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2017/08/16 Road Works, Inc. Certificate of Liability InsuranceACORa CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) �� 6,28/2018 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 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 endorsement(s). PRODUCER CONTACT And Manale NAME: Y Manale Insurance Services A NN (323) 581-4846 FAA/C No; (323)581-4844 817 W. Beverly Blvd. E-MAIL ADDRESS: certificates@manaleins.com Suite 107 INSURERS AFFORDING COVERAGE NAIC# Montebello CA 90640 INSURERA: Financial Pacific Insurance Co. 31453 INSURED INSURER B : Road Works, Inc. INSURER C : INSURER D : 303 Short St. INSURERE: Pomona CA 91768 INSURERF: COVERAGES CERTIFICATE NUMBER: RF=VISInM M MRF=►z- 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 ADDL INSD SUBR WVO POLICY NUMBER POLICY EFF MMIDD/YYYYI POLICY EXP (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 5 100,000 MED EXP (Any one person) S 5,000 60477177 8/16/2017 8/16/2018 PERSONAL & ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT FLOC GENERAL AGGREGATE S 21000,000 PRODUCTS - COMP/OPAGG S 2,000,000 Employee Benefits S OTHER: AUTOMOBILE LIABILITY CEOM�BIINdEeDtSINGLE LIMIT S 1,000,000 BODILY INJURY (Per person) S A ANY AUTO AOSCHEDULED AUTOS AUTOS 60477177 8/16/2017 8/16/2018 I BODILYINJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ Uninsured motorist BI CSL S 1,000,000 X UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE S 1,000,000 AGGREGATE S 2,000,000 A EXCESS LIAB 60477177 8/16/2017 8/16/2018 DED I I RETENTION S S WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N / A STATUTE ER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE S (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S A Business Personal Property 60477177 8/16/2017 8/16/2018 Limit - Buildings 1&2 $629,300 A Inland Marine 60477177 8/16/2017 8/16/2018 Limit - All Scheduled Items $69,400 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) 30 Day written notice of cancellation will be given for non-payment of premium. City of Menifee 29714 Haun Road Menifee, CA 92586 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 Manale/AMO ACORD 25 (2014/01) NS025 (201401) 91988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD FINANCIAL PACIFIC INSURANCE COMPANY 1308 PO BOX 73909, CEDAR RAPIDSr IA 52407 POLICY NUMBER: 60477177 ACCOUNT NUMBER:3000294813 (2) COMMERCIAL AUTO COMMERCIAL AUTO COVERAGE PART DIRECT BILL-- ISSUEDATE 08-03-2017 DMD REPLACEMENT OF1308 1308 60477177 DECLARATIONS RENEWAL EXTENSION NAMEDROAD WORKS INC AGENCY I£CODE 440379 T MANALE INSURANCE SERVICES E INSUREDINLAND EQUIPMENT MARINE LLC M AND 817 W BEVERLY BLVD STE 107 0 ADDRESS 303 SHORT ST e POMONA CA 91768-3301 MONTEBELLO CA 90640 POLICY 12:01 AM. Stardard time FROM: 0 8 —16 — 2 017 TO: 0 8 —16 — 2 018 PERIOD: And for successive olic eriods as stated below. We will provide the insurance described in this policy in return for the premium and compliance with all applicable policy provisions At we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period, subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will terminate after any statutorily required notices are mailed to you. An insufficient funds check is not considered payment. BUSINESS DESCRIPTION: CONTRACTOR FORM OF BUSINESS: _ Individual _ Joint Venture _ Partnership X Corporation _ Other ITEM TWO SCHEDULE OF COVERAGE AND COVERED AUTOS This policy provides only those coverage where a charge is shown in the PREMIUM column below. Each of these coverages will apply only to those "autos" shown as COVERED AUTOS below. COVERAGES COVERED AUTO SYMBOLS LIMIT OF INSURANCE PREMIUM COVERED AUTO LIABILITY 01 $1,000,000 4,288 UNINSURED MOTORISTS—BI ONLY07 $1,000,000 396 (INCLUDING UNDERINSURED MOTORISTS) COMPREHENSIVE 07 SEE SUPPLEMENTAL DECLARATIONS 927 COLLISION 07 SEE SUPPLEMENTAL DECLARATIONS 2,844 MISC. SCHEDULED COVERAGES SEE SUPPLEMENTAL DECLARATIONS 486 Premium Charge Forms Advance Premium Premium Charge Forms Advance SEE UW7002 Other Forms SEE U W 7 0 0 2 AMEND REASON: PREMIUM FOR THIS COVERAGE PART S 8,941 Endorsement Adjustment Premium $ This Declarations Page supersedes and replaces any preceding X declarations page bearing the same policy number for his policy COUNTERSIGNED BY AUTHORIZED REPRESENTATIVE