2021/01/14 Siino, Kitty and Associates, Inc. Karen S. Siino, Kitty S. SiinoACo.F,i7"INSURANCE BINDER
COVERAGES
NAME & AOORESS
LIMITS
X
NOON
IHls AINOER IS ISSUEO'TO EXTENO COVERAGE IN THE AAOVE NAMEO COIIPAI{Y
PER EIPIRING POLICY '
05t17 t2021 12:01 11 117 t2021
00004087
949 218-1020 e)220948
THIS BINDER IS A TEMPORARY INSURANCE CONTRACT SUBJECT TO fHE CONDITIONS SHOWN ON PAGE 2 OF THIS FORM.
Mercu lnsurance Co
coos,045101
n
Karen Siino
1 171 Smoketree Lane
INSIIREO AXO MAILING AOORESS
ta Ana 705
oEscRlPlloN ol oPERAlrolr3 , vEHlcLEs, PRoPERTY {t^orudha !..rrion)
2018 JAGUAR E-PACE SE AWD
SADFPzFX7J1214428
[ ""o^o ! "0."
OEI{ERAL LI,ABILITY
| "o^rr.*",o. ".".*.,'o"','rtI ..^'u"uoo. f lo""u"
PROOUCTS COMP/OP AGGRETRO OATE FOR CLA MS MAOF
PERSONA! A AOV LNJURY
GENERAL AGGREGATE
5
s
s
s
s s00
0
100
2
000
250 000
000
000SCI]EDI,]LEDAUTOS
HIREOAIJTOSONLY
NON.OWNEOAUTOS ONLY
x
aoo
COMBINEOSINGLELMT
!NTNSUFEo roroRrsr l4 Ei4i0
I]N]NSLJREDMOIOR SI
PERSONAL IN.JURY PROI
!!eqq\!ItM!!rs
s 250 000s 500.000
X
X
cotLtstoN
OTHER TI1AN COL
500
250
X actuel crsr ver
STATED AMOUNT !ALL VEHICLES ff, ] screoureove*c.es
s
vEHrcLE PHYSTCA! 0A AGE oEo
i
AUIO ONLY - EA ACC DENT
OTHER TI]AN AUTO ONLY
EACIACCIDENT
l OTHER THAN UMBRELIA FORM REIRO OATE FOR CLAiMS MAOE SELF.INSI]RFI] RFIFNION s
EL OISEASE POLCY LMIT
EL OISEASE E^ EMPLOY€E
E L EACII ACC OENIWORKER!S COIPENSATIOX
Ef,PLOYER'S LIABIIITY
PERSTATUIE
s
5
TAXES
3
XLENOER'S LOSS PAYABLE
Loss PAYEE I vocrcaoee
Additional lnterestCity of Menifee
29844 Haun Road
Menifee, CA 92586
Laura Wse
acoRD 75 (2016103)
Pago I ot 2 @ 1903"2016 AGORD CORPORATIO . All rights rEsorvod
Tho ACORO namg and logo aro roglstarqd marks of ACORD
Printed by LMW on Septembet 22.2021 alO2:04PM
Ortega Ranch lnsurance Agency, Inc.
27221 Ortega Hwy, Suite # D
San Juan Capistrano, CA 92675
lUB COOE:
t oArE rnr,Do,ryyy)I oszztzozt
D€OtrcTtElr cort!* arouirT
I
3
I EACHoccuRRENCE
I DaMA-6E-toI RENTEDPREM]SIS
s
AGGREGATE t
I
ll
AGENcY cusroMER lo: 00004087
CONDITIONS
This Company binds the kind(s) of insurance stipulated on page 1 oI this fom. The lnsurance is subjecl to the terms, conditions and
limitations of the policy(ies) in current use by the Company.
This binder may be cancelled by the lnsured by surrender of this binder or by written notice to the Company stating when cancellation
will be effective. This binder may be cancelled by the Company by notice to the lnsured in accordance with the policy conditions. This
binder is cancelled when replaced by a policy. lI this binder as not replaced by a policy, the Company is entitled to charge a premium
for the binder according to the Rules and Rates in use by the Company.
Applicable in Arizona
Binders are effective for no more than ninety (90) days.
