2022/11/22 TR Design Group, Inc.--ACORD'TRDESIG{1
CERTIFICATE OF LIABILITY INSURANCE 11t29t2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BYTHEPOLICIES
BELOW. THIS CERTIFICATE OF INSURANCE OOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLOER.
IMPORTANT: lf th6 cerlificate holdor ls 6n AODITIONAL INSURED, the pollcy(les) must have AODITIONAL INSURED provisions or b6 6ndors6d.
It SUBROGATION lS WAIVED, sublect to the terms and condltlona oftho policy, certain pollcles may roqulre an endorsement. A statement on
thls cartlflcale do€s not confea rlghls to lho conlflcato hotdor ln Ueu ofsuch ondorsement(s).
tNsuRER a - Property and Casualty ln3uranc6 Cofipany of Hadford
231-2572951
'NsuRER c : Lexi on lnsurance Co panv
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2lnsuracm
51 779-8558
0
9437
s9tES SE
'*SURER A:OhiO
ca hubinternational.com
Kristie KoehrerpRoDUcER License # 0757776
HUB lntomational lnsurance Services lnc.
PO 8ox 53.15Riv€rslde, CA 925i7
li i+j
TR D6sign Group,lrlc.
2900 Adams St., Ste, 4,100
Riverside, CA 92504
TEN MBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NA[,'ED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECTTOWHICH THIS
CERTIFICATE MAY AE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN ls SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
EACH OCCIJRRENCE
OAMAGE TO RENTEO
MEO ExP aAnv one oer$n)
PERSONAL & ADV INJI]RY
GENERAL AGGREGATE
15,000
2,000,000
2,000,000
q 2,000,000
s 4,000,000
3
3
PRODUCTS. COMP/OP AGG
51412022 5t8t2023
s 'l'000,000
s
COMMERCIAL GENERAL LIABILITY
GEN L AGCREGATE LIMIT APPLIES PER
x
x
x LOC
CLAIMS.IVADE
ER
x
MBINED SINGLE LIMIT 2,000,000
51a12022 51a12023
A
OWNEO
AUTOS ONLY
HIRED NON.OWNEO
x
x x
AUTOUOBILE LIABILITY
SCHEDULEDArJaos
BZS (23) s6 41 ,rl 95
EACH OCCURRENCE
AGGREGATE t
tDEDRETENTIONS
OCCUR
CLAIMS.MAOE
UMBRELLA LIAB
EXCESS LIAB
x STATUTE OTH-
1,000,000
1,000,000
E.L EACH ACCIOENT
E L DISEASE. EA EMPLOYEE
B WORKER9 COMPENSATIONAND EIIIPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?
NFSllRIPTI.jN 6F .)PFRATIONS Mbd
l"
wEc EV,r335x 't1t2212022 't1t22t2023
E L OISEASE. POLICYLIMIT 1,000,000sc
c
Professional Liab.
Professional Liab.
031711121
031711121
11122t2022
11122t2022
1'112212023 Oed t2snEAclaim Lmt
'11l22,f2023 AggrGgate
1,000,000
2,000,000
DEscRlPTtoN OF OPERATiOI,IS / LOCATTONS / vEH tCL ES {ACORD 10r, Addhionat R.m.rl. S.h.dut., may b. .n.ch.d ll morc 3pac. l. r.qulr.d)
RE: Agreement No. #2021.0214 and the corr6sponding Purchase Order (PO) #02s75.
The Clty ot 1116nlfee and its officers, employeos, agents, authorlzea, volunlee6 and all peEons or entities are Addltional lnsured with regarcl to General and
Aulo Llabllity when required by w.itten contract per the atlached endorsement form 8P7996 09/16. Primary & Non 4ontributory wording applies wllh regard
ro General Llabllity when required by wrltten contract per the atiached endors€ment form 8P1488 07/13. Walver ot Subrogatlon with regard to Workers
Compensatlon applles when required by wrltton contract per lhe attached endorsehent form WC040306(1).
