2023/09/01 Arroyo SP
ISSUE DATE: 06-17-2023
1863950-2022
47
09-01-2023
09-01-2022/09-01-2023
CITY OF MENIFEE SP
29714 HAUN RD
MENIFEE CA 92586-6540
30
30
UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING:
THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER;
EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING
CALIFORNIA WORKERS' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS'
COMPENSATION LAW.
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 09-01-2022 IS
ATTACHED TO AND FORMS A PART OF THIS POLICY.
ARROYO, ERIC (AND) ARROYO, TERISIA SP
19510 VAN BUREN F-3-192
RIVERSIDE CA 92508
PRINTED : 06-17-2023
POLICYHOLDER COPY
[P19,SK]
DocuSign Envelope ID: B819C53E-0533-4CC0-BC10-FDB85889EF5B