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2019/04/01 VP Concrete Inc. DBA: Valley Pacific Concrete Certicate of Liability Insurance VALLPAC-01 BGO E CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 1/22/2020 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 rAMJacT Beverly Goyen Inland Empire-Alliant Insurance Services,Inc. PHONE,c,f xl 909_ No: Ban Bernardino,CA 92408 Anp8E$s,bgaysntalliant.com INSURER(S)AFFORDING COVERAGE _ NAIC INSURER A:Evanston Insurance Company .35378 INSURED INSURER B:Insurance Corn any of the West 27847 VP Concrete Inc.DBA: Valley Pacific Concrete INSURER C: 27580 Tabb Lane INSURER D: Menifee,CA 92584 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 .ADDL SUBR POLICY NUMBER POLICY EFF + POLICY EXP LIMITS LTR INFO.Ury9... WPDAILl A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ CLAIMS-MADE I X I OCCUR X IMKLV5PBC001430 1/24/2020 1/24/2021 DAMAGE TO RENTED $ 300,000 eBE=U_(Ea occurrence).. . MED EXP LAny one pars_.. 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE_N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 POLICY[X PRO- JECT LOC PRODUCTS-COMP/OP AGG 2,000,000 OTHER: EBL AGGREGATE 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMrr .(Ea_aecideRo $ _ ANY AUTO BODILY INJURY1Perperson). �$ OWNED SCHEDULED AUTOS ONLY _ AUTOS BODILY INJURY(Per acciden ALT03 ONLY AUTOS ONLY PROPERTY acdent DAMAGE A _ UMBRELLA LIAB X OCCUR FA CB G URRENCE 1'000'00U X EXCEISSLIAB CLAIMS-MADE MKLV5EUL102196 1/24/2020 1/24/2021 AGGREGATE DED ! R 1,000,000 ETENTION$ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY y,I _ STATU7 ANY PROPRIETOR/PARTNER/EXECUTIVE ��WSD 5033275 03 4/1/2019 4/1/2020 7,000,000 OFFICER/MEMBER EXCLUDED? Y N/A E.L.EACH ACCIDENT (Mandatory in NH) — E.L DJSEASE-EAEMPL.OY $ 1,000,000 byes,describe under DESCRIPTION OF OPERATIONS below E.L DJSEASE-POLICY MT 11000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD tat,Additional Remarks Schedule,maybe attached if more space Is required) The City of Menifee,its officers,officials,employees,and volunteers are Additional Insured with respect to General Liability for Ongoing and Completed Operations of the Named Insured as required by written contract.See forms attached. CERTIFICATE HOLDER CANCELLATION City of Menifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Menifee City Clerk. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29714 Haun Road ACCORDANCE WITH THE POLICY PROVISIONS. Menifee,CA 92586 JAN 2 7 2020 AUTHORIZED REPRESENTATIVE J4."W" ACORD 25(2016103) Received ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MKLV5PBC001430 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 2037 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED—OWNER S,, LESSEES OR CONTRACTORS — COMPLETED OPERATIONS This endorsement modifies insuran oe provided under the following: COMMERCIAL GENERAL LIABILITY-COVERAGE PART SPHIEDULE Name Of Additional Insured Person(s) Or Organizatiori(s): location And Description Of ComPleted OPerations As required by written contract executed prior to loss All Locations fTfa;ation requJred to complete this Scheduie. 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 organJ1zaffory(s)shDwn in:the $,chedule, M onlywith respect to liability for'bodily injury" or "property dam" age" caused, in whole or in part, by "you( work" at the loCatiol) designated and described in the SChed" ule of this endorsement performed for that additional insured and included in the "products-completed operati6ds hazard", CG 20 37-07 04 0 1180 Pro pertieS, lne.,"2004 Page) ofl MKLV5PBC001430 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 2 010 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS, LESSEES CAR CON TRACTOR S-SCIH'EDULED PERSON OR. ORGANIZATION This endor.sernent madifies,insurance provided under the following: COMMERCIAL GENERAL LIABILITYCOVER GE PART SCHEDULE. Name Of Additional Insured Persai*) Or Or anization s}: Location(s) Of Covered Operations As agreed to by written contract or agreement A[I Locations [nforLrratian ired to complete this Sehedr�le; it nat Shawn above,will be shown in the Declarations. A. Section Il Who Is An Insured is amended,to B. With respect to the insurance afforded :to these include as an: additional insured the person(s). or additional insureds, the following additional exclu- organization(s) shown: in the Schedule, but only dons apply: with respect to liability for"bodily injury", "property. This insurance does not apply'.-to "bodil u "-or "property damage occurring after: damage" or "persona[: and adiertising injury" y injury"ry caused. in whole or in part. by. 1. All work, including materials, parts or eq.uip- I. Your acts or o[im.ission5; or ment furnished in connection with such work, 2. The acts-or omissions of those acting on your on the project (other than service, main.teh*.me behalf; or-repa[M) to be: performed by or on behalf of in the performance of .your ongoing operations for the additional insured(s) at the location of the the additional Insured(§) at the locations) desig- covered operations has been completed; or nated'above. 2. That portion of "your work" out: of .which the injury or damage arises has been put to i.s in- tended use by.any person or organization other than another contractor or subcontractor en- gaged in performing operations: for a principal as apart ofthe same:projer t, CG 2 010 07 04 0 ISO Properties, Ina.,2004 Page 1 of 1 l7