2021/03/28 Quest Media and Supplies Inc. (3)oiQo'CERTIFICATE OF LIABILITY INSURANCE
COVERAGES CERTIFICATE NUMBER: 14100321 15 REVISION NUMBER:
oaTE (t /ooflYYY)
12t29t2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEO
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the certiflcate holder is an ADDITIONAL INSURED, the policy(ies
lf SUBROGATION IS WAIVED, subject to the terms and conditions of the poticy,
this cgrlificate does not confer rights to lhe certificate holder in lieu of such endo
) must have ADDITIONAL INSURED provisions or be e.dorsed.
certain policies may require an endorsement. A statement on
rsement(s).
PROOUCER
HUB lnternational lnsurance Services lnc.
PO Box 255387
Sacramento CA 95865
Debi M er
916-480-4168 s'16-393-7268
debi.meusbu binlernational.com
Ir{suRER(S) AFFOROTNG COVERAGE
INSUR€RA : TTAVCIETS PTOperty Casualty Company ofAmerica 25674
INSUREO
Quest Media and Supplies lnc
(See below for additional named insured, if any)
PO Box 910
Roseville CA 95678
OUESMED.O]lNsui€RB:TheT ravelers lndemnity Company of Connecticul 25682
rNsuRER C I LlOydS Syndicate *2987
X COMMERC IAI. GE NERA L LIABILITY
GEN'L AGGREOATE LIMITAPPLIES PER
OTHER:
JECT LOC
X
x
630-4K340688-TtL-22 1t1i2422 EACH OCCURRENCE s 1.000 000
DAMAGE TO RENTED
PREM SES rEa occLiienel $1,000,000
MED EXP (A.y one pe6on)510.000
PERSONAL & AOV NJURY s 1,000,000
GENERAL AGGREGATE s2.000.000
PRODUCTS . COMP/OP AGG $2,000,000
$
a AI]IOMOBILE LIABILITY
X
OWNEO
AI]TOS ONLY
HIREOAI]TOS ONLY
SCHEDI]LEO
AUTOS
NON.OWNEO
AUTOS ONLY
aA-4K342215-22-t3-G 1t1t2422 1/1t2023 COMBIN EO SINGLE LIMII $ r 000.000
BOoILY INJURY (Per FaBor)S
BOolLY INJURY (Pq aeidenr)S
s
S
UMBRETLATIAB
EXCESS LIAB
X
CLAIMS.MADE
ct_)P4K6 12902-22 1/1D422 11112023 EACH OCCURRENCE $ 15.000 000
x AGGREGATE s 15.000 000
DEO X RETENT ONS N 5
WORKERS COMPEITSATION
ANO EiIPLOYERS' LIAEILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER]M€MAEREXCLLJDEO?
OESCRIPIION OF OPERATONS betu
N
uB-4K594768-22-13-G 1/1D422 1/112023 X STATUTE OTH
E L EACI] ACCIDENT $1,000,000
E L. OISEASE EA EMPLOYEE
E,L. DISEASE. POLICY LIM T
L!0-0q 000
51,000 000c312A120213t24t2022$5,000,000
$5 000.000
oESCRIPTION OF OPERAtlOils / LOCAnONS / VEHICLES (ACORD i 01, Addirion.l Romri. Sch.dul., 6.y b. .nach.d ir ho.o .r.6 t. r.qot d)RE: Agreement for Enterprise Business System Backup SeMces
Addilional lnsuredi City of Menifee ahd its omcers, employees, agents, and authorized volunteers where required by written contract.
