Loading...
2022/12/01 Admail Express, Inc.,ACfu DATE (MM/OOryYYY) 77/ t4 /2022 THIS CERTIFICATE IS ISSUEO AS A !'ATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TIIE CERTIFIGATE HOLDER. THIS CE.TTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFOROED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEO REPRESENTATIVE OR PRODUCER, ANO THE CERTIFICATE HOLOER. IMPORTANT: ll tho cortificate holdo. is an ADDITIONAL lNSl,J REO, tho policy(ies) must be endorsed. IfSUBROGATION lS WAIVED, subiect to lhe terms and conditions of the policy, cartain policios may requiro an ondorsement. A statemont onthis cortlflcato does not confer rights to the certiticate holder ln liou of such endorsement(s), PROOUCER Bay and Basin Insulance Selvices LicenEe *5005??0 3?1 uain Str6€t Salinas CA 93901 Oscar Huerta (831) 540-4583 ohuerta0bayandbasinins . com [{suRER(S) AFFOROTtG COVEnAGE l{suRERA: Ohio Security Insuranc€ Codlpany 24042 II{SURERB:Employers Pref€laed Insulance Company 10346 IIISURER C II{SURER O IIISURER E COVERAGES REVISION NUMBER THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMEOAEOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED EYTHE POLICIES DESCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSANO CONOiTIONS OF SUCH POLICIES LIMITS SHOWN i/lAY HAVE sEEN REDUCED BY PAID CLAIMS. AOOL LIMITS A COMMERCIAL G EII ERA L TIABILITY CLAIMS MADE x OCCUR GEN'LAGGREGATE LIM TAPPL ES PER x POLICY OTHER JECT LOC x 82S5420652?t2/r/2022 72/r/2O23 EACH OCC!RRENCE S 1,000,000 PREMISES lE8 occuren.e)t 1, ooo, ooo ME0 EXP (Any one person)5 15,000 PERSONAL & AOV INJURY $1,000,000 CENERALAGGREGATE I 2,000,000 PRODIJCTS COMP/OPAGG s 2,000,000 s AUTOMOAILE LIAEILITY x ALL OWNEO AUTOS SCHEOIJLED AUTOS NON.O!4NEO AI.]IOSHIREDAI]TOS L2/r/2022 r2/7/2023 COMBINEO SINGLE LiMIT s 1 ,000,000 BOOLLY INJURY (P6. per$n)s mOILY INJURY (P6. a@den0 S S S UMBRE!LA LIAB EXCESS LIA6 OCCUR EACH OCCI]RRENCE S AGGREGATE S oLo RETENTION $5 B WORKERS COMPE*SANOT AIiO EMPLOYERS' LlAAILllY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMAER EXCLUOED' oESCRTPTION OF OPERAT ONS below i2/r/2022 72/t/2O23 oftl E L EACH ACCIOENT I 1.000,000 E L OISEASE. EAEMPLOYEE s 1, 000,000 E L OISEASE POLICY LIMIT S 1,000,000 OESCAIPTIOI OF OPEiAllONS I LOCAnOiS / VEI{ICLES (ACORO t 0i , Addmon.r R.m.rt. &h.dul., m.y b. .ltrch.<, It mn .p... l. r.qulr.dlCity of Menifee and its offj.cers, e[p1oye6s, agents a.d auEholi.zed voluntesrs ale nao€d additionalinsured, REI City of Menafee CoDEunity inforEation Dailings CERTIFICATE HOLDER CANCELLATION City of !,l6nif66 29844 Haun Rd. Menifee, cA 92586 SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED It'I ACCOROANCE WTH THE POLICY PROVISIONS, AUf HORIZED REPRESEIITAT]VE T Barlocker, CIC CRM/ O 1988.2014 ACORO CORPORATION. All rights reserved The ACORO name and logo are registered marks of ACORDACORD 2s (2014/01) lNS025 (2o14oi) CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE NUMBER: c!22111409941 INSURED Ad.naif Express, Inc. Brian Schott 316{0 llat nan stre€t Haywald x BUSINESSOWNERS BP 79 96 09 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESSOWNERS LIABILIry EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM Below is a summarization of the coverages provided by this endorsement. No coverages are given by this summary. Actual coverage descriptions are within this endorsement. SECTION A. SUBJECT Supplementary Payments Bail Bonds Loss Of Earnings Broadened Coverage For Oamage To Premises Rented To You Incidental Medical Malpractice lnjury l\.4obile Equipment Blanket Additional lnsured (Owners, Contractors Or Lessors) Newly Formed Or Acquired Organizations Aggregate Limits Duties ln The Event Of Occurrence, Offense, Claim Or Suit Liability And Medical Expenses Definitions Bodily lnjury lnsured Contract Personal And Advertising lnjury @ 2016 Liberty Mutual lnsurance lncludes copyrighted material of lnsurance Services Offlce, lnc.,with its permission B. c. D. E. F. G. H. t. I BP 79 96 09 16 Page 1 of 4 Section ll - Liability is amended as follows: A. Supplementary Payments Section A.1. Business Liability is modified as follows: l. The $250 limit shown in Paragraph A.1.f.(1)(b) Coverage Extension - Supplementary Payments for the cost of bail bonds is replaced by a $3,000 limit. 2. The $250 limit shown in Paragraph A.1.t.