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2019/10/01 Hot Line Construction, Inc. Certificate of Liability Insurance (3)P52e002su02 CERTIFICATE OF LIABILITY INSURANCE I DATE 0/2DI19 AC GIII?"' 09/30/2019 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, u IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. 00 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 andorsement(s). N W PRODUCER CA LIC OB29370 1-925-244-7700 Edgewood Partners Insurance Centers (EPIC) [San Ramon - Branch ID 14394] P. 0. Box 5003 CONTACT Certificates Department PHONE FAX 925-244-7700 u.925-901-0671 E-MAIL D 8• EPICcerta@8picbrokerH,com INSURE S AFFORDING COVERAGE NAICtf INSURERA:NAVIGATORS SPECIALTY INS CO 36056 San Ramon, CA 94583 INSURERS:ZURICH ANER INS CO 16535 INSURED Hot Line Construction, Inc. INSURERC: ALLIED WORLD NATL ASSUR CO 10690 INSURER0: TRAVELERS PROP CAS CO OF AMER 25674 9020 Brentwood Blvd., Suite H INSURER E INSURERF: Brentwood, CA 94513 COVERAGES CERTIFICATE NUMBER: 57452176 RFVIRICIN NI[MAr-A. 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. INTBR POLICY EFF POLICY EXP RTYPE OF INSURANCE POUCYN ,LMBFR roM LIMITS A X COMMERCIAL GENERAL LIABILITY LA19CGLO19069IC 10/01/19 10/01/20 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE FX_] OCCUR PREMISES XtNTED , $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY � � LOC PRODUCTS - COMP/OPAGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY BAP582210506 10/01/19 10/01/20 W&IBINEOSI LELIMIT $ 2,000,000 BODILY INJURY (Per person) $ ANY AUTO IX OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED X NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY jpgi earclairb C UMBRELLALIAB X OCCUR 03120456 10/01/19 10/01/20 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 X EXCESS LIAB CLAIMS -MADE DIED I X I RETENTION 10,000 $ e WORKERS COMPENSATION WC598904916 10/01/19 10/01/20 g R OTH- SEAT TE ER AND EMPLOYERS' LIABILITY YIN E.L. EACH ACCIDENT $ 1,000,000 ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBEREXCLUDED7 ❑ NIA A E.L. DISEASE - EA EMPLOYE $ 1,000,000 (Mandatory In NH) Ifyan, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 D Installation Floater QT6601797N215TIL19 10/01/19 10/01/20 $5,000 Ded 1,000,000 A Excess Liability SP19EXC882030IC 10/01/19 10/01/20 $5,000,000 XS of 5,000,000 D Rented/Leased Equipment QT6601797N215TIL19 10/01/19 10/01/20 $2,500 Ded 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) ADDITIONAL INSURED: City of Menifee Ur I Ir IUA I t MULUCK UANULL.LA 1 WN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Menifee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 29714 Haun Rd. AUTHORIZED REPRESENTATIVE Menifee, CA 92586 �j_' !� I USA �s..- (f ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Steles -SRC 57452176 P5260028002 g b. 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 contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1.; or Page 2 of 2 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 CG 20 38 0413 P5260028002 POLICY NUMBER: LA19CGLO190691C COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. © Insurance Services Office, Inc., 2012 Page 1 of 1 0- w 0 N w P5260028002 Coverage Extension Endorsement 9 ZURICH Policy No. Eff. Date of Pal. Exp. Date of Pol. Eff. Date of End. Producer No. Add'I. Prem ^ Return Prem. BAP582210506 10/01/2019 10/01/2020 10/01/2019 — — THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section II - Covered Autos Liability Coverage: The following are also "insureds": a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any "employee" of yours is also an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement. d. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance - Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. B. Amendment - Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II - Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds, (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. U-CA-424-F CW (04-14) N V Vl W Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: WC598904916 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.4­84) w WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- w CALIFORNIA ° We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not N enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) > You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0.00 % of the California workers' compensation pre- mium otherwise due on such remuneration. Person or Organization ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION WC 252 (4-84) WC 04 03 06 (Ed. 4-84) Schedule Job Description ALL CA OPERATIONS Page 1 of 1