Applicable in California
When this form is used to provide insurance in the amount of one million dollars ($1,000,000) or more, the title of the form is changed
from "lnsurance Binde/'to "Cover Note".
Applicable in Colorado
With respect to binders issued to renters of residential premises, home owners, condo unit owners and mobile home owners, the
insurer has thirty (30) business days, commencing from the effeclive date of coverage, to evaluate lhe issuance of the insurance
policy.
Applicable in Delaware
The mortgagee or Obligee of any mortgage or other instrument given for the purpose of qeating a lien on real property shall accept as
evrdence of insurance a written binder issued by an authorized insurer or its agent if the binder includes or is accompanied by. the
name and address of the bonower; the name and address of lhe lender as loss payee; a desqiption of the insured real property; a
provision that the binder may not be c.anceled within the term of the binder unless the lender and the insured borrower receive written
notice of the cancellation at least ten (10) days prior to the cancellationi except in the case of a renewal of a policy subsequent to the
closing of the loan, a paid receipt of the full amount of the applicable premium, and the amount of insurance coverage.
Chapter 21 Title 25 Paragraph 21 19
Applicable in Florida
Except for Auto Insurance coverage, no notice of cancellation or nonrenewal of a binder is required unless the duration of the binder
exceeds 60 days. For auto insurance, the insurer must give 5 days prior notice, unless the binder is replaced by a policl or another
binder in the same company
Applicable in Maryland
The insurer has 45 business days, commencing from the effective date of coverage to confirm eligibility for coverage under the
insurance policy.
Applicable in Michigan
The policy may be cancelled at any time at the request of the insured
Applicable in Montana
No binder shall be valid beyond the issuance of the polacy with respect to which it was given or beyond g0 days from iis efrec,tive date,
whichever period is the shorter. lf the policl has not been issued, a binder may be extended or renewed beyond such 90 days with the
written approval of the insurer.
Applicable in Nevada
Any person who refuses to accept a binder which provides coverage of less than $1,000,000.00 when proof is required: (A) Shall be
fined not more lhan $500.00, and (B) is liable to the party presenting the binder as proof of insurance for actual damages sustained
therefrom.
Applicable in Oklahoma
All policies shall expire at 12:01 a.m. standard time on the expiration date stated in the policy.
Applicable in Oregon
Binders are effective for no more than ninety (90) days. A binder extension or renewal beyond such 90 days would require the written
approval by the Director of the Department of Consumer and Business Services.
Applicable in the Virgin lslands
This binder is effective for only ninety (90) days. Wthin thirty (30) days of receipt oI lhis binder, you should request an insurance
policy or certificate (if applicable) from your agent and/or insurance company.
ACORD 7s (2016/03)Page 2 ol2
Printed by LMWon September 22, 2021 at 02 04PM
712712021 Personalumbrella Program for Agents & Brokers
Markel lnsurance Company
Personal and Business Owner's Umbrella Declarations
nmf,n"
Nam€d Insured:
Scott And Karen Siino
1171 Smoke Tree Ln
Santa Ana CA 92705-2328
Policy No: MPU0060213-01
Administered Byj
PersonalUmbrella. com
P O. Box 8586
Emeryville, CA 94662
(800)564-1799
Insurance Services, Inc.
IlDUP 1000 (05/19) Umbrella Declaration
(Page 1 of 1)
Brokeri
Ortega Ranch Insurance Agency, Inc
27221 Ortega Highway
Suite O
San luan Capistrano CA 92675
Contacti Steve Carey
Phone: 949-218-1020
Policy Period: 8/14/2O2L To A/A/2022
(12r01 AIY standard time at the address of the Insured.)
Authorized Rep_ICSCltallyCS!
lohn K. Clark
t(
Order ID:170829 INVIDr1653188 Doc#:l Issue Date:issuedate Producer Print Date: 7/27l2021
Coverage A: Bodily Injury, Personal Injury, Advertising Injury and Property Damage Liability Coverage
Limits of Liability for Each Loss: $1,000.000
* Policy Total Limit: Not applacable
* The Policy Total Limit shown in this policy's Declarations for Coverage A is the most we wall pay for all losses arising out of business
operations and/or business property during each policy period.
