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2017/01/01 STC Traffic, Inc. Certificate of Liability Insurance�Q0 CERTIFICATE OF LIABILITY INSURANCE D6�27�20�) 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 Jacqueline Byrne NAME:Matsen Insurance Brokers, Inc. 3101 Concorde Drive, Suite B 1APHON o Ext: (707) 444-9292 AIC No: (707)444-9529 E-MAIL ADDRESS:ackie@matsen.com INSURERS AFFORDING COVERAGE NAIC # McRinleyville CA 95519 INSURER A Atain SpecialtV Ins. INSURED INSURER B:Nationwide Mutual 23787 INSURER C:Evans ton Insurance Co. STC Traffic, Inc. 5865 Avenida Encinas, Suite 142-B INSURERD:Hartford Insurance Company of the 137478 INSURER E :Llo ds of London Carlsbad CA 92008 1INSURERF: COVERAGES CERTIFICATE NUMBER:CL16123007335 REVISION NUMRFR- 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 SUBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR EACH OCCURRENCE S 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence S 100,000 MED EXP (Any one person) S 5,000 X Y CIP305391 1/1/2017 1/1/2018 PERSONAL & ADV INJURY S 2,000,000 GEN'L POTHER: AGGREGATE LIMIT APPLIES PER: POLICY ELOC GENERAL AGGREGATE S 4,000,000 PRODUCTS SJCT 2,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ACPBA3096931702 1/1/2017 1/1/2018 BODILY INJURY (Per accident) S NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident S SRCH2 S X UMBRELLA LIAB OCCUR EACH OCCURRENCE S 6 000,000 AGGREGATE S 6,000,000 C EXCESS LIAB CLAIMS -MADE DED I RETENTIONS S XOBW6909117 1/1/2017 1/1/2018 1 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA A 57WECGI9278 1/1/2017 1/1/2018 PER OTH- STATUTE ER EA E.L. EACH ACCIDENT S 1,000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT I $ 1,000,000 E Professional Liability 491817 1/1/2017 1/1/2018 Aggregate Limit $3,000,000 Claims made basis Per a Claim $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Menifee and its officers, employees, agents, and authorized volunteers are included as additional insureds on the Genersal Liability policy per attached form attached form AF 000 859. General Liability coverage is primary and noncontributory per the attached form attached form AF 000 859. Waiver of subrogation applies to the General Liability policy per the attached form attached form CG 24 04 05 09. Waiver of subrogation applies to the workers compensation policy per the Extended Broad Form WC990303 attached to this policy. 30 days, advance written notice, 10 days for non-payment of premium, prior to cancellation or material change in policy covers e(s). I.CK I Iris -A I r- 11ULUtK GANIaLLA I IUN City of Menifee 29714 Haun Road Menifee, CA 92586 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 lenn Matsen/EXM ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) INS025 (201401) The ACORD name and logo are registered marks of ACORD 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 FORM SCHEDULE Name of Additional Insured Person(s) Or Organization(s): Location(s) of Covered Operations NY PERSON OR ORGANIZATION AS LOCATION AS REQUIRED BY WRITTEN REQUIRED BY WRITTEN CONTRACT WITH THE CONTRACT NSURED 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 for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such a person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. A personb or organizations status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: Additional Insured Contractual Liability " Bodily injury" or "property damage" for which the "additional insured(s)" are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations or Work " 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 (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. Negligence of Additional Insured "Bodily injury" or "property damage" directly caused by or resulting from the negligence of the "additional insured(s)". ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED This endorsement is effective on the inception date of the policy unless otherwise stated below. (The information below is required only when this endorsement is issued subsequent to preparation of the policy). Policy Number: CIP305391 Named Insured: STC TRAFFIC, INC. Endorsement Effective date: AF 000 859 Included copyrighted material of ISO Properties, INC. Page 1 of 07/ 2012 with its perm fission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 57 WEC G19278 Endorsement Number: Effective Date: 01 / 01 / 17 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: STC TRAFFIC, INC. 2794 LOKER AVE W STE 102 CARLSBAD, CA 92010 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not 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 premium otherwise due on such remuneration. Person or Organization ANY PERSON OR ORGANIZATION FROM WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER OF RIGHTS FROM US. SCHEDULE Countersigned by Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 11 / 12 / 16 2 % of the California workers' compensation Job Description AS REQUIRED BY WRITTEN CONTRACT. Authorized Representative Policy Expiration Date: 01/01/18 POLICY NUMBER: CI P305391 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION WITH WHOM THE INSURED HAS AGREED TO WAIVE RIGHTS OF RECOVERY, PROVIDED SUCH AGREEMENT IS MADE IN WRITING AND PRIOR TO THE LOSS The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 Insurance Services Office, Inc., 2008 Page 1 of 1