2019/02/13 Infrastructure Engineering Corporation Certficiate of Liability InsuranceV DATE (MMIDDIYY
CERTIFICATE OF LIABILITY INSURANCE
1 2/14/2019 yyl
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(ios) 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).
PRODUCER CONTACT
NAME: Certificate Department
Cavignac & Associates PHONE FAX
450 B Street, Suite 1800 IAJC� No, EII 619-744-0574 tIiii , Nor. 6 19-234-8601
E-MAIL fi
San Diego CA 92101 ADDRESS: Certl $CateS@r-aVi-CLnaC.COM
INSURED INFIRENG-W
Infrastructure Engineering Corporation
14271 Danielson Street
Poway. CA 92064
INSU RIER"S AFFORDING COVERAGE
INSURER A '. Travelers Property Casualty Company of America
INSURER B: Hartford Ins Co of the Midwest
INSURER C: XL Spe
Sialty Company
INSURER D:
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER: 1059150678 REVISION NUMBER:
NAIC#
25674
37478
37885
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 AFrORDED 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
INSR ADOL SUBR_ POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE III INVID POLICY NUMBER IMMJDD/YYYYl iMM10Di
LIMITS
A X COMMERCIAL GENERAL LIABILITY y 6BO7HO8841A 21130019 2)1312020
EACH OCCURRENCE $ 1.1300.000
X
CLAIMS -MADE OCCUR
PREMISES(E occurremce�_ $1 , 000 , 000
X Contractua� Lab
MED EXP (Anyone persoi $10,000
X Seperationofln
PERSONAL& ADV INJURY $1 , 000 , 000
GEN'L AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE $2.000.000
PRO-
j POLICY I i JECT L J LOC
PRODUCTS -_COMFI/OP AGG $2.000,000
OTHER
Deductible S D
A AUTOMOBILE LIABILITY BA06213M522 V1312019 211312020
COMBINED SINGLE LIMIT $
(Ea adCdeni _ _ , I
X ANY AUTO
BODIL Y INJUR Y (Per person) S
ALL OwNED SCHEDULED
DODILY INJURY (Per accident): S
AUTOS AUTOS I
X X NON-OwNED
PRCFP_E_RtYDXMAGE_ _$
HIRED AUTOS -ALITOS
�Per accidi
I
Is
UMBRELLA LIAB OCCUR
EACH OCCURRENCE $
EXCESS LIAB LC,,MS-MADEI
AGGREGATE $
DED RETENTION$
$
B WORKERS COMPENSATION 72WEGRT6756 2113t2019 2113/2020
i I
x PER I OTH-
i
AND EMPLOYERTLIABILITY YIN.
STATUTE ER
ANY PROPMETORIPARTNER(EXECUTIVE
E L EACH ACCIDENT S 1,000 000
OFFICERIMEMBER EXCLJDED9 Nii
D
(Mandi in NH)
E L DISEASE - EA EMPLOYEE. $1 000000
Ifrsunder
56deswbe
D RIPTION OF OPERATIONS below
E L DISEASE - POLICY LIMIT S 1,0DO OW
C Professional Liability OPR9938352 211312019 21130020
�acri Claim $2000.000
Aggregate S2000.000
DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES ACORD 101, Additional Remarks Schedule, may be attached it mom space is required)
Re: IEC PrGjecI No� 219.MENI.0002 01, Comprehensive Labor Compliance Services (CA State) for CIP 19-01 (Rustler's Ranch, Phase 11) Project. Additional
Insured coverage applies to General Liability for City of Menifee and its officers employees, agents. and authorized volunteers per policy form. Primary and
Non -Contributory coverage applies to General Liability per policy form. Professional Liability - Claims made form, defense costs included within limit.
rFPTIFIrATF Him nFP r.A?JrFl I ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Menifee
29714 Haun Road
AUTHORIZED REPRESENTATIVE
Menifee CA 92586
@ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
GENERAL PURPOSE ENDORSEMENT POLICY NUMBER. 6807HO8841 A
OFFICE PAC ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CGD425 (07-08) - OTHER INSURANCE ADDITIONAL INSUREDS PRIMARY AND NONCONTRIBUTORY
WITH RESPECT TO CERTAIN OTHER INSURANCE
This endorsement modifies insurance provided under the following:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
OTHER INSURANCE - ADDITIONAL INSUREDS - PRIMARY AND NON-CONTRIBUTORY WITH
RESPECT TO CERTAIN OTHER INSURANCE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following is added to Paragraph 4. a-, Primary Insurance, of
SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS:
However, if you specifically agree in a written contract or agreement
that the insurance afforded to an additional insured under this Coverage
Part must apply on a primary basis, or a primary and non-contributory
basis, this insurance is primary to other insurance that is available to
such additional insured which covers such additional insured as a named
insured, and we will not share with that other insurance, provided that:
(1) The "bodily injury" or "property damage" for which coverage is
sought is caused by an "occurrence" that takes place; and
(2) The "personal injury" or "advertising injury"for which coverage
is sought arises out of an offense that is committed;subsequent to the
signing and execution of that contract or agreement by you.
CG D4 25 07 08
2008 The Travelers Companies, Inc.
CG T8 01 12 18 Page 1 of 1
GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: 68071108841A
OFFICE PAC ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG2404 (10-93) - WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
Any person or organization that you have agreed in a written contract or
agreement to waive your right of recovery against, but only for payments
we make because of:
I -"Bodily injury" or "property damage" that occurs: or
2."Personal injury" or "advertising injury" caused by an offense
committed: after you have executed that contract or agreement.
(If no entry appears above, information required to complete this
endorsement will be shown in the Declarations as applicable to this
endorsement.)
The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition
(Section IV -COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the
addition of the following:
We waive any right of recovery we may have against the person or
organization shown in the Schedule above because of payments we make for
injury or damage arising out of your ongoing operations or "your work"
done under a contract with that person or organization and included in
the "prod ucts-com pleted operations hazards." This waiver applies only to
the person or organization shown in the Schedule above.
CG 24 04 10 93
CG T8 02 12 18 Page I of 2
GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: 68071108841A
OFFICE PAC ISSUE DATE:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG2404 (10-93) - WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
Copyright, Insurance Services Office, Inc., 1992
Page 1 of 1
CG TS 02 12 18 Page 2 of 2
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GENERAL PURPOSE ENDORSEMENT POLICYNUMBER-. 6807HO8841A
OFFICE PAC
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG2037 (07-04) - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
Copyright ISO Properties, Inc, 2004
CG T8 04 12 18 Page 2 of 2
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