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2019/02/14 Leighton Consulting, Inc. Certificate of Liability Insurance (4)
page 2 of 34 C llent#: 1257049 305LEIG HG RO ACORD,, CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 2/20/2019 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(les) 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 NAME: Lori MCNay BB&T Insurance Services PHONE FAX A/C. No, E,3:714 941-2815 n/c• No). of Orange County city of Menifee oAl�s: LMcNay�bbandt.com 2400 E Katella Ave Suite 1100 cityclerk Anaheim, CA 92806 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Lexlnatoninsurance company 19437 INSURED INSURER B : Travelers Indemmiry Co of CT 25682 Leighton Consulting Inc — -- - 17781 Cowan Ste. 100 INSURER C: Irvine, CA 92614-6009 Received INSURER D. INSURER E: 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. ^POLICY EFF POLICY EE (MM/OQIYYYy) •(MwowyY 02/14/2019 02/14/2020 LIMITS EACH OCCURRENCE $1 OOO,OOO - ".del CrurrenceJ_ $50,000 LTRR TYPE OF INSURANCE DD WWI LSR ryp POLICY NUMBER A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 065463440 MED EXP An oneperson) $EXCLUDED PERSONAL & ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PR POLICY a JECOT 1.;.__J LOC GENERAL AGGREGATE $2,000,000 PRODUCTS -COMP/OP AGG $2,000,000 OTHER: Overall Policy BA03051_81419CAG General Aggre acute 32/14/2019 02JI4/2020 $$5.000,000 aB D SINGLE LIMIT 1 000,000 B AUTOMOBILE LIABILITY BODILY INJURY (Per person) $ X ANY AUTO OWNED - SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ A X UMBRELLA LIAB ]( OCCUR 006546318 32/14/2019 02/14/202 C EACH OCCURRENCE $5 00 AGGREGATE 5 000 000 EXCESS LIAR CLAIMS -MADE DER I X RETENTION $10000 $ WORKERS COMPENSATION IPER OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEFVEXECUTIVE YEN OFFICER/MEMBER EXCLUDED? C N /A E.L. EACH ACCIDENT $ - (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ A Prof/Pollutn Liab 013001524 32/14/2019 02/14/202 $2,000,000 Per Claim Claims Made $4,000,000 Aggregate $50,000 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) Additional Insured applies on General Liability per Lexington's Additional Insured Owners, Lessees or Contractors endorsement LX4316 06114 and LX960510/01 attached to the General Liability policy as required by written contract. Primary wording applies to General Liability per Lexington's endorsement LX9838 08(05 attached to policy. Additional Insured and Primary wording applies on Automobile Liability per Travelers endorsement CAT474 (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION (LC)City of Menifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29714 Haun Road ACCORDANCE WITH THE POLICY PROVISIONS. Menifee, CA 92586 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1 Of 2 509 #S22976421/M22957204 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LXMCN page 3 of 34 DESCRIPTIONS (Continued from Page 1) 0215, Blanket Additional Insured -Primary and Non -Contributory with Other Insurance, attached to the Automobile policy as required by written contract. Re: Proj #11051.005 CIP19-01 Rustler's Ranch Resurfacing Project Phase II, NE Newport Rd & Bradley Rd, Menifee. Additional Insured to include per specifications: City of Menifee and Its officers, employees, agents, and authorized volunteers. SAG ITTA 25.3 (2016/03) 2 of 2 #S22976421/M22957204 510 page 4 of 34 ENDORSEMENT 02114/2019 This endorsement, effective 12:01 AM Forms a part of policy no.: 065463440 Issued to: Leighton Consulting Inc By.-LEXINGTON INSURANCE COMPANY CANCELLATION AMENDMENT In consideration of the premium charged, it is hereby agreed that the cancellation provision is amended to 90 days in lieu of (30) days, except for non-payment of premium which remains (10) days. Al other terms and conditions remain unchanged. Authorized Representative OR Countersignature (In states where applicable) LX9586 (02/031 511 a page 5 of 34 This page has been left blank intentionally. 512 page 6 of 34 ENDORSEMENT This endorsement, effective 12:01 AM 02/14/2019 Forms a part of policy no.: 065463440 Issued to: Leighton Consulting Inc By:LEXINGTON INSURANCE COMPANY PRIMARY/NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided by the policy: Notwithstanding any other provision of the policy to the contrary, the insurance afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only with respect to any claim, loss or liability arising out of the Named Insured's operations; and any insurance maintained by the Additional Insured shall be non-contributing. Al other terms and conditions of the policy remain the same. Authorized Representative OR Countersignature (In states where applicable) LX9838 (08/05) 513 N V - page 7 of 34 This page has been left blank intentionally. 