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2019/01/05 TKE Engineering, Inc. Certicate of Liability Insurance TKEENGI-01 TSCHELLING DATE MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE ( 12/27/2018 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 License#OC36861 g�NTACT SD PC SBS Inland Empire-Alliant Insurance Services,Inc. PHONE FAX 735 Carnegie Dr Ste 200 (A1C,No,Ex! AIC,No): San Bernardino, CA 92408 City Of Mennee iE8S. City Clerk INSURER(SI AFMROING COVERAGE NAIC# _ INSURER A.,Travelers Property Casual Com an of America 25674 INSURED UA 2019 INSURER B:California Automobile Insurance Coml3any 38342 TKE Engineering Inc INSURER C: 2305 Chicago Ave Ste#100 INSURER D: Riverside,CA 92507-6948 Received INSURER E: _ 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 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 INSURANCE AODL.Lis INSD SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 2,000,000 CLAIMS-MADE LA OCCUR X X 6806H138419 01/05/2019 01/05/2020 DAMAGETgRENTEDncal S 1,000,000 ME EXP(Any one parsoni 1 5,000 PERSONAL&ADV INJURK A 2,000.000 GENT AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE S 4,000,000 POLICY J C LOC PRODUCTS-COMPfOPAGG S 4,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 ANY AUTO BA040000048572 09/18/2018 09/18/2019 BODILY INJURY PerPayson) $ OWNED 1xx SCHEDULED AUTOS ONLY AUTOS BODILY INJURY PeraccoantX AITOS ONLY AUUTOS ONLY P OP AMAGE $ re $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE JI EXCESS LIAR CLAIMS-MADE AGGREGATE DED I RETENTION$ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY PER ❑TH- TY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN X IUB-9J213184-19-47-G 01/05/2019 01/05/2020 1,000,000 OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT 3 (Mandatory in NH) E.L DISFAS8-EA EMPLOYE 1,000,000 if yes.describe under DESCRIPTI N OF OPERATIONS below E.L DISEASE-POLICY-UMR 1,000,000 I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Project: On Call Services (INSPECTION SERVICES) City of Menifee and its officers,officials,employees,and volunteers are additional instireds,waiver of subrogation applies as respects the general liability per endorsement attached;waiver of subrogation applies as respects to workers compensation per endorsement attached.Replaces and cancels previous cent issued. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Menifee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Steven Glynn,Public Works Manager 29714 Haun Road Menifee,CA 92586 AUTHORIZED REPRESENTATIVE ki'It�1�IL�w�1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AIM TR WORKERS COMPENSATION A>���rps I 1 N E J AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 03 76( A)— 001 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 03.00 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 01/05/2018 Policy No, 9,1213184 Endorsement No. Insured TKE Engineering Inc. Premium Insurance Company Travelers Property Casualty Co of America DATE OF ISSUE: ST ASSIGN: Page 1 of 1 POLICY NUMBER: 68061-1138418 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II —WHO IS h. This insurance does not apply to "bodily AN INSURED: injury" or"property damage" caused by "your Any person or organization that you agree in a work" and included in the "products- "written contract requiring insurance"to include as completed operations hazard" unless the an additional insured on this Coverage Part, but: "written contract requiring insurance" a. Only with respect specifically requires you to provide such to liability for"bodily injury", coverage for that additional insured, and then property damage" or personal injury"; the insurance provided to the additional b. If, and only to the extent that, the injury or insured applies only to such "bodily injury" or damage is caused by acts or omissions of "property damage"that occurs before the end you or your subcontractor in the performance of the period of time for which the "written of "your work" to which the "written contract contract requiring insurance" requires you to requiring insurance" applies, or in connection provide such coverage or the end of the with premises owned by or rented to you. policy period,whichever is earlier. The person or organization does not qualify as an 2. The following is added to Paragraph 4.a. of additional insured: SECTION IV — COMMERCIAL GENERAL c. With respect to the independent acts or LIABILITY CONDITIONS: omissions of such person or organization; or The insurance provided to the additional insured d. For "bodily injury", "property damage" or is excess over any valid and collectible other "personal injury" for which such person or insurance, whether primary, excess, contingent or organization has assumed liability in a on any other basis, that is available to the additional insured for a loss we cover. However, if contract or agreement. you specifically agree in the "written contract The insurance provided to such additional insured requiring insurance" that this insurance provided is limited as follows: to the additional insured under this Coverage Part e. This insurance does not apply on any basis to must apply on a primary basis or a primary and any person or organization for which non-contributory basis, this insurance is primary coverage as an additional insured specifically to other insurance available to the additional is added by another endorsement to this insured which covers that person or organizations Coverage Part. as a named insured for such loss, and we will not share with the other insurance, provided that: f. This insurance does not apply to the oor "property rendering of or failure to render any (1) The "bodily injury" " ert p p y damage" for "professional services". which coverage is sought occurs; and g. In the event that the Limits of Insurance of the (2) The "personal injury" for which coverage is Coverage Part shown in the Declarations sought arises out of an offense committed; exceed the limits of liability required by the after you have signed that "written contract "written contract requiring insurance", the requiring insurance". But this insurance provided insurance provided to the additional insured to the additional insured still is excess over valid shall be limited to the limits of liability required and collectible other insurance, whether primary, by that "written contract requiring insurance". excess, contingent or on any other basis, that is This endorsement does not increase the available to the additional insured when that limits of insurance described in Section III — person or organization is an additional insured Limits Of Insurance. under any other insurance. CG D3 81 0916 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 2 Includes the copyrighted material of Insurance Services Office,Inc.,with its permission COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph B., Transfer 4. The following definition is added to the Of Rights Of Recovery Against Others To Us, DEFINITIONS Section: of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: "Written contract requiring insurance" means that part of any written contract under which you are We waive any right of recovery we may have required to include a person or organization as an against any person or organization because of additional insured on this Coverage Part, payments we make for "bodily injury", "property provided that the "bodily injury" and "property damage" or "personal injury" arising out of "your damage" occurs and the "personal injury" is work" performed by you, or on your behalf, done under a "written contract requiring insurance"with caused by an offense committed: that person or organization. We waive this right a. After you have signed that written contract; only where you have agreed to do so as part of b. While that part of the written contract is in the "written contract requiring insurance" with effect; and such person or organization signed by you before, and in effect when, the "bodily injury" or c. Before the end of the policy period. "property damage" occurs, or the"personal injury" offense is committed. Page 2 of 2 ©2015 The Travelers Indemnity Company.All rights reserved. CG D3 81 09 15 Includes the copyrighted material of Insurance Services Office,Inc.,with its permission