Loading...
2023/09/01 Albert A. Webb AssociatesANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD 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) 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 EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY 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 LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) 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 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.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 9/18/2023 License # 0757776 (951) 779-8558 (951) 231-2572 25674 Albert A. Webb Associates 3788 McCray Street Riverside, CA 92506 A 1,000,000 X P-630-8W805292-TIL-23 9/1/2023 9/1/2024 300,000 $0 Deductible 5,000 1,000,000 2,000,000 2,000,000 1,000,000A X BA-9T94622A-23-43-G 9/1/2023 9/1/2024 A UB-4J648178-23-43-G 9/1/2023 9/1/2024 1,000,000 Y 1,000,000 1,000,000 RE: Operations of the Named Insured during the current policy term City of Menifee and its officers, officials, employees, and authorized volunteers are Additional Insureds with regard to the General Liability policy per the attached endorsement forms CGD414 04/08, CGT100 02/19 (pg. 16), Primary & Non-Contributory included. Additional Insured applies with regard to the Auto Liability policy per the attached endorsement form CAT353 02/15. Primary & Non-Contributory applies with regard to the Auto Liability policy per the attached endorsement form CAT474 02/16. SEE ATTACHED ACORD 101 City of Menifee 29844 Haun Road Menifee, CA 92586 ALBEAWE-01 VSUNGA HUB International Insurance Services Inc. PO Box 5345 Riverside, CA 92517 Kristie Koehrer cal.cpu@hubinternational.com Travelers Property Casualty Company of America X X X X X X X X DocuSign Envelope ID: DB05085B-0DA1-4C79-A91C-A4890ABCF6D7 FORM NUMBER: EFFECTIVE DATE: The ACORD name and logo are registered marks of ACORD ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE FORM TITLE: Page of THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 101 (2008/01) AGENCY CUSTOMER ID: LOC #: AGENCY NAMED INSURED POLICY NUMBER CARRIER NAIC CODE © 2008 ACORD CORPORATION. All rights reserved. HUB International Insurance Services Inc. ALBEAWE-01 SEE PAGE 1 1 SEE PAGE 1 ACORD 25 Certificate of Liability Insurance License # 0757776 0 SEE P 1 Albert A. Webb Associates 3788 McCray Street Riverside, CA 92506 SEE PAGE 1 VSUNGA 1 Description of Operations/Locations/Vehicles: Should the policies be cancelled before the expiration date, Hub International Insurance Services Inc. (Hub), independent of any rights which may be afforded 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-payment of premium, in which case Hub will provide to such certificate holder notice of such cancellation within ten (10) days of the cancellation date. DocuSign Envelope ID: DB05085B-0DA1-4C79-A91C-A4890ABCF6D7 Albert A. Webb Associates Policy Number: P-630-8W805292-TIL-23 Policy Period: 09/01/2023 to 09/01/2024 DocuSign Envelope ID: DB05085B-0DA1-4C79-A91C-A4890ABCF6D7 DocuSign Envelope ID: DB05085B-0DA1-4C79-A91C-A4890ABCF6D7 COMMERCIAL GENERAL LIABILITY 4. Other Insurance (ii)That is insurance for "premises damage";If valid and collectible other insurance is available to (iii)If the loss arises out of thethe insured for a loss we cover under Coverages A maintenance or use of aircraft,or B of this Coverage Part, our obligations are "autos" or watercraft to the extentlimited as described in Paragraphs a.and b.below. not subject to any exclusion in thisAs used anywhere in this Coverage Part, other Coverage Part that applies toinsurance means insurance, or the funding of aircraft, "autos" or watercraft;losses, that is provided by, through or on behalf of: (iv)That is insurance available to a(i)Another insurance company;premises owner, manager or (ii)Us or any of our affiliated insurance companies,lessor that qualifies as an insured except when the Non cumulation of Each under Paragraph 4.of Section II – Occurrence Limit provision of Paragraph 5.of Who Is An Insured, except when Section III – Limits Of Insurance or the Non Paragraph d.below applies; or cumulation of Personal and Advertising Injury (v)That is insurance available to anLimit provision of Paragraph 4.of Section III –equipment lessor that qualifies asLimits of Insurance applies because the an insured under Paragraph 5.ofAmendment – Non Cumulation Of Each Section II – Who Is An Insured,Occurrence Limit Of Liability And Non except when Paragraph d.belowCumulation Of Personal And Advertising Injury applies.Limit endorsement is included in this policy; (b)Any of the other insurance, whether(iii)Any risk retention group; or primary, excess, contingent or on any (iv)Any self-insurance method or program, in other basis, that is available to the which case the insured will be deemed to be insured when the insured is an the provider of other insurance.additional insured, or is any other insured that does not qualify as aOther insurance does not include umbrella named insured, under such otherinsurance, or excess insurance, that was bought insurance.specifically to apply in excess of the Limits of (2)When this insurance is excess, we willInsurance shown in the Declarations of this have no duty under Coverages A or B toCoverage Part. defend the insured against any "suit" if anyAs used anywhere in this Coverage Part, other other insurer has a duty to defend theinsurer means a provider of other insurance. As insured against that "suit". If no otherused in Paragraph c.below, insurer means a insurer defends, we will undertake to do so,provider of insurance.but we will be entitled to the insured's rights against all those other insurers.a. Primary Insurance (3)When this insurance is excess over otherThis insurance is primary except when insurance, we will pay only our share of theParagraphb.below applies. If this insurance is amount of the loss, if any, that exceeds theprimary, our obligations are not affected unless sumof:any of the other insurance is also primary. (a)The total amount that all such otherThen, we will share with all that other insurance insurance would pay for the loss in theby the method described in Paragraph c.below, absence of this insurance; andexcept when Paragraph d.below applies. (b)The total of all deductible and self-b. Excess Insurance insured amounts under all that other (1)This insurance is excess over:insurance. (4)We will share the remaining loss, if any,(a)Any of the other insurance, whether with any other insurance that is notprimary, excess, contingent or on any described in