period. CA 70 41 03 93 COMMERCIAL AUTO COVERAGE PART SCHEDULE OF COVERED AUTOS YOU OWN Coverage is provided where a premium and a I:.... ;+ „+ 1:-k;1;4,, - ahn—n fnr tha rrn/aranFt 1308 08-16-2017 IPOLICYNUMBER: 60477177 UNIT NO. YEAR MAKE MODEL VEHICLE ID NO. COST NEW N MILES) CLASS TERRITORY 001 1999 ISUZU TRUCK 4GTJ7C138XJ600648 175,000 0050 21189 04 103 COVERAGES: LIABILITY PIPIFPB APIPIAFPB MED. PAY. UM UIM COLLISION (5) TOWING CARGO LIMIT (1) (1) (1) COMP (3) 175,000SA 175,000SA 1,000 1,000 DEDUCTIBLE PREMIUM1,282 132 INC 441 1,395 LOSS TOTAL PAYEE GARAGING LOCATION PREMIUM POMONA CA 91768 3,250 UNIT NO. YEAR MAKE MODEL VEHICLE ID NO. COST NEW RADIUS CLASS (IN MILES) TERRITORY T SERIES TRC 1GDK7C1C12J506928 175,000 0050 31189 04 103 002 2002 GMC COVERAGES: LIABILITY PIPIFPB APIPIAFPB MED. PAY. UM UIM COLLISION (5) TOWING CARGO LIMIT (1) (1) (1) COMP (3) 175,000SA 175,000SA DEDUCTIBLE 1,000 1,000 132 INC 409 1,295 PREMIUM 1,503 LOSS TOTAL PAYEE GARAGING LOCATION PREMIUM POMONA CA 91768 3,339 UNIT NO. YEAR MAKE MODEL VEHICLE ID NO. COST NEW RADIUS CLASS (IN MILES) TERRITORY TOPKICK 1GDM7H1M1RJ502287 35,000 0050 31189 04 103 003 1994 GMC UIM COLLISION (5) TOWING CARGO COVERAGES: LIABILITY PIPIFPB APIP/AFPB MED. PAY. UM LIMIT (1) (1) COMP (3) (1) 1,000 1,000 DEDUCTIBLE 132 INC 77 154 PREMIUM LOSS 1,503 TOTAL PAYEE GARAGING LOCATION PREMIUM POMONA CA 91768 1,86E UNIT NO. YEAR MAKE MODEL VEHICLE ID NO. COST NEW (INN MILES) CLASS TERRITORY COVERAGES: LIABILITY PIPIFPB APIPIAFPB MED. PAY. UM UIM COLLISION (5) TOWING CARGO LIMIT DEDUCTIBLE PREMIUM LOSS TOTAL PAYEE GARAGING LOCATION PREMIUM (4) ACTUAL CASH VALUE OR COST OF REPAIR, WHICHEVER IS LESS MINUS S25 ABBREVIATIONS: FOOTNOTES: AFPB=ADDED FIRST PARTY BENEFITS DEDUCTIBLE FOR EACH COVERED AUTO FOR LOSS CAUSED BY MISCHIEF OR APIP=ADDED PERSONAL INJURY PROTECTION (A) GUEST PIP VANDALISM COMP --COMPREHENSIVE (B) PECESTRIAN PIP (5) ACTUAL CASH VALUE OR COST OF REPAIR, WHICHEVER IS LESS M114US THE FPB=FIRST PARTY BENEFITS (1) LIMIT STATED IN "ITEM TWO" ON DECLARATIONS PAGE DEDUCTIBLE SHOWN FOR EACH COVERED AUTO PIP=PERSONAL INJURY PROTECTION (2) LIMIT STATED IN EACH APPLICABLE ENDORSEMENT (S) F=FIRE; F&T=FIRE & THEFT; FTW=FIRE, THEFT & WIND. LSP=LIMITED SPECIFIED SA=STATED AMOUNT BASIS (3) ACTUAL CASH VALUE OR COST OF REPAIR, CAUSE OF LOSS SCL=SPECIFIED CAUSES OF LOSS WHICHEVER IS LESS MINUS DEDUCTIBLE SHOWN FOR (7) PER DISABLEMENT UIM=UNDERINSURED MOTORISTS EACH COVERED AUTO BUT NO DEDUCTIBLE APPLIES TO (g)THEFTINCLUDED UM=UNINSURED MOTORISTS LOSS CAUSED BY FIRE OR LIGHTNING (9) WAIVER OF COLLISION DEDUCTIBLE CA 70 39 02 15 oRo® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/29/2018 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 be endorsed. If SUBROGRATION 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 endorsement(s). PRODUCER Willis Towers Watson CONTACT NAME: Ontario 12980 Metcalf Ave Suite 500 PHONE (A/C, No Ext): (909) 284-7540 FAX (A/C, NO): (360) 828-0699 Overland Park KS 66213 EMAIL ADDRESS: Patty.Bdngas@bbsihq.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 INSURED INSURER B: Barrett Business Services, Inc. L/C/F INSURER C: ROAD WORKS, INC. INSURER D: 303 SHORT ST INSURER E: POMONA, CA 91768 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUES 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES (Ea occurence) $ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG $ POLICY PROJ- F LOC ECT S AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS e BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ UMBRELLA LIAB I JOCCUR EACH OCCURRENCE $ EXCESS LIAB rl OCCUR AGGREGATE $ S DED RETENTIONS A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N C64407120 12/01/17 12/01/2018 �/ WC STATU- TORY LIMITS OTH- ER ANY PROPRIETOR/PARTNER/ EXECUTIVE Y OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under N / A Covered States: CA E.L. EACH ACCIDENT $2,000,000 E.L. DISEASE - EA EMPLOYEE $2,000,000 E.L. DISEASE - POLICY LIMIT S2,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Menifee Y EXPIRATION DATA THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE POLICY PROVISIONS. WITH THE 29714 Haun Road AUTHORIZED REPRESENTATIVE Menifee CA 92586 Authorized //ll JJ Rep f#5 T� C) IU613-2U1U AGURU GORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD.