2021/12/01 Santa Ana Creek Development CoA(:C)fran MARKCOM-03
CERTIFICATE OF LIABILITY INSURANCE '12t1t2021
IMPORTANT: lf the certificate holder is an ADDITIONAL INSt REO, the policy(ies) must have ADOITIONAL INSURED provisions or be endorsed.
lf SUBROGATION lS WAIVED, subject to the terms and conditions olthe policy, certain policies may roquire an endorsement. A slatement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
piooucER License # 0757776
Riverside, CA - HUB Intemational lnsuranco Services lnc
PO Box 5345Riverside, CA 92517
[{suRER(S) AFTOROTITG COVES 9q
[{suRER a rExecutive Risk lndemnity
tNsuRER s :Fedgral lnsurancc compalv
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INAURER F:
lil3)rf., e,,), (ssl) 7ss-8500 [H. r.r,(esl ) 788-sso2
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3518'l
20281
Santa Ana Creek Development co. dba: Mark Company
2288 & 2290 North Batavia St
Orange, CA 92865
RAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR IHE POLICY PERIOD
INDICAIEO. NOTWITHSTANDING ANY REQUIREI4ENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIEEO HEREIN IS SUAJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED AY PAID CLAIMS.
POLICY EFF POLICY EXPIMM/DD/YYYN (MiVDO/YYYY)
54309583
$
i
I
3
I
x 121112021 12t1t2022
1,000,000
GENL AGGREGATE L]]\iITAPPLIES PER
12t1t2021 't21112022
A X co MERC|AL GENERAL LrABrLrrY
CLA MS,MADE X OCCUR
EACH OCCURRENCE
OAMAGE-TORENTEDPREMISES (Ea occ!.rence)
MED ExP (Any one peBo.)
PERSONAI & ADV INJURY
GENERAL ACGBEqAIE
PROOI-ICTS. COMP/OP AGG
1,000,000
100,000
5,000
1,000,000
2,000,000
2,000,000PoLrcY [E i88i E Locv P.r Proi Gen Ado ler conlracl^ OTHER:B lurouoerre rtleLtrY
X rrvruroOWNEO SCHEOULEO
AUTOS ONTY
-
AUTOSHIRED NON OWNEDAUIOS ONLY AIJTOS ONLY
COMBINEO SINGLE LIMIT
BOOILY INJURY (Pqp€Mn)
SOOILY INJURY (Per accide.t)
UMBRELfALIAB OCCUR
EXCESS LIAB CLAIMS.MADE
o.o I I ".r.*rlo*,
EAqt qccuaaElQE
AGGREGAIE
OFFICEF/MEMBER EXCLIJDED?
nasaRlPTloN .)F OPERAnoNS h.l.w
1,000,000
1,000,000
1,000,000
B woRKERs coMPENsATtoN
54309584
5
W PER I OIH.
^ STATIJTE I ERANO EMPIOYERS' LIABILITY
ANY PROPRIETOR/PARTNER]EXECUT VE
E L O SEASE EA EMPLOYEE $
'12t1t202't 't211t2022 L - LALH a(L oENT
oEscRtPTtoN oF oPERArtoNs / LocaTtot{s /vEtttcLEs lacoRD 101, Additional R.m.rt. sch.dul., mry b..fi..h€d il mor..pac. 'E r.qun.d)
RE: All oporalions porformed by th6 Named lnsured during the curent policy poriod. glai
City of Menifee Is lncluded as Additional lnsured as respects General Liablllty per atlached endorcement.
City oI Menifee
297'14 Haun Road
Menifee, CA 92586
SHOULD ANY OF THE ABOYE DESCRIBED POLICIES BE CANCELLEO BEFORETHE EXPIRATION DATE THEREOF, NOTICE I,YILL BE DELIVERED IN
ACCORDANCE wlTH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
o D
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, EXTENO OR ALTER THE COVERAGE AFFORDED BYTHEPOLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
S
S
$
$
$
$
54309582
S
S
BEI
Nnru*,,-
O'1988-2015 ACORD CORPORATION. All rights r6served.
The ACORD name and logo are registered marks of ACORD
ACORD 25 (2016/03)
AGENCY CUSTOMER tD: MARKCOM-03
LOC #: 1
ADDITIONAL REMARKS SCHEDULE
MBRANDMAN
ACORD Page I of 1
AGENCY License # 0757776
Riverside, CA - HUB lnternalional lnsurance Services lnc.Santa Aha Creek Development Co. dba: Mark Company2288 & 2290 North Batavia St
Orango, CA 92865
SEE PAGE 1
NAIC CODE
SEEPlSEE PAGE 1 ErFEcrlvE oarE: SEE pAGE 1
AODITIONAL REMARKS
THIS ADOITIONAL REMARKS
FORM NUMBER: ACORD 25
FORM IS A SCHEDULE TO ACORO FORM,
FORM TITLE:Certificat€ of Liability lnsurance
Cancellalion:
Should the policy(ies) be cancalled before the expiration date, Hub lnternational lnsurance Services lnc. (Hub), independent of any
rights which may be afforded within the policies to the certificate holder named below, will provide to such certificate holder notlce
of such cancellation within thirty (30) days of the cancellation date, except in the event the cancellation is due to non.payment ot
premium, in which case Hub will provide to such certificate holder notice of such cancellation within ten (10) days of the cancellation
date-
@ 2008 ACORD CORPORATIoN. All rights reserved.
Tho ACORD name and logo are registe.ed marks of ACORD
ACORD 101 (2008/01)
POLICY NUMBER: 54309583
Name Of Additional lnsured Person(s)
Or Organization(s)Location(s) Of Covered Operations
Where required by written contract All locations where required by written contract
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
A. Section ll - Who ls 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 forthe 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
lawi and
2. lf 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 afler:
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.
cG 20 10 t2 19 O lnsurance Services Office, lnc., 2018 Page 1 of 2
COMMERCIAL GENERAL LIABILITY
cG 20 10 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modilies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section lll - Limits Of lnsurance:
lf 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
insurancei
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
Page 2 ol 2 O lnsurance Services Office, lnc., 2018 cG 20 101219
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILIry COVERAGE PART
PRODUCTS/COI\4PLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
POLICY NUI\,4BER: 54309583 COMMERCIAL GENERAL LIABILITY
cG 20 37 ',tz 19
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section lll - Limits Of lnsurance:
lf 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:
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
Name Of Additional lnsured Person(s)
Or Organization(s)Location And Description Of completed Operations
All locations where required by written contract
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
cG 20 37 1219 @ lnsurance Services Offlce, lnc., 2018 Page 1 of 1
A. Section ll - Who ls An lnsured 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 endorsemenl
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. lf 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.
Where required by written contract, but only where
the contract specilies coverage for
completed operations.