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2019/07/31 Double D Pipeline, Inc. Certficiate of Liability Insurance�1 coRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/31/2019 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. IMF'UKIAN I: It the certiticate 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). PRODUCER CONTACT Norma F;gueroa _ Alliant Insurance Services, Inc. PH°Ne . 619-849-3871 FAx CA License No. OC36861 Arc Ne:619-699-2163 701 B Street, 6th Floor ADDRlESS. NFigueroa@altiant.com San Dieao CA 92101 INSURED DOUBDPI-01 Double D Pipeline, Inc. 42166 Rio Nedo Temecula CA 92590 COVERAGES CERTIFICATE NUMRFR- 1997a9a9QR INSURERS AFFORDINGCOVERAGE NAIL$ INSURER A: Travelers Property Casualty Cc of Amer 25674 INSURER B: Travelers Indemnity Company of CT 25682 INSURER C : INSURER D INSURER E : INSURER F 0C1/ICIf1A1 A11111ADOD. 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 SU8R -- POLICY NUMBER POLICY EFF MM/DD P LICYEXP MWD LIMITS B X COMMERCIAL GENERAL LIABILITY Y CLAIMS -MADE U OCCUR DT22-CO-4322M140-TCT-19 7/31/2019 7/31/2020 EACH OCCURRENCE I$1,000.000 A M SE TO N ES S 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ I,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � jE LOC GENERAL AGGREGATE $ 2,000.000 PRODUCTS -COMP/OP AGG S 2,000;040 S OTHER; A AUTOMOBILE LIABILITY 810-2N736103-19-26-G 7/31/2019 7/31/2020 COMBIIItlE�DISINGLE LIMIT S1,000,000 X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident S 5 UMBRELLALIAB HCLAIMS OCCUR EACH OCCURRENCE $ AGGREGATE Is EXCESS LIAB DED RETENTION $ is A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE - OFFICER/MEMBEREXCLUDED? N/A UB-8K242035-19-26-G 7/11/2019 7/31/2020 X PER I EOTH- STATUTE I ER R E.L. EACH ACCIDENT $1,000,000 E,L, DISEASE - EA EMPLOYEE .S 9,QQ0,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT S 11OM-000 DESCRIPTION OF OPERATIONS below + I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Menifee is included as Additional Insured. CERTIFICATE HO City of Menifee 29714 Haun Road Menifee CA 92586 TION City clerk � 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 ;� I �--7 .�. . ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: DT22-CO-4322M140-TCT-19 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided underthe following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II - WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: - a. With respect to liability for "bodily injury" or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect; and b. If, and only to the extent that, such 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 or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III - Limits Of Insurance. (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve-,--- maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury" or "property damage" caused by "your work" and . included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against insured does not apply to: the additional insured: CG D2 46 0419 © 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit" as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. Page 2 of 2 © 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19