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2018/01/16 Valley Pipeline Services, Inc. Certificate of Liability Insurance (3)ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11 /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 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 City of Menifee ACT Cynthia Cadenhead NAME, Temecula Insurance Services City Clerk PHONE (951) 694-5200 FAX (951) 302-0470 , No Ext : A/C No): 41923 Second Street Suite 201 DEC 042018 E-MAIL c nthia temeculainsuranceservices.com ADDRESS: y INSURER(S) AFFORDING COVERAGE NAIC # Temecula CA 92590 INSURERA: Kinsale Insurance Company 14027 INSURED Valley Pipeline Services, Inc. Received INSURER B : California Automobile Ins Co 38342 INSURERC: State Compensation Ins. Fund 35076 47-110 Washington St. Ste. 201 INSURER D : Ohio Security Insurance Company 24082 INSURER E : La Quinta CA 92253 INSURER F : COVERAGES CERTIFICATE NUMBER: CL181501935 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 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 ADDLISUL3K INSD WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS -MADE ❑X OCCUR AMA PREMISES Ea occurrence 100000 $, MED EXP (Any one person) s Excluded PERSONAL & ADV INJURY s 1,000,000 A Y 01000492211 03/31/2018 03/31/2019 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE s 2,000,000 X POLICY PRO JECT LOC PRODUCTS-COMP/OPAGG S 2,000,000 Deductible $ 5,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS BA040000011155 12/05/2018 12/05/2019 BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Deductible S $1,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE s 2,000,000 AGGREGATE s 2,000,000 A EXCESS LIAB CLAIMS -MADE 01000492921 03/31/2018 03/31/2019 DIED I I RETENTION S Deductible s 0 WORKERS COMPENSATION X Deductible: N/A AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT S 1,000,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE F N/A 9086042 01/16/2018 01/16/2019 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE- EA EMPLOYEE S 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISFASE - POLICY LIMIT 1,000,000 S Scheduled Limit $811,353 Contractors EquipmenUBPP D Deductible $1,000 BKS56619091 03/31/2018 03/31/2019 Rent/Leased Equipment $300,000 BPP Limit $27,317 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: North Canyon Drive Drainage Improvements CIP 17-06. City of Menifee and it's elected officials, officers, employees, agents, representatives, consultants, contract employees and volunteers are hereby added as additional insures but only as respects work done by, for, or on behalf of the named insured. The Umbrella Liability follows the General Liability and Auto Liability. I.tK I Ir'lL AI t_ NULUt_K L:ANGtLLAI 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