLCSEt1LITSSowNHHBEENEDUEDcBYCDMLAIs.
LIM TS
EACH OCCURRENCE $ 1,000,000
s 300,000
5 10,000
PERSONAL & AOV INJURY s 1,000,000
G€NE RAL AGGREGATE s2,000,000X
83UENZV3951
MEO EXP
LOC
1OB12A21 fit3t2022
"o.,""|!ffi I s 2,000,000oDucTs
GEN'L AGGREGATE L [1T AP
X coMMERctaLGENERAL LtABtLtTy
cLArMs-MAoE I o""r^
L NIiTAINED S]$ 1,000,000
BOOILY INJURY (Per p36on)s
$
6
X
OWNEDAUTOSONLY
HIREO
AUTOS ONLY
SCHEOIJLED
NON,OWNEO
AUTOS ONLYX
AUTOMOBILEIIABIIIIY
X aNYAUTo
83UENPYg1OO 101312021 10t3t2A22
BoDILY TNJURY (Po. a@td6nr)
$X
EACHOCCURRENCEx€ICESS LIAB
OCCUR
X R€TENTION5
cH21EXC885600tC
AGGREGATE
101312021 10t3t2022 s 5,000,000
15.000,000
s
ER
E L EACH ACCIOENT 51,000,000
WORKERS COM PETISATION
ANO EiNPIOYERS' LIABITITY
ANYPROPR]ETORYPARTNER/EXECUTIVF
OFF CEF'MEMBEREXCLUOEO?
83WECE0623 5/1212421 5t12/2022D
EA EMPLOYEE s 1,000.000
0$ 1,000
DESC
STATIJT
E L OISEASE
E,I.. DISEASE
E Erc6ss Lab (2nd)L;yor TER 2861558
8E-A7-X1,0002079-00 10rc12a21
10t3t2421
14ty2022
108t2422 Eech o.dAss-raqais 10,000,000
5,000,000
city of Menifee and its officers, employees, agents, and authorized volunleors are additional insured as respects the General Liability as required by written
DESCRTPT|O{ OF OPERATIONS / LOCAIOIS / VEHTCLES {ACORDRE: Project Name: Leadership Devetopment T;ining l01,AddltlonltRohart.Sch.dut..mayb..t..h.d jf mor..p.c.i!r.qun.d)
CERTIFICATE HOLD
ACORO 25 (2016/03)
ER
@ 1988-2015 ACORD CORPO
The ACORD name and logo are registered ma.ks ofACORD
RATION. All.ights reserved.
CA,NCELLATION
City of Menifee
29844 Haun Road
Menifee CA 92586 AUTHORlzED REPRESENTATIVE
SHOULO ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORETHE-ExprRATroN DArE THEREoF, NorcE wLL ee DiiivEiEt iNACCOROANCE WITH THE POLICY PROVISIONS.
MATTER
AMEND,
CERTIFICATE
wAtvEo,maycertificate
$
S
RBN ]NSURANCE SERVICE S303 E WACKER DR STE 650
CHICAGO ]L 60601
CITY OF MENIFEE29844 HAUN RD
MENIFEE CA 92586.653 9