(fxd) Coverage Extension - Supplementary Payments for reasonable expenses and loss of earnings is replaced by a $500 limit. B. Broadened Covorage For Damago To Premises Rented To You 1. The last paragraph of Section B.l. Exclusions - Applicable To Business Liability Coverage is replaced by the following: With respect to the premises which are rented to you or temporarily occupied by you with the permis- sion of the owner, Exclusions c., d., e., 9., h., k., 1., m., n. and o. do not apply to "property damage'. a 2. Paragraph D.2. Liability And Medical Expenses Limits Of lnsurance is replaced by the following: The most we will pay under this endorsement for the sum of all damages because of all "property damage" to premises while rented to you or temporarily occupied by you with the permission of the owner is the Limit of lnsurance shown in the Declarations. 3. Paragraph D.3. Liability And Medical Expenses Limits Of lnsuranco does not apply. C. lncidontal Medical Malpractice lnjury 1. Paragraph (4) under Paragraph B.lj. Exclusions - Applicable To Businoss Liability Covorago - Profes- sional Sarvices does not apply to "lncidental Medical Malpractice lnjury" coverage. 2. With respect to this endorsement, the following is added to Section F. Liability And Medical Expenses D6finitions: a. "lncidental Medical Malpractice lnjury" means bodily injury arising out of the rendering of or failure to render, during the policy period, the following services: (1) t\4edical, surgical, dental, x-ray or nursing service or treatment or the furnishing of food or beverages in connection therewith; or (2) The furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances. b. This coverage does not apply to: (1) Expenses incurred by the insured for first-aid to others at the time of an accident and the Duties in the Event of Occurrence, Offense, Claim or Suit Condition is amended accordingly. (2) Any insured engaged in the business or occupation of providing any of the services described under a. above. (3) lnjury caused by any indemnitee if such indemnitee is engaged in the business or occupation of providing any of the services desffibed under a. above. D. Mobile Equipment Section C. Who ls An lnsured is amended to include any person driving "mobile equipment" with your permission. E. Blanket Additlonal lnsured (Own€rs, Contractors Or Lessors) 1. Section C. Who ls An lnsured is amended to include as an insured any person or organization whom you are required to name as an additional insured on this policy under a written contract or written agreement. The written contract or agreement must be: a. Currently in effect or becoming effective during the term of this policy; and b. Executed prior to the 'bodily injury", "property damage", or'personal and advertising injury'. 2. The insurance afforded to the additional insured is limited as follows: a. The person or organization is only an additional insured with respect to liability arising out of: (1) Real property, as described in a written contract or written agreement, you own, rent, lease, maintain or occupy; and (2) Caused in whole or in part by your ongoing operations performed for that insured- b. The Limit of lnsurance applicable to the additional insured are those specified in the written contract or written agreement or the limits available under this policy, as stated in the Declara- tions, whichever are less. These limits are inclusive of and not in addition to the Limit of lnsurance available under this policy. c. The insurance afforded to the additional insured does not apply to: (1) Liability arising out of the sole negligence of the additional insured; (2) "Bodily injury", "property damage", 'personal and advertising injury", or defense coverage under the Supplementary Payments section of the policy arising out of an archit6ct's, en- gineer's or surveyor's rendering of or failure to render any professional services including: @ 2016 Liberty lvlutual lnsurance BP79 96 09 16 lncludes copyrighted material of lnsurance Sorvices office, lnc.,wlth its permission. Page2ol 4 I (a) The preparing or approving of maps, shop drawings, opinions, reports, surveys, Iield orders, change orders, or drawings and specifications; and (b) Supervisory, inspection, architectural orengineering activities. (3) Any "occurrence" that takes place after you cease to be a tenant in the premises described in the Declarations; or (4) Structural alterations, new construction or demolition operations performed by or for the person or organization designated in the Declarations. 