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2019/07/07 TNT Blanchard General Engineering, Inc. Certicate of Liability Insurance TNTBLAN-01 3MCCQWAN CERTIFICATE OF LIABILITY INSURANCE DATE 1213 0120 1 YY) 12134l2419 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#0525512 TH ACT TeaggiJe Insurance Agency,Inc. PHONE 4700 Spring 5t.,#400 (JAIC,No.Ext:(B79)464-6851 ,Hoy:�61g 668-4715 La Mesa,CA 91942-0275 E' .info a ueins.com INSURE S AFFORDI G COVERAGE NAIC INSURE AAssoclated Industries 23140 _ INSURED I SURER B:Financial Pacific Insurance Com any 31453 TNT Blanchard General Engineering,Inc. IHsy Rc:Redwood Fire&Cesuafty 11673 46750 Rainbow Canyon Road#D INSURER o: Temecula,CA 92592 INSURERE:. 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 ADD SVBR POLICY NUMBER POLICY EFF POLIC Y EXP LIMITS A X COMMERCIAL GENERAL LIABILITY WVDEACH OCCURRENCE 1,000,000 CLAIMS-MADE EX OCCUR X ES104399404 1213012019 1213012020 DAMAGE 0RENTED 50,000 MED EXP An one arson 5,OD0 PERSONAL a A[}V INJURY 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000.000 1 POLICY PRO- LOC PRODUCTS-C.OMPIOPAGG 2,000.00 JECT OTHER; COMBINED SINGLE LIMIT $ 1,000,000 B AUTOMOBILE LIABILITY 0 IANY AUTO 60507437 717/2019 717/2020 BODILY INJURY rson $ OWNED SCHEDULED BODILY INJURY Per acciden $ AUTOS ONLY AUTOSy�p� p R AUTOS ONLY K f)NLY PerOaccc nt AGE $ UMBRELLA LIAB OCCUR EACHMCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS C WORKERS COMPENSATION �( PERur RH- AND EMPLOYERS'LIABILITY TNWC017709 7/7/2019 71712020 1,000,000 QANpY CPROPRIIETOR/PARTNER/EXECUTIVE YIN `IN N/A E.L.EACHACCIDENT I�il Fll$EF%]n NH)EXCLUDED? u 1�000,000 E.L.DIS F 4SE-EA EMPLOYE _ tTyee descdtaunder 1,000,000 DESCRIPTION OF OPERATIONS belovr E.L.DISEASE-POLICY L1Mif $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If moro space is required) City of Menlfee Is included when required by written contractlagreement as additional insured for ongoing and completed operations with respects to the general liability,per forms attached. CERTIFIC TE HOLDER CANCELLATION City Clerk 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. 29844 Houn Road Menifee,CA 92586 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AES104399404 COMMERCIAL GENERAL LIABILITY CIO 20330704 THIS ENDORSEMENT CHANGES:THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section 1.1 — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or or- additional insureds: the following additional exclu- ganilation for whom you are performing operations sions apply: when you and such: person or organization have This insurance does not apply to: agreed in writing in a contract or agreement that such person or organization be added as an addi- 1. "Bodily injury", "property damage" or "personal tional insured on your policy. Such person or or- and advertising:injury"arising out of the render- ganization is an additional insured only:with re- ing of, or the failure to render; any professional spect to liability for "bodily injury", "property architectural, engineering or surveying servic- damage" or "personal and advertising injury" es, including: caused, in whole or in part, by- a. The preparing, approving: or failing to pre- 1.. Your acts or omissions;or pare or approve, maps, shop drawings, opi- nions, reports, surveys, field orders., change 2. The acts or omissions of those acting on your orders or drawings and specifications; or behalf; b. Supervisory, inspection, architectural or in the performance of your ongoing operations for on.gineering activities. the additional insured. 2. "Bodily injury" or "property damage" oocurring A person's or organization's status as an additional after: insured under this endorsement ends when your operations for -that additional insured are com- a. All work, including materials, parts or pleted. equipment furnished in connection with such work, on the project(other than ser- vice; maintenance or repairs) to be per- formed by or on behalf of the additional in sured(s) at the location of the covered operations has been completed; or b. That portion of"your work" out of which the injury or damage arises has been put to its intended use by any person or:org.anization other than another contractor or subcontrac for engaged in: performing operations for a principal as a part of the same project. CG 20 33 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 p POLICY NUMBER: AES104399404 COMMERCIAL GENERAL LIABILITY CG20370704 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS -- COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations All persons or organizations where written contract with the Named Insured requires additional insured completed operations.This form does not apply to your work. on "residential property Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11 — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury"or"property dam- age" caused, in whole: or in hart: by "your work" at the location designated and descfibed in the sche- dule of this endorsement performed for that addi- tional insured and inclucdew in the "products- competed operations hazard" CG 20 37 07 04 0 ISO Properties, Inc.; 2004 Page 1 of 1 13