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2019/01/24 VP Concrete Inc. DBA: Valley Pacific Concrete Certificate of Liability InsuranceVALLPAC-01 EIGOYD ,d►�oRO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 03/22/2019 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. 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 lie_ u of such endorsement(s). PRODUCER License # OC36861 AcT Beverly Goyen Inland Empire-Alliant Insurance Services, Inc. PHONE 909 886-986- rAX 735 Carnegie Dr Ste 200 (. �.A99 {AfC, Ne):(91D 886-2013 San Bernardino, CA 92408 R' sg; hgoyen@alliant.com INSURER AFFORDING COVERAGE _ NAIC # ..I INSURER A:United _ SpecialtXlnsuranceCompany. 12537 INSURED INSURER B : National Union Fire insurance Company of Pittsburgh, Pa 19445 VP Concrete Inc. DBA: Valley Pacific Concrete INSURERC:_Insurance Company of the West _ 27847 27580 Tabb Lane INSURER 0: Menifee, CA 92584 - llilil7kER tN SURER 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 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 I ADDL sum, POLICY EFF POLICY EXP t I TYPE OF INSURANCE LIMITS POLICY NUMBER (MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ 1,000,000 1 CLAIMS -MADE Ll OCCUR X ATN-SF1953538 01/24/2019 01/24/2020 DAMAGE TORcNuT,uED $ 50,000 LAGGREGA_ LIMIT APPLIES PER: POLICY I.i� I JEC l LOC AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS j AUTOS ONLY _ AU OS ONLY B UMBRELLA LIAB X OCCUR X EXCESS LIAB _ CLAIMS -MADE DED I I RETENTION $ 0 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NI ANY PROPRIETOR/PARTNER/EXECUTIVE I Y 1 N / OFFICER/MEMBER EXCLUDED? (Mandatory in NH) IF yes, describe under MED EXP (Any one person) City of Menifee. PERSONAL &ADV INJURY city clerk GENERAL AGGREGATE_ 9 JEBLAGGREGATE COMBINED SINGLE LIMIT (Ee_7CCJd@(1� Received BODILY INJURY (Per; PROPERTY DAMAGE (Per accident) EACH OCCURRENCE 8286257 01/24/2019 01/24/2020 1 AGGREGATE PER Ol X STATUTE WSD 5033275 03 04/01/2019 04/01/2020 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPL( DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 161 Additional Remarks Schedule, maybe attached If mart apace is required) The City of Menifee, Its officers, officials, employees, anld volunteers are additional insureds as respects to general liability per endorsements attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Menifee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29714 Haun Road ACCORDANCE WITH THE POLICY PROVISIONS. Menifee, CA 92586 AUTHORIZED REPRESENTATIVE c SLAI, ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: ATN-SF1953538 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Or anization s : As required by written contract, fully executed prior to the named insured's work SCHEDULE Location And Description Of Completed Opera- tions As required by written contract, fully executed prior to the named insured's work Information required to complete this Schedule, if not shown above. will be shown in the nPriaratinnc Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ POLICY NUMBER: ATN-SF1953538 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Omanizatiank): As required by written contract, fully executed prior to the named insured's work Information required to complete this Schedule, if not shown A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by, 1. Your acts or omissions; or 2. The acts or omissions of those acting on your be- half', in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above - Of Covered Operations As required by written contract, fully executed to the named insured's work will be shown in the Declarations. B. With respect to the insurance afforded to these addi- tional insureds, the following additional exclusions ap- ply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the pro- ject (other than service, maintenance or repairs) to be performed by or on behalf of the additional in- sureds) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another con- tractor or subcontractor engaged in performing op- erations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0