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2018/01/01 STC Traffic, Inc. Certificate of Liability Insurance (7).4CaR& CERTIFICATE OF LIABILITY INSURANCE DATE(YYYY) 03/15/205/2018 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 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 rights to the certificate holder in lieu of such endorsemenl(s). PRODUCER CONTACT NAME' Jacqueline Byrne Matsen Insurance Brokers, Inc. PHONE 1G No Eat : (707)444-9292 ArX. Not; (707)444-9529 3101 Concorde Drive, Suite B [:.MAIL ADDRESS: jackie@matsen.com INSURER(S � AFFORDING COVERAGE NAIC # McKinleyville CA 95519 INSURER A: Atain Specialty Ins. INSURED INSURER B: Nationwide Mutual 23787 STC Traffic, Inc. INSURERC: Evanston Insurance Co. 5865 Avenida Encinas, Suite 142-B INSURER D : Hartford Insurance Company of the Midwest 37478 INSURER E: Lloyds of London Carlsbad CA 92008 INSURER F: COVERAGES CFRTIFICATF NIIMRFR• CL181907671 DI7511QIf%hI \u uaDDD. 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 NSD WVD POLICY NUMBER POLIC MMIDD.rYYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ 2.000,000 PREMISES Eanccurrence S 100,000 MED EXP (Any oneperson) S 5,000 PERSONAL BADVINJURY S 2,000,000 A Y CIP329651 01/01/2018 01/01/2019 GEN'L AGGREGATE LIMIT APPLIES PER: JG POLICY [- LOC GENERALAGGREGATE $ 4,000,000 PRODUCTS - 2,000,000JECT S $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acclden $ 1,000,000 ANY AUTO BODILY INJURY(Per person) S BOWNED I SCHEDULED AUTOS ONLY AUTOS ACPBA3006931702 01/01/2018 01/01/2019 BODILY INJURY Per accident ( ) S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY - PROPERTY DAMAGE Per acciden $ Surcharges $ x UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE s 6,000,000 C EXCESS LIAB XOBV 7454118 01/01/2018 01/01/2019 AGGREGATE S 6.000,000 DED RETENTION $ PER O7H- $ WORKERS COMPENSATION D AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA 57WECGI9278 01/01/2018 01/01/2019 X STATU7E ER E L. EACH ACCIDENT S 1,000,000 EL. DISEASE- EA EMPLOYEE S 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below I EL DISEASE -POLICY LIMIT $ 1,000,000 E Professional Liability - Claims Made Basis 501730 01/01/2018 01/01/2019 Aggregate Limit $3,000,000 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 General Liability policy per attached form AF000859. General Liability coverage is primary and noncontributory per the attached form AF0013970712. Waiver of subrogation applies to the General Liability policy per the attached form CG24040509. 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 coverage(s). Project #SSARPL-5483 (006): City of Menifee SSARP .I.AIVL tLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Menifee ACCORDANCE WITH THE POLICY PROVISIONS. 29714 Haun Road AUTHORIZED REPRESENTATIVE Menifee CA 92586 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 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 ORORGANIZATION 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 ANY PERSON OR ORGANIZATION AS LOCATION AS REQUIRED BY WRITTEN REQUIRED BY WRITTEN CONTRACT WITH THE CONTRACT INSURED 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 persons 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" forwhich 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) atthe 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: CIP329651 Named Insured: STC TRAFFIC, INC Endorsement Effective date: AF 000 859 Included copyrighted material of ISO Properties, INC. Page 1 of 1 0712012 with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 57 WEC GI9278 Endorsement Number: Effective Date: 01/01/18 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: STC TRAFFIC, INC. 5865 AVENIDA ENCINAS STE 142 B CARLSBAD, CA 92008 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 2 % of the California workers' compensation Job Description AS REQUIRED BY WRITTEN CONTRACT. Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 11 / 11 / 17 Policy Expiration Date: 01 / 01 / 19 Policy Number: ACPBA3006931702 CA 20 48 (02-99) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name of Person(s) or Organization(s): City of Menifee 29714 Haun Road Menifee CA 92586 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. Copyright, Insurance Services Office, Inc., 1998 CA 20 48 (02-99) POLICY NUMBER: CI P329651 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 City of Menifee 29714 Haun Road Menifee CA 92586 Information required to complete this Schedule if notshown above will be shown inthe Declarations 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 0509 Insurance Services Office, Inc., 2008 Page 1 of 1