Should th6 pollcles be cancelled before lhs expiration date, Hub lnternatlonal lnsurance Servlces lnc. (Hub), independent of any rights which may be afforded
SEE ATTACHEO ACORD 1OI
The City of Menifee
Attn: Paula Muratorc
29844 Haun Road
M6nife., CA 92586
SHOULD AllY OF THE ABOVE DESCRIAED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE wlLL BE OELryERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZED REPRESENTATIVE
H LDER
ACORD 25 (2016/03)
)NZt
BZS (23) 56 41 4'r 95
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Nfl,ru*,-
O 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo ar€ registered marks of ACORD
AGENCY CUSTOMER tO. TRDESIG-01
LOC *: 'l
ADDITIONAL REMARKS SCHEDULE
SGONZALEZ
ACORD'Page 'l ol 'l
AGENCY License f 0757776
HUB lnternational lnsurance Services lnc.
NAIIIEO INSIJREDTR Desion GrouD. lnc.
2900 AdEms Sr., Sre. 4400
Riverside. CA 92504
SEE PAGE 1
NAIC CODE
EE PAGE 1 EEPl EFFECNVE OATEI sEE PAGE {
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORi' IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE:Certifical€ of Llability lnsurance
Descriplion of Operations/LocationsNehicles:
within the policies to the certificate holder named below, will provide to such certificate holder notice of such cancellation within
thirty (30) days of the cancellation date, except in the event the cancellation is due to non-paymenl of premium, in which case Hub
will provide to such certificate holder notice of such cancellation within ten (10) days of the cancellation date.
O 2008 ACORO CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORO 101 (2008/01)
lnsured: TR Design Group, lnc.
Policy No.: BZS (23) 56 41 41 95
Policy Period: 5!812022 to 5lal2o23
BUSINESSOWNERS
BP 79 96 09 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESSOWNERS LIABTLITY EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COVERAGE FORI\,4
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 SUBJECT
Supplementary Payments
Bail Bonds
Loss Of Earnings
Broadened Coverage For Damage To Premises Rented To You
lncidental llledical Malpractice lnjury
[,llobile Equipment
Blanket Additional lnsured (Owners, Contractors Or Lessors)
Newly Formed Or Acquired Organizations
Aggregate Limits
Duties ln The Event Of Occunence, Offense, Claim Or Suit
Liability And Medical Expenses Definitions
Bodily lnjury
lnsured Contract
Personal And Advertising lnjury
Section ll - Liability is amended as followsl
A. Supplementary Payments
Section A.'1. Business Liability is modified as follows:
l. The $250 limit shown in Paragraph A.1.f.(1Xb) 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.f.(fxd) Coverage Extension - Supplomentary Payments for
reasonable expenses and loss of earnings is replaced by a $500 limit.
B. Broadened Coverage For Oamage To Premises Rented To You
1. The last paragraph of Section B.'1. Exclusions - Applicable To Businsss Liability Coverage is replaced
by the following:
With respect to the premises which are rented to you or temporariiy 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 lo "property damage".
A
BP 79 96 09 t6 Page I of 4
@ 2016 Liberty Mutual lnsurance
lncludes copyrighted material of lnsurance Services Ofllce, lnc.,with its permission.
B.
c.
D.
E.
F.
G.
H.
