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2010/04/01 Bureau Veritas North America, Inc. Certificate of Liability Insurance0 ,4coRo® CERTIFICATE OF LIABILITY INSURANCE DATE09/15 09/15/2010 2010 PRODUCER Aon Risk Services Northeast, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Stamford CT Office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 1600 Summer Street CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Stamford CT 06907-4907 USA COVERAGE AFFORDED BY THE POLICIES BELOW. 4-1 INSURERS AFFORDING COVERAGE NAIC # w PHONE-(866) 283-7122 FAX- (847) 953-5390 INSURED INSURERA: Lexington Insurance Company 19437 Bureau Veritas North America, Inc. 11590 W. Bernardo Court, #100' 19445 INSURERB: National union Fire Ins co of Pittsburgh San Diego CA 92127 USA 23809 °m INSURERC: Granite State Insurance Company INSURERD: New Hampshire Ins Co 23841 d INSURERE: Commerce & industry Ins co llq4ln 0 VV♦G1V1lJG0 --,1K applles per terms ana conaltlons of the policy ^ 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED INSA LTR DD INSIUD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DD/ POLICY EXPIRATION DATE(MM/DD/YYYY LIMITS E ULqERAL GL6439313 04/01/2010 04/01/2011 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1,000,000 CLAIMS MADE © OCCUR - PREMISES (Ea occurrence) r•-I O P (AnV one person PERSONAL & ADV INJURY $1, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- El JECT LOC mo mo O �t O GENERAL AGGREGATE $2 , 000, 000 PRODUCTS - COMP/OP AGO $ 2 , 000 , 000 B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS CA9835763 40S CA9835764 MA 04/01/2010 04/01/2010 04/01/2011 04/01/2011 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 p Z tv R cr BODILY INJURY SCHEDULED AUTOS ( Per person),+. HIRED AUTOS t NON OWNED AUTOS BODILY INJURY (Per accident) (, HX Comp Ded: $1,000 PROPERTY DAMAGE X Coll Ded: $1,000 (Per accident) GARAGE LIABILITY n ANY AUTO ?SS / UMBRELLA LIABILITY OCCUR ❑ CLAIMS MADE AUTO ONLY - EA ACCIDENT OTHERTHAN EA ACC AUTO ONLY: AGO EACH OCCURRENCE AGGREGATE — WORKERS COMPENSATION AND 11 .Y/ ul/ cuiu %( WC STATU- OTH- EMPLOYERS' LIABILITY Y/ N ADS TORY ITS ER E.L. EACH ACCIDENT $1,000,000 6 D III I WC24549235 04/01/2010 04/01/2011 ANY PROPRIETOR/PARTNER/EXECUTIVE LJ CA E.L. DISEASE -EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -POLICY LIMIT $1,000,000 ICyes, describe wider SPECIAL PROVISIONS belotc A OTHER 024647119 11/30/2009 Each claim $1,000,000 Archit&Eng Prof Aggregate $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Project: Civil Plan Check. City of Menifee is included as Additional insured with respect to General Liability �- and Auto Liability policies where required by written contract. A waiver of subrogation is granted in favor of Additional insured on the workers' Compensation policy where required by written contract. The insurance provided CERTIFICATE HOLDER CANCELLATION tW city of Menl fee 29714 Haun Road -SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Meni fee CA 92 586 USA DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE � �/I� � L .�i ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD Attachment to ACORD Certificate for Bureau veritas North America, Inc. The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURED Bureau veritas North America, Inc 11590 W. Bernardo court, #100 San Diego CA 92127 USA INSURER INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. LTR R ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY DESCRIPTION POLICY EFFECTIVE DATE POLICY EXPIRATION DATE LIMITS DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS shall be primary and any other insurance maintained by the Additional Insured is excess and Non -Contributory. see attached Endt. CG20100704, 87950 (10/05), 74434 (10/99) and wc04O361. Certificate No : 570040096041 ENDORSEMENT This endorsement, effective 12:01 A.M. 04/01/2010 forms a part of Policy No. 9835764 issued to BUREAU VER I TAS NORTH AMER I CA, I NC . by NAT I ONAL UNION FIRE INSURANCE COMPANY OF P I TTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: WHERE REQUIRED BY CONTRACT L SECTION II - LIABIUTY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add: d, Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered `auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. 87960 (10/06) Auth ized Representative or Countersignature (in States Where Applicable} Page 1 of 1 BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12.01 AM 04/01/2010 forms a part of Policy No. WC 24549236 Issued to BUREAU VERITAS NORTH AMERICA, INC By NEW HAMPSH I RE INSURANCE COMPANY We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against any person or organization with whom you have .a written contract that requires you to obtain this agreement from us, as regards any work you perform for such person or organization. The additional premium for this endorsement shall be '2 % of the total estimated workers compensation premium for this policy. WC 04 03 61 Countersigned by (Ed. 11/90j Authorized Representative POLICY NUMBER: GL 643-93-13 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization(s): Location(s) Of Covered Operations BLANKET AS REQUIRED BY WRITTEN CONTRACT 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 1. include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on 2. your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: All work, including materials, parts or equip- ment 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 location of the covered operations has been completed; or That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organ- ization other than another contractor or sub- contractor engaged in performing oper- ations for a principal as a part of the same project. CG 20 10 07 04 0 ISO Properties, Inc.,2004 Page 1 of 1 0 ENDORSEMENT This endorsement, effective 12:01 A.M. 04/01 /2010 forms a part of policy No. GL 643-93-13 issuedto BUREAU VERITAS NORTH AMERICA, INC by COMMERCE AND INDUSTRY INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - PRIMARY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Section IV, Commercial General Liability Conditions, paragraph 4., Other Insurance, subparagraph a. Primary Insurance, is amended by the addition of the following: However, coverage under this policy afforded to an additional insured will apply as primary insurance where required by contract, and any other insurance issued to such additional insured shall apply as excess and noncontributory insurance. 40.A44w- Authorized Representative or Countersi nature (in States Where Applicablell 74434 (10199)