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2020/02/18 L.C. Paving & Sealing, Inc. Certificate of Liability Insurance (11) �a CERTIFICATE OF LIABILITY INSURANCE DAT9/1512020 Y) 0 911 5/2 0 2 0 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 NAME JANA CLARK HARTLEY CYLKE PACIFIC-#0574253 PHONE (619)295 ExIl -5155 FAX 1AIC No (619)291-0912 INSURANCE SERVICES,INC. E-MAIL jana@hcpacinsurance.com ADDRESS: 2747 UNIVERSITY AVENUE INSURER(5)AFFORDING COVERAGE NAIL# SAN DIEGO CA 92104-4068 INSURER A: UNITED SPECIALTY INSURANCE CO. INSURED INSURER B: WATFORD INSURANCE COMPANY 25585 L.C. Paving&Sealing,Inc INSURER C: TOPA INSURANCE COMPANY 620 Alpine Way INSURER D: CLEAR SPRING PROPERTY&CASUALTY CO INSURER E: PALOMAR SPECIALTY INSURANCE CO Escondido CA 92029 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2091566406 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. tLTR TYPE OF INSURANCE INSD V�A/D POLICY NUMBER MNI DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000 DAMAGE TO RENTE157_7 CLAIMS-MADE I—XI OCCUR PREMISES Ea occurrence $ 50,000 MED EXP(Any one Gerson) $ 5,000 A Y ATN2035914 02/18/2020 02/18/2021 PERSONAL&ADV INJURY $ 1.000.000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑JPrRzG 71 LOC PRODUCTS-COMP/OPAGG $ 2.000,000 OTHER: $ AUTOMOBILE LIABILITY COMHINEO5INGLE LIMIT $ 1,000,000 Ea aeadan _ ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED WIC100396400 02/18/2020 02/18/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Par accident Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 C x EXCESS LIAB CLAIMS-MADE XL0020024203 02/18/2020 02/18/2021 AGGREGATE $ 4,000,000 D E D I I RETENTION $ $ WORKERS COMPENSATION X S ATUTE ER AND EMPLOYERS'LIABILITY Y/N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE �I E.L.EACH ACCICENT $ D OFFICER/MEMBER EXCLUDED? I� N/A CSWK0000002670 09/12/2020 09/12/2021 (Mandatory in NH) E.LDISEASE-EAEMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ INLAND MARINE E IMFLP20202100300 02/1812020 02/16/2021 LEASED/RENTED EQP $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Menifee and its elected officials,officers,employees,agents,representatives,consultants,contract employees and volunteers are hearby added as additional insured but only as respects work done by,for,or on behalf of the named insured.*10 day notice of cancellation for non-payment of premium shall apply. RE:PW 17-02 ON CALL CONCRETE MAINTENANCE SERVICES CERTIFICATE HOLDER CANCELLATION 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 Rd. 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 a F Ac" CERTIFICATE OF LIABILITY INSURANCE 7DATE(MMIDDNYYY) 9/15/2020 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 CONTACT NAME: JANA CLARK HARTLEY CYLKE PACIFIC-#0574253 prvaNE (619)295-5155 F (619)291-0912CA Na No Xt) INSURANCE SERVICES,INC. E-MAADORERS lana@hcpacinsurance.com 2747 UNIVERSITY AVENUE INSURER(S)AFFORDING COVERAGE NAIC# SAN DIEGO CA 92104-4068 INSURER A: UNITED SPECIALTY INSURANCE CO. INSURED INSURER B: WATFORD INSURANCE COMPANY 25585 L.C.Paving&Sealing,Inc. INSURER C: TOPA INSURANCE COMPANY 620 Alpine Way INSURER D: CLEAR SPRING PROPERTY&CASUALTY CO INSURER E: PALOMAR SPECIALTY INSURANCE CO Escondido CA 92029 INSURERF: COVERAGES CERTIFICATE NUMBER: CL2091566406 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. I TYPE OF INSURANCE POLICY NUMBER MM/DD/YCY YYY MM/DD/YYYY LIMITS LTR 1 D WVD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Fx]OCCUR PREMISES fEa occurrence $ 50,000 MED EXP fAny one person) $ 5,000 A Y ATN2035914 02/18/2020 02/18/2021 PERSONAL&ADV INJURY $ 1,000.000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000.000 JECT ❑ LOC PRODUCTS $POLICY❑ PRO 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLELIMIT $ 1,000,000 X ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y WIC100396400 02/18/2020 02/18/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY PeracGdenl Medical payments $ 5.000 UMBRELLA LAB OCCUR EACH OCCURRENCE $ 4,000,000 C X EXCESS LIAB CLAIMS-MADE XL0020024203 02/18/2020 02/18/2021 AGGREGATE $ 4,000,000 DED RETENTION $ $ WORKERS COMPENSATION X STATUTE OERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 D OFFICER/MEMBER EXCLUDED? N/A CSVVK0000002670 09/12/2020 09/12/2021 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1.000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ INLAND MARINE E IMFLP20202100300 02/18/2020 02/18/2021 LEASED/RENTED EQP $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Menifee and its elected officials,officers,employees,agents,representatives,consultants,contract employees and voluteers are hearby added as additional insured but only as respects work done by,for,or on behalf of the named insured.