2021/06/01 Integrated Project Services, Inc. dba Pettit (3)COVERAGES
INTEGRA.Ol
CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NUMBER REVISION NUMBER
3t14t2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORIVIATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE OOES 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 PROOUCER, ANO THE CERTIFICATE HOLDER.
IMPORTANT: ll tho certificate holdor is an A0DITIONAL INSURED, th€ policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.lI SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, conain policies may r6quire an endorsefiont. A statement on
this certificate does not conler rights to tho conificate holder in lisu of such endorsoment(s).
INSURER C:
Jena Hallison
ena umrisk.com
Com on lns. Fund 3507
PHONE
pRooucER License 485
Spoctrum Risk Manaqement & lnsurance Services, LLC
74 Discoverv
lrvlne, CA 91618
lntegratod Project Services, lnc. dba Pettit
1787 Pomona Road, Suite D
Corona, CA 92878
THIS IS TO CERIIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE AEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED NOTWTHSTANDING ANY REOUIREMENT TERM OR CONDITION OT ANY CONTRACT OR OTHER DOCUMENTWTH RESPECTTO WTIICH THIS
CERTIFICATE MAY AE ISSUED OR I''AY PERIAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIAED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONOITIONS OF SUCH POLICIES, LIIdITS SHOWN IUAY HAVE BEEN REDUCED BY PAID CLAIMS.
EACH OCC!RRENCE
P8$4.SqS-G4a!EJ.J9&&)
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9313908-2021 61112021 3t'1612022
WORKERS COMPENSATIONAND €MPLOYERS' LIABILITY
ANY PROPRIEIORlPAR I N €R]E XEC U TIVEOFFIC€R/MEMAER E^C-LI]OED'
DEscFrPTtoN oF opERATroNq
OE SCRIPTION OF OPERATIONS / LOCAIONS / VEHICLES IACORO 101, Addltlo..l R.m.rt. Sch.dul., ruy b..tr.ch.d llmoE.p.c. ir EqulEdl
Re: FY2021-22 On-Call Engineering Services (Land Oevelopment Review) (Recoverable)
The City of Menifee, its directors, officials, officers, employees, agents and volunteers are cenificate holder. Waiver of subrogation applies to certificate
holder. 30 day notice of cancellation applies.
City of Monlfoe
298,t4 Haun Rd.
Menifeo, CA 92586
SHOULO ANY OF THE ABOVE OESCRIBEO POLICIES BE CANCELLEO BEFORET}IE EXPIRATION DATE THEREOF, I{OTICE WILL BE DELIVEREO IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZEO R€PRESEN1ATIVE
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@ 1988-2015 ACORO CORPORATION. All riqhts reserved
The ACORD name and logo are registered marks ot ACORD
ACORD 2s (2016/03)
A,CORD
FUNtr'
coMFar\rs^troNINSUFANCi
HOM€ OFFICE
SAN FRANCISCO
BLANKET BASIS
EFFECTIVE JUNE I, 2O2I AT
AND EXPIRING MARCH 15,
12.01 A.M.
2022 AT 12.0I A
ENDORSEMENT AGREEMENT
WAIVER OF SUBROGAT I ON
BROKER COPY
9313908-2r
NEW
SP5-50-55-04PAGE 1 OF ]
ALL EFFECTIVE OATES ARE
AT 12:01 AM PACIFIC
STANOARO TIME OR THE
TIME INDICATEO AT
PACIFIC STANOARO TIME
M
PETT I T
1787 POMONA
CORONA, CA
RD
9287I
PERSON OR ORGANIZATION
WE HAVE THE RI6HT TO RECOVER OUR PAYNENTS FROH ANYONE
LIABLE FOR AN INJURY COVERED BY THIS POLICY. I.IE WILL
NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR
ORGANIZATION NA}{ED IN THE SCHEDULE.
THIS AGREEI{ENT APPLIES ONLY TO THE EXTENT THAT YOU
PIRFORH WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU
IO OBTAIN THIS AGREET,{ENT FROH US.
THE ADDITIONAL PREI'TIUN FOR THIS ENDORSE},(ENT SHALL BE
2.007 OF THE TOTAL POLICY PRE},IIU},T.
SCHEDU LE
JOB DESCRIPTION
ANY PERSON OR ORGANIZATION
FOR HHOI.I THE NAXED INSURED
HAS ACREED BY WR I TTEN
CONTRACT TO FURNISH THI S
WAI VER
BLANKET IJAIVER OF
SUBROGATION
NOTHING IN THIS ENOORSEMENT CONTAINED SHALL BE HELO TO VARY, ALTER, WAIVE
OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS
POLICY OTHER THAN AS SIATED, NOTHING ELSEWHERE IN THIS POLICY SHALL BE
HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONOITIONS, AGREEMENTS OR
LIMITATIONS OF THIS ENOORSEM€NT.
CoUNTERSTGNED AND TSSUED Ar SAN FRANCTSCO, UARCH 7 , 2022
//-,.- l-;..-,-
PRESIDENT AND CEO oLo oP 2r7
STATE
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