Loading...
2022/10/03 Interwest Consulting GroupSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 6/15/2023 RBN Insurance Services 303 E Wacker Dr Ste 650 Chicago IL 60601 Ashley Williams 312-856-9400 312-856-9425 awilliams@rbninsurance.com Hartford Fire Insurance Co.19682 SAFELLC-01 Hartford Casualty Insurance Co 29424InterwestConsultingGroup 444 N.Cleveland Ave. Loveland CO 80537 Great American E&S Ins.Co.37532 Bridgeway Insurance Company 12489 Lexington Insurance Company 19437 1865408599 A X 1,000,000 X 1,000,000 10,000 1,000,000 2,000,000 X Y 83UENZV3951 10/3/2022 10/3/2023 2,000,000 B 1,000,000 X X X Y 83UENPY9100 10/3/2022 10/3/2023 D E X 10,000,000 X 8E-A7-XL-0002079-01 011170903 10/3/2022 10/3/2022 10/3/2023 10/3/2023 10,000,000 X 0 C Professional Liability TER 4495168 10/3/2022 10/3/2023 Each Claim/Aggregate 10,000,000 CITY OF MENIFEE and its officers,officials,employees,and volunteers are additional insured as respects the General Liability and Automobile Liability as required by written contract. CITY OF MENIFEE 29844 HAUN ROAD MENIFEE CA 92586 DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF 25. "Your work":ROMS, tapes, drives, cells, data processing devices or any other media which are used with a.Means: electronically controlled equipment.(1)Work or operations performed by you or 21."Suit"means a civil proceeding in which on your behalf; and damages because of "bodily injury", "property (2)Materials, parts or equipment furnished in damage" or "personal and advertising injury" to connection with such work or operations.which this insurance applies are alleged. "Suit" b.Includesincludes: (1)Warranties or representations made at a.An arbitration proceeding in which such any time with respect to the fitness, damages are claimed and to which the quality, durability, performance or use ofinsured must submit or does submit with our "your work", and consent; or (2)The providing of or failure to provide b.Any other alternative dispute resolution warnings or instructions.proceeding in which such damages are claimed and to which the insured submits with our consent. 22."Temporary worker"means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions. 23."Volunteer worker"means a person who a.Is not your "employee"; b.Donates his or her work; c.Acts at the direction of and within the scope of duties determined by you; and d.Is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 24."Your product": a.Means: (1)Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a)You; (b)Others trading under your name; or (c)A person or organization whose business or assets you have acquired; and (2)Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b. Includes (1)Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your product"; and (2)The providing of or failure to provide warnings or instructions. c.Does not include vending machines or other property rented to or located for the use of others but not sold. HG 00 01 09 16 Page 21 of 21 DocuSign Envelope ID: D21F2C9B-581C-4FB3-A2E0-6BFE783763CF