514 r page 8 of 34 Leighton Consulting Inc BA0305 L81419CAG COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph A.1.c., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy'period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II. 2. The following is added to Paragraph B.5., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5.Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an addi- tional insured person or organization is the first named insured when the written contract or agreement between you and that person or or- ganization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy pe- riod, requires this insurance to be primary and non-contributory. CA T4 74 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 515 IN page 9 of 34 This page has been left blank intentionally. 516 r page 10 of 34 5 POLICYNUMBER: 065463440 ENDORSEMENT# COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 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 Person or Organization: AS REQUIRED BY WRITTEN CONTRACT (LC)City of Menifee 29714 Haun Road Menifee, CA 92586-0000 Re: Proj #11051.005 CIP19-01 Rustler's Ranch Resurfacing Project Phase II, NE Newport Rd & Bradley Rd, Menifee. Additional Insured to include per specifications: City of Menifee and its officers, employees, agents, and authorized volunteers. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II -Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily injury" or "property damage" occurring after: CG 20 10 10 01 ISO Properties, Inc., 2000 LX9605 (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 site 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 contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 1 of 1 517 page 11 of 34 ENDORSEMENT This endorsement, effective 12:01 AM 02/14/2019 Forms a part of policy no.: 065463440 Issued to: LEIGHTON GROUP, INC. By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED , OWNERS, LESSEES OR CONTRACTORS- COMPLETED OPERATIONS (Based on CG2037 04/13) This endorsement modifies insurance provided by the following: COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Additional Insured Person($) Location of Completed Operations or Organization(s) AS REQUIRED BY WRITTEN CONTRACT (LC)City of Menifee 29714 Haun Road Men'rfee, CA 92586-0000 Re: Proj #11051.005 CIP19-01 Rustler's Ranch Resurfacing Project Phase II, NE Newport Rd & Bradley Rd, Menifee Additional Insured to include per specifications: City of Menifee and its officers, employees, agents, and authorized volunteers. Information required to complete this Schedule, if not shown above, will be shown in the Declarations 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", 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". However: 1. The insurance afforded to such additional insured only applies to the e)dent permitted by law, and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. . With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: IL_A3MM4y__ i Includes opyng ted Intormationo image a Insurance Services To Offices, Inc., with its permission. All Rights Reserved. 518 page 12 of 34 1. Required by the contractor agreement or 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 All other terms and conditions of the policy remain the same. Authorized Representative Includes Copyrighted Inton-nation of the Insurance Services Page 2 of 2- I Offices, Inc., With its permission. All Rights Reserved. 519 page 13 of 34 Client#: 1257049 305LEIG HG RO DATE (MM/DD/YYYY) ACORD, CERTIFICATE OF LIABILITY INSURANCE 2/20/2019 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 pollcy(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: Lori MCNay BB&T Insurance Services Na E714' 941-2815 E Pam_ ---- - I IAIC Noj. of Orange County AnD IL LMcNay@bbandt.com 2400 E Katella Ave Suite 1100 INSURER(S) AFFORDING COVERAGE NAIC u Anaheim, CA 92606 Lexin ton lneurancaCompany 19437 INSURED Leighton Consulting Inc 17781 Cowan Ste. 100 Irvine, CA 92614-6009 INSURER A . 9 INSURER B : Travelere Indemnity Co of CT 25682 INSURER C. INSURER D: INSURER E : 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 TYPE OF INSURANCE POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS ---- IiNSIR LTR ADD INSR BR 'WVD POLICY NUMBER POLICY EKP (MNMD/YYYY POLION 013 �M_II__.PR YYYY A X -- COMMERCIAL GENERAL LIABILITY 065463440 02/14/2019 02/14/2020 EACH OCCURRENCE $1 000 000 CLAIMS-MADEFIX OCCUR EaEmnE5 Ea occur nc $50000 MED EXP(Any one person) $EXCLUDED PERSONAL & ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000 OOO l PRO - POLICY [X JECT X LOG PRODUCTS - COMP/OP AGG $2000000 $$5 000 000 OTHER: Overall Policy BA0305LB1419CAG general 32/14/2019 A re ate B AUTOMOBILE LIABILITY 02/14/202 °°W."ED.11INGLELIMrr 1 000 000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLYMAUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY JX PROPERTY DAMAGE „LPerae0* $ A X UMBRELLA LIAB �( OCCUR 006546318 D2/14/2019 02/14/202 EACH OCCURRENCE 5 000 OOO AGGREGATE $5 000 000 EXCESS LIAR CLAIMS -MADE DED_ X I RETENTION 