3. Any coverage provided hereunder shall be excess over any other valid and collectible insurance avail- able to the additional insured whether primary, excess, contingent or on any other basis unless a contract specifically requires that this insurance be primary or you request that it apply on a primary basis. F. Newly Formed Or Acquired Organizations The following is added to Section C. Who ls An lnsured: Any business entity acquired by you or incorporated or organized by you under the laws of any individual state of the United States oi America over which you maintain majority ownership interest exceeding fifty percent. Such acquired or newly formed organization will quality as a Named lnsured if there is no similar insurance available to that entity. However: 1, Coverage under this provision is atforded only until the 180th day after the entity was acquired or incorporated or organized by you or the end of the policy period, whichever is earlier; 2, Section A.1, Business Liability does not apply to: a. "Bodily injury" or "property damage" that occurred before the entity was acquired or incorporated or organized by yout and b. "Personal and advertising injury" arising out of an offense committed before the entity was ac- quired or incorporated or organized by you. 3. Records and descriptions of operations must be maintained by the first Named lnsured- No person or organization is an insured wilh respect to the conduct of any current or past partnership, joint venture or limited liability company that is nol shown as a Named lnsured in the Declarations. G. Aggregate Limits The following is added to Paragraph D.4. Aggregate Limits Liability and Medical Expenses Limits Of lnsurance: 1. The Aggregate Limits apply separately to each of the "locations" owned by or rented to you or temporarily occupied by you with the permission of th€ owner. 2. The Aggregate Limits aiso apply separately to each of your projects away from premises owned by or rented to you. For the purpose of this endorsement only, "location" means premises involving the same or connect- ing lots, or premises whose connection is interrupted only by a street, roadway, waterway or right- of-way of a railroad. H. Duties ln The Event Of Occurrence, Offense, Claim Or Suit 1. Paragraph E.2.a. Duties ln The Event Of Occurrence, Offense, Claim Or Suit Liability And Medical Expenses General Condition applies only when the "occunence" is known to any insured listed in Paragraph C.1. Who ls An lnsured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim. Paragraph E.2.b, Duties ln The Event Of Occurrence, Offense, Claim Or Suit Liability And N4edical Expenses General Condition will not be considered breached unless the breach occurs after such claim or "suit" is known to any insured listed under Paragraph C.1. Who ls An lnsured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim. @ 2016 Liberty Mutual lnsurance lncludes copyrighted matorial oI lnsurance SeNices Office, lnc.,with its permission 2 BP 79 96 09 16 Page 3 of 4 8 l. Section F. Liability And Medical Exp€nses Definitions is modified as follows: 1. Paragraph F.3. is replaced by the following: 3. 'Bodily lnjury" means bodily injury, sickness, disease, or incidental medical malpractice injury sustained by a person, and includes mental anguish resulting from any of these; and including death resulting from any of these at any time. 2. Paragraph F.9. is replaced by the following: 9. "lnsured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of prem- ises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement: c. Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indem- nification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization, provided the "bodily injury" or "property damage" is caused, in whole or in part, by you or by those acting on your behalf. However, such part of a contract or agreement shall only be considered an "insured contract" to the extent your assumption of the tort liability is permitted by law. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (l) That indemnifies a railroad for 'bodily injury" or "property damage' arising out of con- struction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opin- ions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instruclions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (2) above and supervisory, inspection, architectural or engineering activities. 3. Paragraph F.l4.b. Personal And Advertising lnjury is replaced by the following: b, Malicious prosecution or abuse of process; BP 79 96 09 16 Page 4 of 4 @ 2016 Liberty Mutual lnsurance lncludes copyrightad material of lnsurance Services Offic6, lnc., with its permission.