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2023/05/01 Stradling Yocca Carlson and Rauth APC
INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADE OCCUR MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: LOCJECT COMBINED SINGLE LIMIT $(Ea accident) BODILY INJURY (Per person)$ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS AUTOS ONLY HIRED PROPERTY DAMAGE $AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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. 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 any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE Vigilant Insurance Company Federal Insurance Company 6/21/2023 McGriff Insurance Services LLC 130 Theory Ste 200 Irvine, CA 92617 714 941-2800 CertsCA@McGriff.com Stradling Yocca Carlson & Rauth APC 660 Newport Center Drive, Suite #1600 Newport Beach, CA 92660 20397 20281 A X X X 35327003 05/01/2023 05/01/2024 1,000,000 1,000,000 10,000 1,000,000 2,000,000 INCLUDED B X X 74988851 05/01/2023 05/01/2024 1,000,000 B X X 79726620 05/01/2023 05/01/2024 27,000,000 27,000,000 A 71700994 11/03/2022 11/03/2023 X 1,000,000 1,000,000 1,000,000 ***************************** SUPERSEDES ANY CERTIFICATE PREVIOUSLY ISSUED ******************************* Certificate is subject to policy limits, conditions and exclusions. RE: Contract Agreement; BONDED CFDs BOND COUNSEL SERVICES. City of Menifee, its officers, agents and employees are included as Additional Insured as respects General Liability as required by written Contract. General Liability is Primary and Noncontributory as required by (See Attached Descriptions) City of Menifee Attn: Office of Finance 29844 Haun Road Menifee, CA 92584 1 of 2 #S32399173/M32063844 305STRADYOCClient#: 1252713 KSELF 1 of 2 #S32399173/M32063844 DocuSign Envelope ID: 8225908E-C398-4F79-9E1C-DD74CCBABC2D SAGITTA 25.3 (2016/03) DESCRIPTIONS (Continued from Page 1) written contract. Designated Insured applies to the Auto Liability as required by written contract. Waiver of Subrogation applies as respects Workers Compensation as required by written contract. 60 Day Notice of Cancellation- Nonrenewal (20 Day in the event of non-payment). 2 of 2 #S32399173/M32063844 DocuSign Envelope ID: 8225908E-C398-4F79-9E1C-DD74CCBABC2D # - $+-+)-)(&% 0,'-+%/ * 757:<:4<86 1 ' ,"-1 %$" +-"% *%!"1%/- /$% )%- 9= 8:97 $ )%- 9= 8:96 )%- 98= 8:97 )%- 9= 8:97 (*'#1 "*/( $%!-%. @ ! $/( $% ''# - 3 " ! ! ,-%-"1' '*10*'* 3 # - ; * 1 * = += 2 # ! ; !2 2 = = = = ; 2 3 % ? >; * 1 * = ; ? = ; > = = to05/01/2023 05/01/2023 05/01/2024 35327003 Stradling Yocca Carlson & Rauth APC DocuSign Envelope ID: 8225908E-C398-4F79-9E1C-DD74CCBABC2D # - $+-+)-)(&% 0,'-+%/ ) 0/ . = / = = * ; ! = $ * ; # = = ; 1 ; # DocuSign Envelope ID: 8225908E-C398-4F79-9E1C-DD74CCBABC2D POLICY NUMBER: COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II – Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I – Covered Autos Coverages of the Auto Dealers Coverage Form. Persons or organizations that you are obligated, pursuant to a contract or agreement between you and such person or organization, to provide with such insurance as is afforded by this policy. However, no such person or organization is an insured under this provision who is more specifically described under any other provision of the “Who Is An Insured” section of this policy (regardless of any limitation applicable thereto) or who is a branch, department, agency, corporation or other governmental authority of the Federal Government of the United States of America. Stradling Yocca Carlson & Rauth APC 74988851 05/01/2023 DocuSign Envelope ID: 8225908E-C398-4F79-9E1C-DD74CCBABC2D This page has been left blank intentionally. DocuSign Envelope ID: 8225908E-C398-4F79-9E1C-DD74CCBABC2D Stradling Yocca Carlson & Rauth APC 7170099411/03/2022 DocuSign Envelope ID: 8225908E-C398-4F79-9E1C-DD74CCBABC2D This page has been left blank intentionally. DocuSign Envelope ID: 8225908E-C398-4F79-9E1C-DD74CCBABC2D