L
I
2. Parcgtaph D.2. Liability And Medical Exp6ns6s 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 Oeclarations
3. Paragraph D.3. Liability And Medical Expenses Limits Of lnsurance does not apply.
C. lncidental Medical Malpractice lniury
1. Paragraph (4) under Paragraph B.1.i. Exclusions - Applicable To Businass Liability Coverage - Profes-
sional Services 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
Definitions:
a. "lncidental l\,4edical Malpractice lnjury" means bodily injury arising out of the rendering of or
failure to render, during the policy period, the following services:
(1) Medical, surgical, dental, x-ray or nursing service or treatment or the fumishing 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 Occunence, 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 described 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 Additional lnsured (Owners, 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
agreemenl. The wriften contract or agreement musl 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:
(l) Real property, as described in a written contracl 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 specifled in the written
contract or written agreement or the limits available under this policy, as staled 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 nol apply to:
(l) Liability arising out ofthe sole negligence ofthe 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 architect's, en-
gineer's or surveyor's rendering of or failure to render any professional services including:
@ 2016 Liberty Mutual Insurance
BP79 96 09 16 lncludes copyrighted material of lnsorance Services Offlce, lnc.,with its permission. Page2of 4
3
(a) The preparing or approving of maps, shop drawings, opinions, reports, surveys, field
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 Acquir6d Organizations
The following is added to Section C. Who ls An Insured:
Any business entity acquired by you or incorporated or organized by you under the laws of any individual
state of the United States of America over which you maintain majority ownership interest exceeding fifty
percent. Such acquired or newly formed organization will qualify as a Named lnsured if there is no similar
insurance available to that entity. However:
1. Coverage under this provision is afforded only until the 'l80th 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.l. Business Liability does not apply to:
a. "Bodily injury" or "property damage" that occurred before the entity was acquired or incorporated
or organized by you; 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 fhst Named lnsured.
No person or organization is an insured with respect to the conduct of any currenl or past partnership, joint
venture or limited liability company that is not 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 the owner.
2. The Aggregate Limits also 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 l/edical
Expenses General Condition applies only when the "occurrence" is known to any insured listed in
Paragraph C.l. Who ls An lnsured or any "employee" authorized by you to give or receive notice of an
'occurrence" or claim.
Paragraph E.2.b. Outies ln The Event Of Occurrence, Offense, Claim Or Suit Liability And i,,ledical
Expenses General Condition will not be considered breached unless the breach occurs afler 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 i/utual lnsurance
lncludes copyrighted material of lnsurance Services Office, lnc., with its permission
3
2
BP 79 96 09 16 Page 3 of 4
I
s
Section F. Liability And Medical Expenses 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 contracl" 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
wilh 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 exlent 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 mntract or agreement:
('l) That indemnifies a railroad for "bodily injury" or "property damage" arising oul of crn-
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, lleld orders, change orders or drawings and specificationsi or
(b) Giving directions or instructions, 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.14.b. Personal And Advertising lniury is replaced by the following:
b. Malicious prosecution or abuse of process;
o 2016 Liberty Mutual lnsurance
lncludes copyrighted material of lnsurance Services Office, lnc., with its permissionBP 79 96 09 't6 Page 4 of 4
8
lnsured: TR Design Group, lnc.
Policy No.: BZS (23) 56 41 41 95
Policy Period: 51812022 lo 51812023
The following is added to Paragraph H. Other ln-
surance of Section lll - Common Policy Condi-
tions and supersedes any provision to the con-
trary:
Primary And Noncontributory lnsurance
This insurance is primary to and will not seek
contribution from any other insurance avail-
able to an additional insured under your poli-
cy provided that:
l. The additional insured is a Named ln-
sured under such other insurance; and
BUSINESSOWNERS
BP 14 88 07 13
You have agreed in writing in a contract
or agreement that this insurance would
be primary and would not seek contribu-
tion from any other insurance available
to the additional insured.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
2
J
BP 't4 88 07 13 @ lnsurance Services Office, lnc.,2012 Page 1 of 1
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM
PRIMARY AND NONCONTRIBUTORY
OTHER INSURANCE CONDITION
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF OUR RIGHT TO RECOVER FROM
OTHERS ENDORSEMENT - CALIFORNIA
Policy Number: 72 WEC EV4335 Endorsement Number:
Effective Dalei 1'l122122 Effective hour is the same as stated on the lnformation Page of the policy.
Named lnsured and Address: TR DESIGN GROUP INC
29OO ADAMS ST UNIT A.4OO
RIVERSIDE CA 92504
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our
right against the person or organization named in the Schedule. (This agreement applies only to the extent that you
perform work under a written contract that requires you to obtain this agreement from us,)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work
described in the Schedule.
SCHEDULE
Person or Organization Job Description
Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from
US
K-;rt" K"r/^"*
Authorized Representative
Form WC 04 03 06 (1 ) Printed in U.S.A.
Process Date:'10/13/22
"tr
The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due
on such remuneration.
Countersigned by
Policy Expiration Dalei 11122123