Coverage B: Excess Uninsured and Underinsured Motorists Bodily Injury Coverage
Limits of Liability for Ea€h Loss:
Policy Total Limit:
$ 1,000,000
$ 1,000,000
Self Insured Retention: None ($0)
charges Policy Premium:
Total Policy Premium:
$1,934
$1,934
MUP 0001 (05/19)
MJrL 1000 (06/10)
Endorsements Attached to this Policy at Time of Issue:MDUP 1000 (05/19)
r.4DUP 1001 (05/19)
i4rL 1214 (09/17)
MPrL 1073-CA (05/14)
MPUP 1004-CA (05/r9)State and Privacy Notices: MPUP 100s-cA (0s/1s)
MPIL 1007 (01/20)
MPrL 1083 (04/15)
h(ps://www.personalumbrella.com/midmic_order_dec.asp
tr &"k-
Attached to and forming a part of Form:
7 t27 t2021 Personalumbrella Program for Agents & Brokers
Umbrella Schedule
Effective Date: 8/ L4 /2021
Expiration Datet I / t4 / 2022
Personal Property
Following are the locations declared in your applicataon covered under a Personal Liability or Homeo!/ners policy
Primary lnsurance Company &
Limits of Liability (in thousands)
l.4ercury $500
14740 U.S.95 Blythe CA- Personal Resjdence Aegis $500
480 S. Grand St Orange CA- Rental Residence Travelers $500
478 S. Grand St Orange CA- Rental Residence Travelers $s00
2731 E Lomita Ave Orange CA- Rental Residence Safeco $5oo
Drivers Date of Birth Drivers License #
Karen Siino o7/03/1951 cA - N3419513
Scott J. Siino o8/2311960 cA N5664551
Personal Automobiles
Following are personal vehicles listed in this policy and covered under a peEonal auto policy
Personal Automobiles Primary Insurance Company &
Limit of Liability (in thousands)
2018 laguar E-Pace IYercury $250/500/ 100
1935 Ford Model 50 1/2 ton truck Hagerty Classic
Ins $250/500,/ 100
1991 Harley Davidson FXSTS springer Softa Progressive $250/500/r00
Personal Uninsured/Underinsured Motorist
Following are policies covering uninsured motorist listed in this policy and covered under a personal auto policy
Primary Insurance Company & Limit of Liability (in thousands)
Mercury/Hagerty Classic Insg250/500
Progressive $2s0ls00
Description Primary Insurance Company &
Limit of Liability (in thousands)
2006 SeaDoo Bombardier - xcc/xmph - Uniicensed
Vehicles/Jetski Safeco $s00
2OO5 HONDA MARINE AQUATRAX F.12X .
xcc/xmph - Unlicensed Vehicles/Jetski Safeco $s00
2OO2 YAMAHA WAVE RUNNER FX1 . xcc/xmph.
Unlicensed Vehicles/JetSka Safeco $500
Losses arising out of ! property, auto, unllcensed vehicle or watercraft that is acquired or leased durirg th€ policy period are
cov€red by this pollcy rfthcy a.e cover€d by your primary insurance listed aboye or another rcplacement insurtnce company
A.l.l. Best rated B+ (vII) or higher.
https://wwwpersonalumbrella.com/midmic_order_dec.asp 214
Policy No: MPU0060213-01
Covered Personsr Scott And Karen Siino
Personal Umbrella
Personal Drivers
Following are the drivers declared in your application and are the only drivers who live in your household and/or regulariy drive your vehicles.
Unlicensed Vehicles, ,etskis & watercraft
Following are unlicensed vehicles, jet skis and watercraft listed in this policy and covered under a liability policy.
Personal Residences,
Rentals or Vacant Land
1171 Smoke Tree Ln Santa Ana CA- Personal Residence
o.Qo'
09t22t2021
rHE CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPOI{ THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRI|IATIVELY OR NEGATIVELY AMEND, EXTENO OR ALTER THE COVERAGE AFFOROEO BY THE POLICIESBELOW. THIS CERTIFICATE OF TNSURANCE DOES NOT CONSTTTUTE A COi{TRACT BETWEEN THE tSSU[{c TNSURER(S), AUTHORTZED
REPRESEI{TATIVE OR PRODUCER, ANO T}IE CERTIFICATE HOLDER.