10000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILR'Y ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? N/A PER OTH- E— E,L, EACH ACCIDENT $ ;Mandatory 1n NH) E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ $2,000,000 Per Claim If yes, describe under DESCRIPTION OF OPERATIONS below _ 013001524 D2114/2019 02114/202C A Prof/Pollutn Liab Claims Made $4,000,000 Aggregate $50.000 Dad DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required) Additional Insured applies on General Liability per Lexington's Additional Insured Owners, Lessees or Contractors endorsement LX4316 06114 and LX960510/01 attached to the General Liability policy as required by written contract. Primary wording applies to General Liability per Lexington's endorsement LX9838 08/05 attached to policy. Additional Insured and Primary wording applies on Automobile Liability per Travelers endorsement CAT474 (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE (LC)City(LC)Clty of Menifee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29714 Haun Road ACCORDANCE WITH THE POLICY PROVISIONS. Menifee, CA 92586 AUTHORIZED REPRESENTATIVE 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD 520 #S22976422/M22957204 LXMCN page 14 of 34 DESCRIPTIONS (Continued from Page f) 0215, Blanket Additional Insured -Primary and Non -Contributory with Other Insurance, attached to the Automobile policy as required by written contract. Re: Pro] #11051.003 Newport Road Rehabilitation from Bradley Road to Murrleta Road, PMP 16-01, Newport Rd, Menifee. Additional Insured to include per specifications: City of Menifee and its officers, employees, agents, and authorized volunteers. SAGITTA 25.3 (2016/03) 2 of 2 #S22976422/M22957204 521 page 15 of 34 ENDORSEMENT 02/14/2019 This endorsement, effective 12:01 AM Forms a pert of policy no.: 065463440 Issued to: Leighton Consulting Inc By:LEXINGTON INSURANCE COMPANY CANCELLATION AMENDMENT In consideration of the premium charged, it is hereby agreed that the cancellation provision is amended to 90 days in lieu of (30) days, except for non-payment of premium which remains (10) days. All other terms and conditions remain unchanged. Authorized Representative OR Countersignature (In states where applicable) LX9586 (02/031 522 M page 16 of 34 This page has been left blank intentionally. 523 page 17 of 34 ENDORSEMENT This endorsement, effective 12:01 AM 02/14/2019 Forms a part of policy no.: 065463440 Issued to: Leighton Consulting Inc By:LEXINGTON INSURANCE COMPANY PRIMARY/NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided by the policy: Notwithstanding any other provision of the policy to the contrary, the insurance afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only with respect to any claim, loss or liability arising out of the Named Insured's operations; and any insurance maintained by the Additional Insured shall be non-contributing. All other terms and conditions of the policy remain the same. Authorized Representative OR Countersignature (In states where applicable) LX9838 (08/05) 524 page 18 of 34 This page has been left blank intentionally. 525 page 19 of 34 Leighton Consulting Inc BA03051_91419CAG COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NONCONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph A.i.c., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or orginni7ation, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II. 2. The following is added to Paragraph B.5., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an addi- tional insured person or organization is the first named insured when the written contract or agreement between you and that person or or- ganization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy pe- riod, requires this insurance to be primary and non-contributory. CA T4 74 02 15 © 2016 The Travelers Indemnity Compzny. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 526 page 20 of 34 This page has been left blank intentionally, 527 page 21 of 34 POLICYNUMBER: 065463440 ENDORSEMENT# COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 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 Person or Organization: AS REQUIRED BY WRITTEN CONTRACT (LC)City of Menifee 29714 Haun Road Menifee, CA 92586-0000 Re: Proj #11051.003 Newport Road Rehabilitation from Bradley Road to Murrieta Road, PMP 16-01, Newport Rd, Menifee. Additional Insured to include per specif"lions: City of Nknifee and its officers, employees, agents, and authorized volunteers. