2022/12/01 Charles E. Thomas Company, Inc.dAD"
COVEHAGES
CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NUMBER: 1477060761 HEVISION NUMBER: 1
OAIE (IIX,DO,'Y YYY)
11t16n022
THIS CERTIFICATE IS ISSUEO AS A MATTER OF INFOFMATION ONLY AND CONFEBS NO RIGHTS UPON THE CERTIFICATE HOLDEF, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGANVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 8Y THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUFER(S), AUTHORIZEO
REPBESENTATIVE OB PRODUCER, AND THE CERTIFICATE HOu)ER.
IMPORTANT: ll the certlficate holder ls rn ADDITIONAL INSUBEO, the pollcy(les) must have ADDITIONAL INSURED provl3lons or br endorred.
ll SUBROGATION lS WAIVED, subiect lo the terms and condlllons ol the pollcy, cerhln pollcles may requhe an endor3ement. A ltatement on
thls cenltlcate does not confer rlghts to the ccnlrlcate holder In lleu ol such qndor8ement(+
PFOOUCEA
Andreini & Company-San Mal€o
220 West 20th Ave
San Mateo CA 94403
lr,6UnEO
Charles E Thomaa Company, lnc
'13701 So Alms Av€nue
Gardena CA 90249
il[Eln usa salcicc,a
PHON€650-378-4238 650-378-4361
lsalcrcc andreinr com
INSU REAIS) AFFOBDING COVEFAGE NAIC '44524TNaUFEFA: Crum EForste'Specralty lns Co
tlsuREF B, Fedoral lnsurance 9l!1Pl!v 20281
43753l'lsl8Ej S ij!pu!!!g ]lqcllry Co ot CaIf
INSUFEBO
I AUBEB E
THIS IS TO CEFTIFY THAT THE POLICIES OF INSURANCE LISTEO BELOW HAVE BEEN ISSUEO IO THE INSURED NAMEO ABOVE FOR THE POLICY PERIOD
INOICATED. NOTWTHSTANDING ANY REOUIREMENT. TERM OF CONOITION OF ANY CONTRACT OB OTHER OOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PEBTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCNIBED HEREIN IS SUBJECT TO ALL IHE TERMS.
EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN FEDUCED BY PAID CLAIMS,
TYF€ OFINSUFANCE POLICY NIJi/I8EF r.[iTsINSF
EPK137916 1211t2022 17J1n023
MEO EXP (An 000
PERSONAL & ADV INJUSY
12.000 000
6100 000
EN
X COlrfEBClAl OEllERAl LIAIIUTY
- "ro,r" u^r, T *"u"
GENEAA AGGBEGATE
PFODUCTS COUP,OP AGG
EACH OCCUAFENCE
D'SITGETdFEN]Ed
i$2 000 000
s2 000 000
r2.000.000
$2.000 000l .] cer--eorr,u
-
GEN'L AGOREGATE LIUIT APPLIES PEAI
"or", .1' ffiP, ' .o"
ts
SEHEOULEOL AUIOS
Nor.r OWNEOL ^ulos or{[Y
I X
"or
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73612365
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s
121112022 121112023
A6E
c s1000
t 1 000 000AUTOMOBILE UABILl.rY
OWNEOrdJTos onlY
HIBEDAUTOS OI{LY
EOOILY ll\UUFY lP.roroon) ll
----i____motLY tfuuFY (Pe a@d6nl) $
UMBFELLA LtAB
EXCESg UAB
@CUF
ct.^rMs MAoE
oeo X crrtuort
X
X t!.090,990
5
EFX119335
AOGFEGAIE
121112022 12112023 E cHoccUBFENcE
woaKEas cflPENs IoN
ANO EI'PLOYEAS' LIABIUTY
AAYPBOPFIETO&PAFTiIER'EXECUIIVE
OFFICEF./MEMBEAEXCLUDEO?(tt.hd.iory ln NH)
N
25532243
Y/N
c 1211a022 12t1t2o23 X
$ 1 000 000
E L OISEASE. POLICY LIMII $ 1.000 000
E L. EACH ACCIOENT
EL DIA€ASE EA EMPLOYEE $I,OOOOOt)
EPK137916 12J1n022 1211D023 o<.u ea s2 000 000
$2 000 000
DEgCaImO OFOPEBATIONi/LOCATIoI{S/VEIIICLES (ACOBO 101. Addlllon.lBrlx .gch.dul.m
City of Menit6e and its olicrals offrc.rs. Gmploya!6 and volunt6lrE ero includad as
wntten contract per lho attBched blanket ehdorsem€nt
ba dlrhad ll mora arac. l. r.quLd)
dditronal lnsur6d wrth r.sp6cts to Gcnoral Liability wh€re r€quirod by
CEBTIFICATE HOLOER CANCELLATION
City of Menifee
29844 Haun Road
lyienifee CA 92586
SIIOULD A}IY OF THE ABOVE DESCBIBED POUCIES BE CANCELLEO BEFONE
THE EXPIFATION DA'TE THEFEOF, NOTICE WILL 8E DELIVEREO IN
ACCOAOANCEWTHTHE POLICY PBOVISIONS.
AIJTHOhIZEO FEPFESENIATIVE
AwSuu,o-u^a../
O ls88-2015 ACOBD COBPORATION. All rlghb rlscrvrd.
lho ACORD nrmo rnd logo ero r.gltt.rod msrk! ol ACORD
2ot3 3688
ACORO 25 (2016/03)
$ 5.000.000
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - STATE OR GOVERNMENTAL
AGENCY OR SUBDIVISION OR POLITICAL
SUBDIVISION - PERMITS OR AUTHORIZAT!ONS
This endoGement modrfres insurance provided under the followang
COMMERCIAL GENERAL LIABILITY COVERAGE PART
CONTRACTORS POLLUTION LIABILITY COVERAGE PART
ERRORS AND OIVIISSIONS LIABILIry COVERAGE PART
THIRD PARTY POLLUTION LIABILIry COVER PART
ONSITE CLEANUP COVERAGE PART
SCHEDULE
Stat Or Governmental Agency or subdivision or Political Subdivision:
Where Required By Written Contract
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
Under the Common Provisions, Section lll -Who ls An lnsured is amended to include as an
insured any state or governmental agEncy or
subdivision or political subdivision shown in the
Schedule, subject to the following provisrons:
1. This insurance applies only with resp€ct to
operations performed by you or on your be-
half for which the state or governmental
agency or subdivision or political Eubdivision
has issued a permit or authorization.
2. This insurance does not apply to:
a. "Bodily injury', "property damage" "per-
sonal and advertising inju4f , a "pollution
condition" or a "wrongful act" arising out of
operations performed for the federal gov-
ernment, state or municipality: or
b. "Bodily injury" or 'property damage" in-
cluded within the "products-completed op-
erations hazard",
EN0'145.1 '1 1 1
lnc udes copyrighted material of lnsurance SeMce Office, lnc. with its permit6ion
Page 'l of '1
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