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2018/10/01 A.M. Ortega General Engineering Contractors, Inc. Certficiate of Liability InsuranceClient#: 1807054 303AMORT page 2 of 4 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/25/2018 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 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Marie GUerard BB&T-John Burnham Ins Services PHONE FAX (A/C, No, E,): 619 231-1010 1 (A/C, No): 6192369134 750 B Street Suite 2400 CJty of Menifee ADDRESS: San Diego, CA 92101 INSURER(S) AFFORDING COVERAGE NAIC # 619 231-1010 Clty Clerk INSURER A: Execullve Risk Indemnity Inc 35181 INSURED VCT 042018 A.M. Ortega General Engineering 1 INSURER B : Federal Insurance Company 20281 Contractors, Inc. ' INSURER C: INSURER D: 10125 Channel Road Received INSURER E : Lakeside, CA 92040 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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 ADD INSR SUBR W E POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMBS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 54303214 10/01 /2018 10/01 /2019 EACH OCCURRENCE_ $1 ,000,000 PREMISES Eaoccurrence $100,000 X MED EXP (Any one person) $5,000 PD Ded:5,000 PERSONAL 8 ADV INJURY S1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-]JECT LOC GENERAL AGGREGATE S2,0009000 PRODUCTS - COMP/OP AGG s2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 54303213 10/01 /2018 10/01 /2019 Ea aBcideD SINGLE LIMIT $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO WNED AUTOS ONLY SCHEDULED AUTOS HIRED ONLY x NON -OWNED AUTOS ONLY X BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ S UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N EXCLUDED? ❑ N/A 54303215 10/01/2018 10/01 /2019 X PER OTH STATUTE ER E.L. EACH ACCIDENT O $1OFFICER/MEMBER , 00,000 E.L. DISEASE - EA EMPLOYEE $1 ,000,000 (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1 ,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) Certificate is subject to policy limits, conditions and exclusions. This certificate only applies to the operations for which our Insured actually performs work and is referenced by written contract between the certificate holder and our Insured. Certificate holder is Named additional insured (GL) per the captioned operations of the Named Insured. CITY OF MENIFEE 29714 HAUN RD. Sun City, CA 92586 I-A1VI.CLLA I IUIV 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 ACORD 25 (2016/03) 1 of 1 1945 #S21052739/M21049117 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MGGUE page 3 of 4 Pojicy:54303214 COMMERCIAL GENERAL LIABILITY 10-02-2508 (Ed. 7-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY (CONTRACT ORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION II — WHO IS AN INSURED is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an 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. The person or organization does not qualify as an insured with respect to the independent acts or omissions of such person or organization. The insurance provided to the insured by this endorsement is limited as follows: a. 0 In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance', the insurance provided to the insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. The insurance provided to the insured does not apply to damages, loss, cost or expense arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) 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 (2) Supervisory, inspection, architectural or engineering activities. c. The insurance provided to the insured does not apply to "bodily injur}!' or "property damage" caused by `your work" and included in the "products -completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that insured, and then the insurance provided to the insured applies only to such "bodily injury" or "property damage" that occurs before: (1) The end of the period of time for which the "written contract requiring insurance" requires you to provide such coverage; or (2) The end of the policy period; whichever is earlier. The insurance provided to the insured by this endorsement is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the insured which covers that person or organization as a named insured for such loss, and we will not share with that other insurance. But the insurance provided to the insured by this endorsement still is excess over any other valid and collectible insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when that person or organization is an additional insured under such other insurance. 4. As a condition of coverage provided to the insured by this endorsement: a. The insured must give us written notice as soon as practicable of an "occurrence" or an 10-02-2508 (Ed. 7-15) Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 2 with its permission. W01111 page 4 of 4 offense which may result in a claim. To the extent possible, such notice should include: (1) How, when and where the ;'occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against the insured, the insured must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. The insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. The insured must 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. d. The insured must tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover the insured for a loss we cover under this endorsement. However, this condition does not affect whether the insurance provided to the insured by this endorsement is primary to other insurance available to the insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V — DEFINITIONS: "Written contract requiring insurance' means that part of any written contract or agreement under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury' and "property damage" occurs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., 10-02-2508 (Ed. 7-15) with its permission. 1947 AN M page i oT 4 09/27/2018 5400 H CITY OF MENIFEE 29714 HAUN RD. Sun City, CA 92586 1944