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2020/02/14 Leighton Consulting, Inc. Certificate of Liability Insurance (12)DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE vucnaTr. rear vra 305LEIGHGRO ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/Y YYY) 2/17/2020 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Lori McNay McGriff Insurance Services PHONE 714 941-2815 FAX A/C, No, Ext : A/C, No): 2400 E Katella Ave Suite 1100 E-MAIL LMcNay@mcgriffinsurance.com g ADDRESS: Anaheim, CA 92806 INSURER(S) AFFORDING COVERAGE NAIC# 714 941-2800 Lexington Insurance Company 19437 INSURER A : 9 P Y INSURED INSURER B : Travelers Indemnity Co of CT 25682 Leighton Consulting Inc 17781 Cowan Ste. 100 INSURER C : Irvine, CA 92614-6009 INSURER D : 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 CONTRACTOR 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 065463440 2/14/2020 02/14/2021 EACH OCCURRENCE $1,000,000 CLAIMS -MADE � OCCUR PREMISES ERENTED ccr nce $ 50,000 MED EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY XI JECT [XILOC PRODUCTS - COMP/OPAGG $2,000,000 $$5,000,000 OTHER: Overall Policy General Aggregate B AUTOMOBILE LIABILITY BA0305L81420CAG 2/14/2020 02/14/2021 CMINED Ea acciden SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY A X UMBRELLA LIAB X OCCUR 006546318 2/14/2020 02/14/2021 EACH OCCURRENCE s5,000,000 AGGREGATE s5,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $10000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F7 N / A PER OH - STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Prof/Pollutn Liab 013001524 02/14/2020 02/14/2021 $2,000,000 Per Claim Claims Made $4,000,000 Aggregate $50,000 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional Insured applies on General Liability per Lexington's Additional Insured Owners, Lessees or Contractors endorsement LX4316 06/14 and LX9605 10/01 attached to the General Liability policy as required by written contract. Primary wording applies to General Liability per Lexington's endorsement LX9838 08/05 attached to policy. Additional Insured and Primary wording applies on Automobile Liability per Travelers endorsement CAT474 (See Attached Descriptions) ILO] a.a I I a PL•\ III IRE III Lai El NJ a01"aA AG\II PJ0 (LC)City of Menifee 29714 Haun Road Menifee, CA 92586 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1 of 2 #S25219683/M25211722 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LXMCN DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE DESCRIPTIONS (Continued from Page 1) 0216, Blanket Additional Insured -Primary and Non -Contributory with Other Insurance, attached to the Automobile policy as required by written contract. Re: Proj #11051.005 CIP19-01 Rustler's Ranch Resurfacing Project Phase II, NE Newport Rd & Bradley Rd, Menifee. Additional Insured to include per specifications: City of Menifee and its officers, employees, agents, and authorized volunteers. SAGITTA 25.3 (2016/03) 2 of 2 #S25219683/M25211722 DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE ENDORSEMENT 02/14/2020 This endorsement, effective 12:01 AM Forms a part of policy no.: 065463440 Issued to: Leighton Consulting Inc By:LEXINGTON INSURANCE COMPANY CANCELLATION AMENDMENT In consideration of the premium charged, it is hereby agreed that the cancellation provision is amended to 90 days in lieu of (30) days, except for non-payment of premium which remains (10) days. All other terms and conditions remain unchanged. Authorized Representative OR Countersignature (In states where applicable) LX9586 (02/03) DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE This page has been left blank intentionally. DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE ENDORSEMENT This endorsement, effective 12:01 AM 02/14/2020 Forms a part of policy no.: 065463440 Issued to: Leighton Consulting Inc By:LEXINGTON INSURANCE COMPANY PRIMARY/NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided by the policy: Notvvithstanding any other provision of the policy to the contrary, the insurance afforded by this policy for the benefit of the Additional Insured shall be primary insurance, but only with respect to any claim, loss or liability arising out of the Named Insured's operations; and any insurance maintained by the Additional Insured shall be non-contributing. All other terms and conditions of the policy remain the same. LZ Authorized Representative OR Countersignature (In states where applicable) LX9838 (08/05) DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE This page has been left blank intentionally. DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE Leighton Consulting Inc BA0305L81420CAG COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance pr(bded underthe following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph A.1.c., Who Is An Insured , of SECTION II — COVERED AUTOS LIABILITY COVERAGE This includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you b efore the "bodily injapfi'rty)rd*nage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only ftEddinwhich this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". The following is added to Paragraph B.5., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS Regardless of the provisions of paragraph a. and paragraph d. of this part fhi9ther Insurance, insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is