IMPORTANT: lf the cedticato hold€r l! an AOOITIONAL INSURED! the pollcy(16!) mult h.ve ADDITIONAL INSURED provlalon. or be endo6ed.f SUaROGATIOI lS WAIVED, rublect to tho tarma rnd condition! of the pollcy, cortlln pollciea may r€qulre .n endoBem.nt. A ltrtemsnt onthll certltlcate does not confer rights to the csrlifictte holder in lieu ofsuch endorsement(!)
LIA ADMINISTRATORS & INSURANCE
SERVICES
PO BOX 1319
SANTA BARBARA CA 93102.1319
DANA DAMI o
805-963-6624 -0652
AFFOROII!G COVEiAGE
ruuatee,SENTINEL INSURANCE COMPANY LTD. I l1OOO
rlunED SllNO, KITTY & ASSOCTATES INC
KAREN S, SIINO/ KITTY S SIINO
115 E. 2ND STREET, SUITE 1OO
TUSTIN, CA 92780
tD# 161352
nsunrna,ASPEN AMERICAN INSURANCE COMPANY 43464
CERTIFICATE OF LIABILITY INSURANCE
COVERAGES CERTIFICATE NUMBER:REVISION NUI,lBER:
CANCELLATION
@ 1988-20'15 ACORD CORPORATION. All rights reserved.
The ACORD nahe and logo arc rogistercd marks of ACORD
THIS IS TO CERTIFY IHAT THE POLICIES OF INSURANCE LISTED AELOW HAVE AEEN ISSUEO TO THE INSUREO NAMED AAOVE FOR THE POIICY PERIOD
INOICATEO, NOIWTHSIANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONIRACT OR OTI]ER DOCUMENT WTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSUFIANCE AFFOROEO BY TI]E POTICIES DESCRIBED HEREIN IS SUEJECT TO ALT THE TERMS,
EXCLUSIONS ANO CONOITIONS OF SUCH POLICIES LIMIIS SHOUA MAY HAVE BEEN REOUCED BY PAIO CLAIMS
COf TIERCIAL GENERAL LIABILIIY Y
GEN'L AGGREGATE LIU T APPL ES PER
L ] JECI X
72SBM8A9637 12tO6t202 12t06t2A2i , 1,000,000r 1.000.000r 10,000
PREM S€S rE.o@m^a)
MEO EXP (Anr o.. ts.oi)
PERSONAL & ADV NJURY r 1000,000
s 2,000,000
PRODUCTS COMP/OP AGG r 2,000,000
HIRED
SCH€DIJLEO
COMBINED SING!E L MIT
5
BODILY INJU RY (Pd .ed.nr)I
s
9
I
s
llORXEil COraPEr'lSATlON
AXD EiTPIOYERS' LAAILIIY
ANY PROPRIETOR/P^RTNER'DGCUT]VE
OFF CER/MEMBER EXCLUDED?
RIPTION OF OPERATIONS bdd
s
s
s
EL D SENSE EAEMPIOYEE
E L DSEASE POLICY LIMIT
B AAt004502-06 01t14t2021 01t141202i $1,000,000 EACH c
$2 000,000 AGGRE
LAIM
SATE
OEICRImO OT OP€RATIOi{3, tOC llON!,vEHrctAl OCOiO 101,lddldo lR. rb !ct.duh, tuyt .ttr.h.a t .L.p.o L -qut.dl
REAL ESTATE APPRAISAL SERVICES
THE BELOW CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED WITH RESPECTS TO
THE COMMERCIAL GENERAL LIABILITY POLICY
CITY OF MENIFEE
29844 HAUN ROAD
IV1ENIFEE, CA 92586
L
SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRANON OATE THEREOF, NONCE WILL BE DELIVERED IN
ACCOROANCE wlTH THE POLICY PROVISIONS,
.2-_<___-r
CERTIFICATE HOLDER
ACORD 2s (2016/03)
E
BODILY INJURY (P.r p.rsn)
E
PROFESSIONAL LIABILITY
^Jlr,oRsEo
?'E"RE=N'^M
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