Loading...
2023/01/25 Rhythm Tech Productions LLC (2)The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECT PRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)LIMITS PER STATUTE OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 04/25/2023 JASON WOLCOTT INSURANCE SERVICES 23120 ALICIA PARKWAY SUITE 231 MISSION VIEJO CA 92691 RHYTHM TECH PRODUCTIONS LLC 264 N. Pennsylvania Ave. Colton CA 92324 ROBERT GROTH 949-916-0360 949-916-0370 ROBERTG@WOLCOTTINS.COM SCOTTSDALE INSURANCE COMPANY INFINITY SELECT INSURANCE CO STATE COMPENSATION INSURANCE FUND A ✔ ✔ ✔ Y Y CPS7716469 01/25/2023 01/25/2024 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 B ✔ ✔Y Y 504610113601001 04/20/2023 04/20/2024 1,000,000 C N Y 9316160-23 04/13/2023 04/132024 ✔ 1,000,000 1,000,000 1,000,000 RE:ALL OPERATIONS AND EVENTS City of Menifee and its Officers ,employees ,agents and Authorized Volunteers have been added as additional insured to above referenced policy letter A & B including waiver of subrogation and primary and non-contributory wording for policyA. In regards to workers compensation policy letter C a Blanket Waiver of subrogation Applies. CITY OF MENIFEE ITS OFFICERS,EMPLOYEES ,AGENTS AND AUTHORIZED VOLUNTEERS 29844 HAUN ROAD MENIFEE CA 92311 DocuSign Envelope ID: 4B253213-8C26-42E9-8BB8-8581580BA28C DocuSign Envelope ID: 4B253213-8C26-42E9-8BB8-8581580BA28C DocuSign Envelope ID: 4B253213-8C26-42E9-8BB8-8581580BA28C DocuSign Envelope ID: 4B253213-8C26-42E9-8BB8-8581580BA28C DocuSign Envelope ID: 4B253213-8C26-42E9-8BB8-8581580BA28C Part A - Liability Coverage, is changed as follows: The definition of insured is changed to include the additional insured named above. Adding an insured will not increase the limit of our liability. The insurance provided by this endorsement will be excess over any other valid and collectible insurance. All other parts of this Policy remain unchanged. ADDITIONAL NAMED INSURED ENDORSEMENT This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the time changes are requested. Additional Insured ENDORSEMENT: AMEND DATE: 50461AIS01 Copy To Customer Service:Claims Service: Policy ID Number Expiration Date Named Insured 12:01 a.m. Infinity Commercial Auto Underwritten by: Infinity Select Insurance Company "11700 Great Oaks Way, Suite 450" "Alpharetta, GA 30022" (800) 722-3391 (800) 334-1661 City of Menifee its Officers, employees, agents 29844 HAUN RD MENIFEE, CA 92586-6539 504-61011-3601-001 04/20/2024 RHYTHM TECH PRODUCTIONS LLC City of Menifee its Officers, employees, agents ADDL INSURED COPY 7-1 04/20/2023 DocuSign Envelope ID: 4B253213-8C26-42E9-8BB8-8581580BA28C PRIMARY AND NONCONTRIBUTORY ENDORSEMENT AMEND DATE: ENDORSEMENT: This endorsement modifies the insurance provided under your COMMERCIAL AUTO POLICY. PART A – LIABILITY COVERAGE OTHER INSURANCE – PART A ONLY The following is added to this section: The coverage afforded under your Commercial Auto Policy is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: a.You have agreed in writing in a contract or agreement that the coverage afforded under your Commercial Auto Policy would be primary and would not seek contribution from any other insurance available to such additional insured; and b. Such additional insured is a named insured under such other insurance. ALL OTHER TERMS, LIMITS, CONDITIONS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. Customer Service:Claims Service: Policy ID Number Expiration Date This endorsement is attached to and forms a part of the listed policy. The following endorsement applies only if Form Number 500PNCV01 appears on your Declarations Page. Copy To Named Insured 12:01 a..m. 500PNCV01 Infinity Commercial Auto Underwritten by: Infinity Select Insurance Company "11700 Great Oaks Way, Suite 450" "Alpharetta, GA 30022" (800) 722-3391 (800) 334-1661 City of Menifee its Officers, employees, agents 29844 HAUN RD MENIFEE, CA 92586-6539 504-61011-3601-001 04/20/2024 Rhythm Tech Productions Llc ADDL INSURED COPY 04/20/2023 7-1 DocuSign Envelope ID: 4B253213-8C26-42E9-8BB8-8581580BA28C DocuSign Envelope ID: 4B253213-8C26-42E9-8BB8-8581580BA28C