the first named insured when the written contract or agreement between you and that person or organization, that is signed by you b efore the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non-contributory. CA T4 74 02 16 og1UtfrETEI;wTe&elers Indemnity Company. All Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE This page has been left blank intentionally. DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE POLICY NUMBER: 065463440 ENDORSEMENT# 004 COMMERCIAL GENERAL LIABILITY CG 20 10 10 01 THISENDORSEMENT CHANGESTHE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNER$ LESSEES OR C�ONTRAGTORS - SCHEDULED PERSON This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: AS REQUIRED BY WRITTEN CONTRACT ;LC)City of Menifee 29714 Haun Road Menifee, CA 92586-0000 Re: Proj #11051.005 CIP19-01 Rustler's Ranch Resurfacing Project Phase Il, NE Newport Rd & Bradley Rd, Menifee. Additional nsured to include per specifications: City of Menifee and its officers, employees, agents, and authorized volunteers. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II - Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2.Exclusions This insurance does not apply to "bodily in- jury" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 10 01 0 ISO Properties, Inc., 2000 Page 1 of 1 0 LX9605 DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE ENDORSEMENT # 021 This endorsement, effective 12:01 AM 02/14/2020 Forms a part of policy no.: 065463440 Issued to: LEIGHTON GROUP, INC. By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS- COMPLETED OPERATIONS (Based on CG2037 04/13) This endorsement modifies insurance provided by the following: COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Additional Insured Person(s) Location of Completed Operations or Organization(s) AS REQUIRED BY WRITTEN CONTRACT (LC)City of Menifee 29714 Haun Road Menifee, CA 92586-0000 Re: Proj #11051.005 CIP19-01 Rustler's Ranch Resurfacing Project Phase II, NE Newport Rd & Bradley Rd, Menifee. Additional Insured to include per specifications: City of Menifee and its officers, employees, agents, and authorized volunteers. Information required to complete this Schedule, if not shown above, will be shown in the Declarations A. Section II - 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 damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: LX4 6 06 4) Includes Copyrighted Informationo the Insurance Services Page 1 of 2 Offices, Inc., with its permission. All Rights Reserved. DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations All other terms and conditions of the policy remain the same. Authorized Representative LX4316 (06/14) Includes Copyrighted Information othe Insurance ervices Page 2 of 2 Offices, Inc., with its permission. All Rights Reserved. DocuSign Envelope ID: D466DEDD-Cl64-409B-9305-22E87346FBAE gg7E page 6 of 9 Client#: 1257049 30SLEIGHGRO ACORD. CERTIFICATE OF LIABILITY TE INSURANCE D8/20/ /DD/YYYY) /28/2020 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 poiicy(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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME, CONTACTLori McKay McGriff Insurance Services PHONE 714 941-2815 (A/C, No, Ex : N4 2400 E Katella Ave Suite 1100 Aoaa' s: LMcNay@mcgriff.com Anaheim, CA 92806 INSURERS) AFFORDING COVERAGE NAIC # 714 941-2600 INSURER A: Travelers Property Casualty Co of Amer :25674 INSURED INSURER B: Leighton Consulting Inc INSURER C 17781 Cowan Ste. 100 INSURER D Irvine, CA 92614-6009 INSURER E INSURER F: r`PIVCOAr_I:C CFRTIFICATF N1IMRFR: 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. TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FI OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- _ POLICY El JECT 0 LOC OTHER: T AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY H AUTOS ONLY UMBRELLA LIAB OCCUR EXCESS LIAB _ CLAIMS_MADE POLICY A WORKERS COMPENSATION V B1 R5099812043 AND EMPLOYERS' LfASILITY Y / N ANY PROPRIETOR£PARTNEWEXECUTIVE OFFICER/MEMBEREXCLUDED? rk N/A (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below LIMITS ppEppACCH OCCURRENCE $ Pf1 AE4dfi (a�rrsnce) $ MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMACit $ Pero ` earl EACH OCCURRENCE $ AGGREGATE $ E.L. EACH ACCIDENT $1 E.L. DISEASE - EA EMPLOYEE $1 E.L,DISEASE-POLICY LIMIT $1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Waiver of Subrogation applies to Workers Compensation per endorsement WC990376(A), per written contract. Re: Proj #11051 City of Menifee Professional Services, Various Locations in to City of Menifee. r Gra Tl UTATIZ wr%I MPM rANrFI I. ATION of Menifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE (LC )Cit y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29714 Haun Road ACCORDANCE WITH THE POLICY PROVISIONS. Menifee, CA 92586-0000 AUTHORIZED REPRESENTATIVE 01988-2015 ACORD CORPORATION. All rights reserves. ACORD 25 (2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD 4097 #S26401715/M26401547 LXMCN DocuSign Envelope ID: D466DEDD-C164-409B-9305-22E87346FBAE W. page 8 of 9 Leighton Consulting Inc TRAVELERSJM WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) — POLICY NUMBER: UBi R5099812043 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 % 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 Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: - - ST ASSIGN: Page 1 of 1 4099