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2018/09/18 Superior Pavement Markings, Inc. Certificate of Liability InsuranceRv �� CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) 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(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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Patriot Risk & Insurance Services NAME 2415 Campus Drive, Suite #200 PHONE (949L4$6-7900 FAx NO); 949 486-T950 Irvine, CA 926121-rJMAH(Al www.patdsk.com OK07568 INSURED — -- Superior Pavement Markings, Inc. 5312 Cypress St. Cypress CA 90630 INSURER D : INSURER E : INSURER F : Insurance COVERAGES CERTIFICATE Nt]MRFR-- rnr.9nzna 0FVICIr11J IJIIMRFD• NAIC # 25011 16691 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 TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY E:(P LTR JNMPOLICY NUMBER LIMITS A COMMERCIAL GENERAL LIABILITY �/ `/ WPP158316101 9/18/2018 9/18/2019 EACH OCCURRENCE $1 000 000 CLAIMS -MADE F�IOCCUR DAMAGETORENTED PREMISES Ea oo $ 300 000 MED EXP (An one person) $ 5 000 PERSONAL & ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ✓� PRO- JECT LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $ 2 000 000 $ OTHER: A AUTOMOBILE LIABILITY WPP158316101 9/18/2018 9/18/2019 acl dens LLI $1 000 000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYOAMAeE Per aocid I $ B UMBRELLA LIAB ,/ OCCUR TUE 2191315 01 9/18/2018 9/18/2019 EACH OCCURRENCE $ 9 000 000 AGGREGATE $ 9 000 000 EXCESS LIAO CLAIMS -MADE DED I I RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N OFFICER/MEMBER EXCLUDED?ANYPROPRIETORIPARTNERIEXECUTIVE N /A �/ SUWC033321 6/1/2019 6/1/2020 ER E77— R E.L. EACH ACCIDENT $1 QQQ 000 E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yyes, descril o under E.L. DISEASE -POLICY LIMIT $1 000 000 DESCR PTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: Menifee, CA - On -Call Asphalt Striping Services, Project No: PW19.01 City of Menifee, Its officers, agents and employees are named as Additional Insured as respects to General Liability per endorsement attached where required by written contract. Waiver of Subrogation aFplies to General Liability and WC and In favor of the additional insured per attached endorsement. "30-day notice of cancelllation / 10-days for non-payment of premium. CERTIFICATE HOLDER CANCELLATION Clttyy 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 Dave Jacobson ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 50620306 1 18/19 GL/AU/UMB - 19/20 WC I Rachael Burnham 1 6/16/2019 11:03:20 AM (PDT) I Page 1 of 11 This certificate cancels and supersedes ALL previously issued certificates.