*10 day notice of cancellation for non-payment of premium shall apply. RE:CIP No. 15-05, Holland Road Missing Sidewalk CERTIFICATE HOLDER CANCELLATION 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 Rd 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 ACC CERTIFICATE OF LIABILITY INSURANCE DATE(MM/2020 Y) o9r1s/ o2o 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 NAME TACT JANA CLARK HARTLEY CYLKE PACIFIC-#0574253 PHONE (619)295-5155 a�NO), (619)291-0912 INSURANCE SERVICES,INC. E-MAIL Jana@hcpacinsurance.com ADDRESS: 2747 UNIVERSITY AVENUE INSURER(S)AFFORDING COVERAGE NAIC# SAN DIEGO CA 92104-4068 INSURERA: UNITED SPECIALTY INSURANCE CO. INSURED INSURER B: WATFORD INSURANCE COMPANY 25585 L.C. Paving&Sealing,Inc, INSURER C: TOPA INSURANCE COMPANY 620 Alpine Way INSURER D: CLEAR SPRING PROPERTY&CASUALTY CO INSURER E: PALOMAR SPECIALTY INSURANCE CO Escondido CA 92029 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2091566406 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. 1N TYPE OF INSURANCE L F P Ll EXP LTR 1 D WVD POLICY NUMBER MMlODIYYYY MM/OU/YYYY LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000 DAMAGETORENTED CLAIMS-MADE � OCCUR PREMISES Ea occurrence s 50,000 MED EXP(Any one person) $ 5,000 A Y ATN2035914 02/18/2020 02/18/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICY JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 EC OTHER: $ AUTOMOBILE LIABILITY COM 91 NED SINGLE LIMIT $ 1,000,000 ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED WIC100396400 02/18/2020 02/18/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY rPar accdenl Medical payments $ 5,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C > EXCESS LIAB CLAIMS-MADE XL0020024203 02/18/2020 02/18/2021 AGGREGATE $ 4,000,000 DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 1,000,000 D ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA CSWK0000002670 09/12/2020 09/12/2021 E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000.000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ INLAND MARINE E IMFLP20202100300 02I18/2020 02/18/2021 LEASED/RENTED EQP $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Menifee and its elected officials,officers,employees,agents,representatives,consultants,contract employees and volunteers are hearby added as additional insured but only as respects work done by,for,or on behalf of the named insured.*10 day notice of cancellation for non-payment of premium shall app!y. RE:Quail Valley Goetz Road Pedestrian Sidewalk Improvements Project CIP 16-10 CERTIFICATE HOLDER CANCELLATION 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 Rd AUTHORIZED REPRESENTATIVE Menifee CA 92586 k ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AC V CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 09/15/2020 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 CONSTITUTEA 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 CONTACTJANA CLARK HARTLEY CYLKE PACIFIC-#0574253 ti ONnEo Ext (619)295-5155 AX roa (619)291-0912 INSURANCE SERVICES,INC. E-MAIL S: lana@hcpacinsurance.com 2747 UNIVERSITY AVENUE INSURER(S)AFFORDING COVERAGE NAIC# SAN DIEGO CA 92104-4068 INSURERA: UNITED SPECIALTY INSURANCE CO. INSURED INSURER B: WATFORD INSURANCE COMPANY 25585 L.C.Paving&Sealing,Inc. INSURER C: TOPA INSURANCE COMPANY 620 Alpine Way INSURER D: CLEAR SPRING PROPERTY&CASUALTY CO INSURER E: PALOMAR SPECIALTY INSURANCE CO Escondido CA 92029 INSURER F COVERAGES CERTIFICATE NUMBER: CL2091566406 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. IN SR ADDL15U&N POLI Y EFF LI X LTR TYPE OF INSURANCE IN D WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000 CLAIMS-MADE OCCUR PREMISES Es occurrence $ 50,000 MED EXP(Anv one person) $ 5,000 A Y ATN2035914 02/18/2020 02/18/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑JEGi ❑LOC 2,000.000 PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY C,OMBINEDSIN L UMI7 $ 1.000,000 -- X ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y WIC100396400 02/18/2020 02/18/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLYH I Por accldanl Medical payments $ 5,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESS LIAR CLAIMS-MADE XL0020024203 02/18/2020 02/18/2021 AGGREGATE $ 4,000,000 DIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY X STATUTE ERH Y/N 1,000,000 D ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A CSWK0000002670 09/12/2020 09/12/2021 E L,EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ INLAND MARINE E IMFLP20202100300 02/18/2020 02/18/2021 LEASED/RENTED EQP $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) City of Menifee and its elected officials,officers,employees,agents,representatives,consultants,contract employees and volunteers are hearby added as additional insured but only as respects work done by,for,or on behalf of the named insured.