Forms: CGD246 0419
CERTIFICATE HOLDER CANCELLATION
City of lrenifee
29844 Haun Rd.
Menifee CA 92586
SHOULO ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLEO BEFORETHE E,(PIRATrcN OATE THEREOF, NOTICE I/YILL BE OELIVEREO IN
ACCOROANCE wlTH THE POLICY PROVISIONS,
AUTHORIZEO REPRESENTATIVE
O'1988-20'15 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are reqistered marks of ACORDACORD 25 (20.t6/03)
I
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWTHSTANDING ANY REOUIREMENT, 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 IERMS,EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED 8Y PAIO CLAIMS,
11112023
i
I
cT1134821
iln,M-
POLICY NUMBER: 630-4K340688-TlL-22 CO[,,I[,4ERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
BLANKET ADDITIONAL INSURED
(lncludes Products-Completed Operations If Required By Contract)
This endorsement modifies insurance provided under the follo/ving
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS
The following is added to SECTION ll - WHO lS AN
INSURED:
Any person or organization that ycu agree in a
written contract or agreement to indude
additional insrred on this Co\,erage Part
insured, but only;
as anis an
a. With respect to liability for "bodily injury" or
"property damage" that occurs, or for "personal
injuqy'' caused by an offense that is committed,
subsequent to the signing of that cmtract d
agreement and while that part of the @ntra(, d
agreement is in efiecl: and
b. ll and only to the extent that, such injury or
damage is caused by acts or omis"sions of ycu d
)/ttrur subcontraclor in the performance of ")our
work" to which the written contracl or agreement
applies. Such person or organization does not
qualify as an additional insured with respect tothe independent acts or omissions cf such
person or organization-
The insurance provided lo such additional insured is
subject to the fcllowing provisions:
a. lf the Limits of lnsurance of this Coverage Part
shown in the Dedarations exceed the minimum
Iimits required by the written contract tr
agreernent, the insuranc€ proMded to the
additional insured will be limited to such
minimum required limits. For the purpces of
determining whether this limitation applies, the
minimum limits required by the written contrad or
agreernent will be considered to include the
minimum limits of any Umbrella or Exoess
liability coverage required fd the additional
insured by that written contract or agreement.
This provision will not increase the limits of
insurance described in Section lll - Limits Of
lnsurance.
b. The insurance provided to such additional
insured does not apply to:
(1) Any "bodily injury", "property dam4e" or
"personal injury" arising out of the providing,or failure to provide, any professional
architectural, engineering d surveying
services, including:
(a) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surve!6,
fidd orders or change orders, or the
preparing, approving, or failirg to
prepare or approve, drawings and
specifications; and
(b) Supervisory, inspection, architectural or
engineering adivitieS.
(2) Any "bodily injuly'' or "property damage'
caused by ")^f,ur work" and induded in the
"producls-completed operations hazatd"
unless the writlen contract or agreernent
specifically requires }icu to provide such
co\€rage fd that additional insured during
the policy period.
The additional insured
following duties:
must comply with the
(1) Give us written nctice as soon as pradicable
cf an "occurrence" c an cffense which may
result in a claim. To the extent possible, such
notice should indude:
(a) How, when and where the "occurrence"
or offense took place;
(b) The names and addresses cf any injured
persons and wilnesses; and
(c) The nature and location of any injury or
damage arising out of the "occurrence"
or cffense.
(2) lfa claim is made or "suit'is brought againsl
the additional insured:
c
cG D2 46 04 19 O 2018 The Travelers lndemnity Company. All rights reserved.Page 1 of 2
COMMERCIAL GENERAL LIABILITY
(a) lmmediately record the specifics of the
claim or "suit" and the date received; and
(b) Notify us as soon as practicable and see
to it that we receive written notice of the
claim or "suit" as soon as practicable.
(3) lmmediately send us copies of all legat
papers received in connecrion with the claimor "suit', coopeE e with us in the
in\€stigation c settlement of the daim a
defense against the "suit', and otherwise
comply with all policy conditions.
(4) Tender the defense and indemnity of any
claim or "suit' to any provider of other
insurance which would cover such additional
insured for a loss we co\€r. However, this
condition does not affect whether the
insurance provided to such additional
insured is primary to other rnsurance
available to such additional insured which
co\€rs that person or organization 6 a
named insured as described in Paragraph 4,,
Other lnsurance, of Sedion lV - Commercial
General Liability Conditions.
Page 2 of 2 O 2018 The Travelers lndemnity Conpany. All rights reserved cG D2 46 04 19