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II -Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily injury" or "property damage" occurring after: CG 20 10 10 01 ISO Properties, Inc., 2000 LX9605 (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 site 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 contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 1 of 1 528 page 22 of 34 ENDORSEMENT This endorsement, effective 12:01 AM 02/14/2019 Forms a part of policy no.: 065463440 Issued to: LEIGHTON GROUP, INC. By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS- COMPLETED OPERATIONS (Based on CG2037 04/13) This endorsement modifies insurance provided by the following: COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Additional Insured Person(s) Location of Completed Operations or Organization(s) AS REQUIRED BY WRITTEN CONTRACT (LC)City of Menifee 29714 Haun Road Menifee, CA 92586-0000 Re: Proj #11051.003 Newport Road Rehabilitation from Bradley Road to Murdeta Road, PMP 16-01, Newport Rd, Menifee. Additional Insured to include per specifications: City of Menifee and its officers, employees, agents, and authorized volunteers. Information required to complete this Schedule, if not shown above, will be shown in the Declarations 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", 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". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law, and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. . With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: j TX4M (W14) Indude�opyngTit_e_d i nformation of the I nsurance Services Page Io Offices, Inc., with its perrnisslan. All Rights Reserved. 529 Mz' page 23 of 34 1. Required by the contractor agreement; or 2. Available under the applicable Limits of Insurance shover in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations All other terms and conditions of the policy remain the same. Authorized Representative Includes opyng rmaton ofthe Insurance Services i Page 2 of 2- I Ofioes, Inc., Wth its permission. All Rights Reserved. 530 101 page 24 of 34 Client#: 1257049 305LEIG HG RO ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/20/2019 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(les) 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). NTA PRODUCER NAME: Lori MCNay BB&T Insurance Services PHONE 1:AX w �C. No, Ext): 714 941-2815 M. Ng): of Orange County A• aAp LNtcNay®f�baftdt.cOm 2400 E Katella Ave Suite 1100 Anaheim, CA 92806 INSURER(S) AFFORDING COVERAGE NAIC # 19437 INSURED Leighton Consulting Inc 17781 Cowan Ste. 100 Irvine, CA 92614-6009 COVERAGES CERTIFICATE NUMBER: INSURERA: Lexington lneurance Company INSURER B: Travelers lndemnity Co of CT 25682 INSURER C : INSURER D: INSURER E : INSURER F: 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 ADO UBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE _ (per WD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 065463440 D2/14/2019 02114/202C EACH OCCURRENCE $1 000000_ CLAIMS -MADE FX1 OCCUR PREMI8ET0 R�Ncur enc $59,000 _ MEDEXP(Any one person) $EXCLUDED PERSONAL & ADV INJURY $1 000 000 GEN'L AGGREGGAAT�E LIMIT APPLIES PER: GENERAL AGGREGATE $2,t000,000 POLICY I!�I JECOT LOC PRODUCTS - COMP/OP AGG $2 000 000 OTHER: Overall Policy General Aggregate, $$5 000 000 B AUTOMOBILE LIABILITY BA03051_8141 9CAG D2/14/2019 02/14/202 COMBINED SINGLE LIMIT 1 000 OOO Ea acciden X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY Per accident) AUTOS ONLY AUTOS ( $ X HIRED X NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per acciden A X UMBRELLA LIAB X OCCUR 006546318 02/14/2019 02/141202a EACH OCCURRENCE s5.000.000 EXCESS LIAB CLAIMS -MADE AGGREGATE $5 000 000 DE'X RETENTION $10000 _ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN T ANY PROPRIEI TPARTNERIEXECUTNE E.L. EACH ACCIDENT $ OFFiCER+MEMBER EXCI,UDE07 L NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Prof/Pollutn Liab 013001524 32/14/2019 02/14/202 $2,000,000 Per Claim Claims Made $4,000,000 Aggregate $50.000 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) Additional Insured applies on General Liability per Lexington's Additional Insured Owners, Lessees or Contractors endorsement LX4316 06114 and LX960510/01 attached to the General Liability policy as required by written contract. Primary wording applies to General Liability per Lexington's endorsement LX9838 08/05 attached to policy. Additional Insured and Primary wording applies on Automobile Liability per Travelers endorsement CAT474 (See Attached Descriptions) L�l_1CLtlRSw-11ILola (LC)City of Menifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29714 Haun Road ACCORDANCE WITH THE POLICY PROVISIONS. Menifee, CA 92586 AUTHORIZED REPRESENTATIVE S�Ye"� xieY 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD 631 #S22976423/M22957204 LXMCN page 25 of 34 DESCRIPTIONS (Continued from Page 1) 0215, Blanket Additional Insured -Primary and Non -Contributory with Other Insurance, attached to the Automobile policy as required by written contract. Re: Pro] #11051.004 Newport Road Widening from Haun Road to Bradley Road, CIP 15-04, Newport Rd, Menifee. Additional Insured to include per specifications: City of Menifee and Its officers, employees, agents, and authorized volunteers. !��Ir� ;-.