2018/02/13 Infrastructure Engineering Corporation Certficiate of Liability Insurance (4)ACCIORbr CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDNYYY)
1 9/19/2018
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 enclorsement(s).
PRODUCER
Cavignac & Associates
450 B Street, Suite 1800
San Diego CA 92101
CONTA T
NAME: Certificate Department
PHONE IFAX
WC. No, Ext), 619-744-0574 (AIC' No)! 619-234-8601
E-MAIL
ADDRESS: certificates@cavignae.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Travelers Property & Casualty Company of Anterica
25674
INSURED INFRENG-01
Infrastructure Engineering Corporation
14271 Danielson Street
INSURER B: Hartford Ins Cc of the Midwest
37478
INSURER C: XL Specialty Company
37885
INSURER D:
Poway, CA 92064
INSURER E:
INSURER F:
L,UVrKAk2=.3 1.1-H I 11-11-ATF N[IMFtFR- 91qr1;9A9P4 DC111Q1f'%k1 ki"
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.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUBRI
WVD
POLICY NUMBER
POLICY EFF
(MMIDDIYYYY)
POLICY EXP
(MMIDDNYYY)
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
F_V_1
CLAIMS -MADE OCCUR
Y
6807HO8841A
2/13/2018
2113/2019
EACH OCCURRENCE
$1,000,000
DAMAGE—Tb RENTED
PREMISES (Ea occurrence)
$1.000.000
X
MED EXP (Any one person)
$10.000
Contractual Liab
X
Separation of In
PERSONAL &ADV INJURY
$1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
PRO- F] LOC
POLICY JECT
I GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,G00
Deductible
$0
OTHER:
A
AUTOMOBILE
LIABILITY
BA0643M522
2/1312018
2/13/2019
MBINE' SINGLE LIMIT
(CEO, accident)
$1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
Ix
BODILY INJURY (Per accident)
$
x NON -OWNED
HIREDAUTOS AUTOS
PROPERTY DAMAGE
(Per accident)
$
$
UMBRELLA LIAB
HCLAIMS-MADE
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
DED I I RETENTION$
$
B
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTIVE -1
OFFICER/MEMBER EXCLUDED? r
NIA
72WEGRT6756
2/13/2018
2/13/2019
X IPER -FOTH-
STATUTE E
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEd
$ 1,000.000
(Mandatory In NH)
If yes, describe under
E.L. DISEASE - POLICY LIMIT 1
$ 1,000,DOO
DESCRI PTION OF OPERATIONS below
C
Professional Liability
DPR9921869
2113/2018
2/1312011
E ch Claim $2,000,000
Aggregate $2.000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Re: IEC Project No: 219.MENI.0001.01, Comprehensive Labor Compliance Services (CA State) for PMP 18-01 (FY18/19 Slurry Seal Program). 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.
City of Menifee
29714 Haun Road
Menifee CA 92586
I lurt
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
(0 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
Policy #6807HO8841A
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
(ARCHITECTS, ENGINEERS AND SURVEYORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1 The following is added to SECTION III - WHO IS
ANINSURED:
Any person or organization that you agree in a
,.written contract requiring insurance" to include as
an additional insured on this Coverage Part, but:
a. Only with respect to liability for "bodily injury",
'.property damage" or "personal injury"; and
b. If, and only to the extent that, the injury or
damage is caused by acts or omissions of
you or your subcontractor in the performance
of "your work" to which the "written contract
requiring insurance" applies, or in connection
with premises owned by or rented to you.
The person or organization does not qualify as an
additional insured:
c. With respect to the independent acts or omis-
sions of such person or organization; or
d. For "bodily injury", "property damage" or "per-
sonal injury" for which such person or organi-
zation has assumed liability in a contract or
agreement.
The insurance provided to such additional insured
is limited as follows:
e. This insurance does not apply on any basis to
any person or organization for which cover-
age as an additional insured specifically is
added by another endorsement to this Cover-
age Part.
f. This insurance does not apply to the render-
ing of or failure to render any "professional
services".
g. In the event that the Limits of Insurance of the
Coverage Part shown in the Declarations ex-
ceed the limits of liability required by the "writ-
ten contract requiring insurance", the insur-
ance provided to the additional insured shall
be limited to the limits of liability required by
that "written contract requiring insurance".
This endorsement does not increase the lim-
its of insurance described in Section III - Lim-
its Of Insurance.
h. This insurance does not apply to "bodily inju-
ry" or "property damage" caused by "your
work" and included in the "products -
completed operations hazard" unless the
"written contract requiring insurance" specifi-
cally requires you to provide such coverage
for that additional insured, and then the insur-
ance provided to the additional insured ap-
plies only to such "bodily injury" or "property
damage" that occurs before the end of the pe-
riod of time for which the "written contract re-
quiring insurance" requires you to provide
such coverage or the end of the policy period,
whichever is earlier.
2. The following is added to Paragraph 4.a. of SEC-
TION IV - COMMERCIAL GENERAL LIABILITY
CONDITIONS:
The insurance provided to the additional insured
is excess over any valid and collectible other in-
surance, whether primary, excess, contingent or
on any other basis, that is available to the addi-
tional insured for a loss we cover. However, if you
specifically agree in the "written contract requiring
insurance" that this insurance provided to the ad-
ditional 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 available to the additional insured
which covers that person or organizations as a
named insured for such loss, and we will not
share with the other insurance, provided that:
(1) The "bodily injury" or "property damage" for
which coverage is sought occurs; and
(2) The "personal injury" for which coverage is
sought arises out of an offense committed;
after you have signed that "written contract requir-
ing insurance". But this insurance provided to the
additional insured still is excess over valid and
collectible other insurance, whether primary, ex-
cess, contingent or on any other basis, that is
CG D3 81 09 15 @ 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 2
Includes the copyrighted material of Insurance Services Office, Inc., with its permission
Policy #6807HO8841A
COMMERCIAL GENERAL LIABILITY
available to the additional insured when that per-
son or organization is an additional insured under
any other insurance.
3. The following is added to Paragraph 8., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV - COMMERCIAL GENERAL LI-
ABILITY CONDITIONS:
We waive any right of recovery we may have
against any person or organization because of
payments we make for "bodily injury", "property
damage" or "personal injury" arising out of "your
work" performed by you, or on your behalf, done
under a "written contract requiring insurance" with
that person or organization. We waive this right
only where you have agreed to do so as part of
the "written contract requiring insurance" with
such person or organization signed by you be-
fore, and in effect when, the "bodily injury" or
.'property damage" occurs, or the "personal injury"
offense is committed.
4. The following definition is added to the DEFINI-
TIONS Section:
"Written contract requiring insurance" means that
part of any written contract under which you are
required to include a person or organization as an
additional insured on this Coverage Part, provid-
ed that the "bodily injury" and "property damage"
occurs and the "personal injury" is caused by an
offense committed:
a. After you have signed that written contract;
b. While that part of the written contract is in ef-
fect; and
c. Before the end of the policy period.
Page 2 of 2 @ 2015 The Travelers Indemnity Company. All rights reserved. CG D3 81 09 15
Includes the copyrighted material of Insurance Services Office, Inc., with its permission