this Excess Insuranceother basis: provision and was not bought specifically to(i)That is Fire, Extended Coverage,apply in excess of the Limits of InsuranceBuilder's Risk, Installation Risk or shown in the Declarations of this Coveragesimilar coverage for "your work";Part. CG T1 00 02 19 ú 2017 The Travelers Indemnity Company. All rights reserved.Page15 of21 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Albert A. Webb Associates Policy Number: P-630-8W805292-TIL-23 Policy Period: 09/01/2023 to 09/01/2024 DocuSign Envelope ID: DB05085B-0DA1-4C79-A91C-A4890ABCF6D7 COMMERCIAL GENERAL LIABILITY c. Method Of Sharing a.The statements in the Declarations are accurate and complete;If all of the other insurance permits contribution by equal shares, we will follow this method also.b.Those statements are based upon Under this approach each insurer contributes representations you made to us; and equal amounts until it has paid its applicable c.We have issued this policy in reliance uponlimit of insurance or none of the loss remains,your representations.whichever comes first.The unintentional omission of, or unintentional errorIf any of the other insurance does not permit in, any information provided by you which we reliedcontribution by equal shares, we will contribute upon in issuing this policy will not prejudice yourby limits. Under this method, each insurer's rights under this insurance. However, this provisionshare is based on the ratio of its applicable limit does not affect our right to collect additionalof insurance to the total applicable limits of premium or to exercise our rights of cancellation orinsurance of all insurers.nonrenewalin accordance with applicable insurance d. Primary And Non-Contributory Insurance If laws or regulations. Required By Written Contract 7. Separation Of Insureds If you specifically agree in a written contract or Except with respect to the Limits of Insurance, andagreement that the insurance afforded to an any rights or duties specifically assigned in thisinsured under this Coverage Part must apply on Coverage Part to the first Named Insured, thisa primary basis, or a primary and non-insurance applies:contributory basis, this insurance is primary to a.As if each Named Insured were the onlyother insurance that is available to such insured Named Insured; andwhich covers such insured as a named insured, b.Separately to each insured against whom claimand we will not share with that other insurance, is made or "suit" is brought.provided that: 8. Transfer Of Rights Of Recovery Against Others(1)The "bodily injury" or "property damage" for To Uswhich coverage is sought occurs; and If the insured has rights to recover all or part of any(2)The "personal and advertising injury" for payment we have made under this Coverage Part,which coverage is sought is caused by an those rights are transferred to us. The insured mustoffense that is committed;do nothing after loss to impair them. At our request,subsequent to the signing of that contract or the insured will bring "suit" or transfer those rightsagreement by you.to us and help us enforce them. 5. Premium Audit 9. When We Do Not Renew a.We will compute all premiums for this Coverage If we decide not to renew this Coverage Part, we willPart in accordance with our rules and rates.mail or deliver to the first Named Insured shown in b.Premium shown in this Coverage Part as the Declarations written notice of the nonrenewaladvance premium is a deposit premium only. At not less than 30 days before the expiration date.the close of each audit period we will compute If notice is mailed, proof of mailing will be sufficientthe earned premium for that period and send proof of notice.notice to the first Named Insured. The due date SECTION V – DEFINITIONSfor audit and retrospective premiums is the date shown as the due date on the bill. If the sum of 1."Advertisement" means a notice that is broadcast or the advance and audit premiums paid for the published to the general public or specific market policy period is greater than the earned segments about your goods, products or services premium, we will return the excess to the first for the purpose of attracting customers or Named Insured.supporters. For the purposes of this definition: c.The first Named Insured must keep records of a.Notices that are published include material the information we need for premium placed on the Internet or on similar electronic computation, and send us copies at such times means of communication; and as we may request.b.Regarding websites, only that part of a website 6. Representations that is about your goods, products or services for the purposes of attracting customers orBy accepting this policy, you agree: supporters is considered an advertisement. Page16 of21 ú 2017 The Travelers Indemnity Company. All rights reserved.CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: DB05085B-0DA1-4C79-A91C-A4890ABCF6D7 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED – PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 2.The following is added to Paragraph B.5.,Other Insurance of SECTION IV – BUSINESS AUTO1.The following is added to Paragraph A.1.c., Who CONDITIONS:Is An Insured, of SECTION Il – COVERED AUTOS LIABILITY COVERAGE:Regardless of the provisions of paragraph a. and This includes any person or organization who you paragraph d. of this part 5. Other Insurance, this are required under a written contract or insurance is primary to and non-contributory with agreement between you and that person or applicable other insurance under which an organization, that is signed by you before the additional insured person or organization is the "bodily injury" or "property damage" occurs and first named insured when the written contract or that is in effect during the policy period, to name agreement between you and that person or as an additional insured for Covered Autos organization, that is signed by you before the Liability Coverage, but only for damages to which "bodily injury" or "property damage" occurs and this insurance applies and only to the extent of that is in effect during the policy period, requiresthat person's or organization's liability for the this insurance to be primary and non-contributory.conduct of another "insured". CA T4 74 02 16 ú 2016 The Travelers Indemnity Company. All rights reserved.Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Albert A. Webb Associates Policy Number: BA-9T94622A-23-43-G Policy Term: 09/01/2023 to 09/01/2024 DocuSign Envelope ID: DB05085B-0DA1-4C79-A91C-A4890ABCF6D7