*10 day notice of cancellation for non-payment of premium shall apply. RE:Sun City Blvd.ADA Improvements-CIP 18-04 CERTIFICATE HOLDER CANCELLATION 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 ACC CERTIFICATE OF LIABILITY INSURANCE DATE 115/2020 Y) 09/15/20- 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 NA r JANA CLARK HARTLEY CYLKE PACIFIC-#0574253 PHONE (619)295-5155 i/C No: (619)291-0912 INSURANCE SERVICES,INC. E-MAIL jana@hcpacinsurance.com ADDRESS. 2747 UNIVERSITY AVENUE INSURER(S)AFFORDING COVERAGE NAIC# SAN DIEGO CA 92104-4068 INSURERA: UNITED SPECIALTY INSURANCE CO, INSURED INSURER B: WATFORD INSURANCE COMPANY 25585 L.C.Paving&Sealing,Inc. INSURER C: TOPA INSURANCE COMPANY 620 Alpine Way INSURER D: CLEAR SPRING PROPERTY&CASUALTY CO INSURER E: PALOMAR SPECIALTY INSURANCE CO Escondido CA 92029 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2091566406 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. INS INSR ADLYL TYPE OF INSURANCE P / Y E / XP LTR INSD WV POLICY NUMBER MM/DDIVYYY MM/DDlYYYV LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000.000 -MMCLAIMS-MADE Fx_] OCCUR PREMISES fEa occurrence $ 50.000 MED EXP(Any one person) $ 5,000 A Y ATN2035914 02/18/2020 02/18/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $ 2,000,000 POLICY JEC1' El LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER; _ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea da ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y WIC100396400 02/18/2020 02/18/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYIDAMAGE $ AUTOS ONLY AUTOS ONLY Per addenl Medical payments $ 5.000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C X EXCESS LIAR CLAIMS-MADE XL0020024203 02/18/2020 02/18/2021 AGGREGATE $ 4,000.000 DED I I RETENTION$ $ WORKERS COMPENSATION PER ERH- AND EMPLOYERS'LIABILITY STATUTE ER YIN 1,000,000 D ANY PRO PRI RIPARTNE EXECUTIVE ❑ N/A CSWK0000002670 09/12/2020 09/12/2021 E.L EACH ACCIDENT $ OFFICER/MEMBMB ER EXCLUDED? 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ INLAND MARINE E IMFLP20202100300 02/18/2020 02/18l2021 LEASED/RENTED EQP $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Menifee and its elected officials,officers,employees,agents,representatives,consultants,contract employees and volunteers are hearby added as additional insured but only as respects work done by,for,or on behalf of the named insured.*10 day notice of cancellation for non-payment of premium shall apply. RE:CIP 18-04-Sun City ADA CERTIFICATE HOLDER CANCELLATION 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 Q Menifee CA 92586 ' 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AC" CERTIFICATE OF LIABILITY INSURANCE =EglMM/DDNYYY) 5/2020 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 rCONT JANA CLARK HARTLEY CYLKE PACIFIC-#0574253 PHONE (619)295-5155 FAX (619)291-0912 A/C NQ Exlk AIC NO: INSURANCE SERVICES, INC. ADDRESS: jana@hcpacinsurance.com 2747 UNIVERSITY AVENUE INSURER(S)AFFORDING COVERAGE NAIC# SAN DIEGO CA 92104-4068 INSURERA: UNITED SPECIALTY INSURANCE CO. INSURED INSURER B: WATFORD INSURANCE COMPANY 25585 L.C. Paving&Sealing,Inc. INSURER C: TOPA INSURANCE COMPANY 620 Alpine Way INSURER D: CLEAR SPRING PROPERTY&CASUALTY CO INSURER E: PALOMAR SPECIALTY INSURANCE CO Escondido CA 92029 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2091566406 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ' P / EFT POLICY E LIMITS LTR IN SD POLICY NUMBER MM/DD/VYYY MM/DDIYYYY COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ CLAIMS-MADE ❑X OCCUR PREMISES F.sacc+errence $DAMAGE TO RENTEIF- 50,000 MED EXP Any one person $ 5,000 A Y ATN2035914 02/18/2020 02/18/2021 PERSONAL&ADV INJURY $ 1.000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 0PROJECT LOG PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 ..tFA Wceldent.L__.«< ]� ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y WIC100396400 02/18/2020 02/18/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accldanl Medical payments $ 5.000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C X EXCESS LAB CLAIMS-MADE XL0020024203 02/18/2020 02/18/2021 AGGREGATE $ 4,000,000 DED RETENTION $ $ WORKERS COMPENSATION �/ AND EMPLOYERS'LIABILITY /� STATUTE ER Y/N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E L,EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDED? NIA CSWK0000002670 09/12/2020 09/12/2021 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1.000.000 If yes,describe under 1,000.000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ INLAND MARINE E IMFLP20202100300 02/18/2020 02/18/2021 LEASED/RENTED EQP $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Menifee and its elected officials,officers,employees,agents,representatives,consultants,contract employees and volunteers are hearby added as additional insured but only as respects work done by,for,or on behalf of the named insured.*10 day notice of cancellation for non-payment of premium shall apply. RE:CIP No. 18-06&Newport Road and Menifee Road Street Improvements project CERTIFICATE HOLDER CANCELLATION 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