-__---�=��glnlnn�ll'� wv •c:��lll�!Wllu—..ter-..+.,, .,F w„�a.ga . �I�. SAG ITTA 25.3 (2016/03) 2 of 2 #S22976423/M22957204 532 page 26 of 34 ENDORSEMENT 02/14/2019 This endorsement, effective 12:01 AM Forms a part of policy no.: 065463440 Issued to: Leighton Consulting Inc By:LEXINGTON INSURANCE COMPANY CANCELLATION AMENDMENT In consideration of the premium charged, it is hereby agreed that the cancellation provision is amended to 90 days in lieu of (30) days, except for non-payment of premium which remains (10) days. All other terms and conditions remain unchanged. f ! J Authorized Representative OR Countersignature (In states where applicable) LX9586 (02/031 533 page 27 of 34 This page has been left blank intentionally, 534 M. page 28 of 34 ENDORSEMENT This endorsement, effective 12:01 AM 02/14/2019 Forms a part of policy no.: 065463440 Issued to: Leighton Consulting Inc ey:LEXINGTON INSURANCE COMPANY PRIMARY/NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided by the policy: Notwithstanding any other provision of the policy to the contrary, the insurance afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only with respect to any claim, loss or liability arising out of the Named Insured's operations; and any insurance maintained by the Additional Insured shall be non-contributing. All other terms and conditions of the policy remain the same. Authorized Representative OR Countersignature (In states where applicable) LX9838 (08105) 535 page 29 of 34 This page has been left blank intentionally. 536 page 30 of 34 Leighton Consulting Inc BA03051_81419CAG COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph A.1.c., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in SECTION II. 2. The following is added to Paragraph B.5., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an addi- tional insured person or organization is the first named insured when the written contract or agreement between you and that person or or- ganization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy pe- riod, requires this insurance to be primary and non-contributory. CA T4 74 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with Its permission, 537 page 31 of 34 This page has been left blank intentionally. 538 page 32 of 34 POLICYNUMBER: 065463440 ENDORSEMENT# COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 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 Person or Organization: AS REQUIRED BY WRITTEN CONTRACT (LC)City of Menifee 29714 Haun Road Menifee, CA 92586-0000 Re: Proj #11051.004 Newport Road Widening from Haun Road to Bradley Road, CIP 15-04, Newport Rd, Menifee. Additional Insured to include per specifications: City of Menifee and its officers, employees, agents, and authorized volunteers. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II -Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to 'bodily injury" or "property damage" occurring after: CG 20 10 10 01 ISO Properties, Inc., 2000 LX9605 (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 site 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 contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 1 of 1 539 page 33 of 34 ENDORSEMENT This endorsement, effective 12:01 AM 02/14/2019 Forms a part of policy no.: 065463440 Issued to: LEIGHTON GROUP, INC. By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS- COMPLETED OPERATIONS (Based on CG2037 04/13) This endorsement modifies insurance provided by the following: COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Additional Insured Person(s) Location of Completed Operations or Organization(s) AS REQUIRED BY WRITTEN CONTRACT (LC)City of Menifee 29714 Haun Road Menifee, CA 92586-0000 Re: Proj #11051.004 Newport Road Widening from Haun Road to Bradley Road, CIP 15-04, Newport Rd, Menifee. Additional Insured to include per specificatlons: City of Menifee and its officers, employees, agents, and authorized volunteers. Information required to complete this Schedule, if not shown above, will be shown in the Declarations 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", 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". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law, and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. . With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: W4yincludes Copyrighted Information of the Insurance Services image 1 of 2 Offices, Inc., with its permission. All Rights Reserved. 540 page 34 of 34 1. Required by the contract or agreement; or 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 All ether terms and conditions of the policy remain the same. Authorized Representative Includes opy g to n Rnatlon of the Insurance Services Page 2 o 1 1 Oifioes, Inc., with Its permission. All Rights Reserved. 541 MY page 1 of 34 02/22/2019 McGriff Insurance Services PO Box 819 Wilson NC 27894-0819 5400 H (LC)City of Menifee 29714 Haun Road Menifee, CA 92586 508