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2011/01/25 Becker Engineering Certificate of Liability InsuranceOP ID: JB � I"' CERTIFICATE OF LIABILITY INSURANCE DATE08/09D/YYYY) 8/09/11 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 endorsements . PRODUCER 805-495-4634 Associated Insurance Services, 805-494-0781 600 Hampshire Rd., #150 Westlake Village, CA 91361 Jennifer Kight CONTACT NAME: PHONE FAX A/C No Ext : fAIC,No): E-MAIL PRODUCER CUSTOMER ID #: BECKE-1 INSURERS AFFORDING COVERAGE NAIC # INSURED Becker Engineering Walt Becker P O Box 890365 INSURERA: Century Surety Company INSURER B : Hartford, The 22357 Temecula, CA 92589 INSURER C INSURER D : INSURER E : INSURER F : 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 ADD SUB POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X CCP682972 01/26/11 01/25/12 -PREMISES Ea occu ante S 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO LOC POLICY JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) S SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $ HIRED AUTOS $ NON -OWNED AUTOS S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ S RETENTION S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? N / A 57WECDE7880 07/01/11 11/01/11 WC STATU- OTH- X T LI I E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEEI S 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate holder is named as additional insured. 10 day notice of cancellation may apply for non-payment of premium. ctK I It-ICA I t NULUtK CANCELLATION City of Menifee Public Works Dept 29714 Haunt Rd Menifee, CA 92586 CITYMEN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE / a ! S ;; _y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUG 12 2011 AUTHORIZED REPRE! I Jennifer Kight P � ' t. ©1988-20 9 ACORD CO The ACORD name and logo are registered marks of ACORD Q1 TION. All ri0it reserved. ACORD 25 (2009109) CGL 1816 0106 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - PRIMARY AND NON-CONTRIBUTORY COVERAGE This endorsement modifies insurance provided under the following: CONTRACTORS LIMITED CLAIMS MADE GENERAL LIABILITY COVERAGE FORM CONTRACTORS LIMITED CLAIMS MADE AND REPORTED GENERAL LIABILITY COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Locations Of Covered Operations A. Section II — Who Is An Insured is amended to 2. That portion of "your work" out of which the include as an additional insured the person(s) or injury or damage arises has been put to its organization(s) shown in the Schedule, but only intended use by any person or organization with respect to liability for "bodily injury", "property other than another contractor or subcontractor damage" or "personal and advertising injury" engaged in performing operations for a caused, in whole or in part, by: principal as a part of the same project. 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 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 project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or C. It is agreed that the insurance provided for the benefit of the above additional insured(s) shall be primary and non-contributory, 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 behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. CGL 1816 0106 Includes copyrighted material of Insurance Services Office, Inc. with its Page 1 of 1 ❑ permission. © ISO Properties, Inc., 2004