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2021/02/18 L.C. Paving & Sealing, Inc.ACOREd CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 02119/2021 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: CONTAC JANA CLARK HARTLEY CYLKE PACIFIC-#0574253 PHONE (619) 295-5155 FAX 619 291-0912 LAIC- o Ex! : AIC, Na' ( ) INSURANCE SERVICES, INC. ADDRESS: jana@hcpacinsurance.com 2747 UNIVERSITY AVENUE INSURER(S) AFFORDING COVERAGE NAIC# SAN DIEGO CA 92104-4068 INSURER A: TRAVELERS PROPERTY & CASUALTY CO OF 25674 INSURED INSURER B : CLEAR SPRING PROPERTY & CASUALTY CO L.C. Paving & Sealing, Inc. INSURER C: PALOMAR SPECIALTY INSURANCE CO 620 Alpine Way INSURER D: INSURER E: Escondido CA 92029 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2121968480 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM DD/Y YY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1XI OCCUR EACHOCCURRENCE $ 1,000,000 PREMISES EaocEurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A Y DT22COOS13576ATIL21 02/18/2021 02/18/2022 GEN'LAGGREGATE LIMIT APPLIES PER: X POLICY ZROT LOC GENERAL AGGREGATE $ 2,000.000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED Sl GLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 8100S0955232126G 02/18/2021 02/18/2022 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE PeraCBdwt $ Medical payments $ 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000.000 A EXCESS LAB CLAIMS -MADE CUPOS1373832126 02/18/2021 02/18/2022 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A CSW000024401 09/12/2020 09/12/2021 PER OTH- X STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000.000 INLAND MARINE C 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: 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AC'"R►o CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 02/19/2021 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 PHONE E <t : (619) 295-5155VC. No); (619) 291-0912 IAIC-INSURANCE ADDRESS: lana@hcpacinsurance.com SERVICES, INC. 2747 UNIVERSITYAVENUE INSURER(S) AFFORDING COVERAGE NAIC# SAN DIEGO CA 92104-4068 INSURERA: TRAVELERS PROPERTY & CASUALTY CO OF 25674 INSURED INSURER B : CLEAR SPRING PROPERTY & CASUALTY CO L.C. Paving & Sealing, Inc. INSURER C: PALOMAR SPECIALTY INSURANCE CO 620 Alpine Way INSURER D: INSURER E . Escondido CA 92029 INSURERF: COVERAGES CERTIFICATE NUMBER: CL2121968480 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTH E 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. iLTR TYPE OF INSURANCE INSD VWD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx] OCCUR EACH OCCURRENCE $ 1,000,000 DA PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000-000 A Y DT22COOS13576ATIL21 02/18/2021 02/18/2022 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY 0 PROJECT 7 LOC GENERAL AGGREGATE $ 2.000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea soddenS $ 1,000,000 ANYAUTO BODILY INJURY (Per person) $ A OWNED SCHEDULED AUTOS ONLY AUTOS Y 8100SO955232126G 02/18/2021 02/18/2022 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per acGdenl $ Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE CUPOS1373832126 02/18/2021 02/18/2022 DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA CSW000024401 09/12/2020 09/12/2021 �/ PER OTH- XSTATUTE I I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ INLAND MARINE C 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 UCR I iritUm I C MULUCK UANL;tLLA I IVN 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 ACOPRO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 02/19/2021 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: JANACLARK HARTLEY CYLKE PACIFIC-#0574253 HO No (619) 295-5155 A (619) 291-0912 ; No INSURANCE SERVICES, INC. ADDRESS:jana@hcpacinsurance.com 2747 UNIVERSITY AVENUE INSURER(S) AFFORDING COVERAGE NAIC # SAN DIEGO CA 92104-4068 INSURER A: TRAVELERS PROPERTY & CASUALTY CO OF 25674 INSURED INSURER B : CLEAR SPRING PROPERTY & CASUALTY CO L.C. Paving & Sealing, Inc. INSURER C: PALOMAR SPECIALTY INSURANCE CO 620Alpine Way INSURER Di INSURER E: Escondido CA 92029 INSURERF: COVERAGES CERTIFICATE NUMBER: CL2121968480 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. INSk LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx] OCCUR EACH OCCURRENCE $ 1,000,000 PREMJSES Fa occurrence $ 300,000 MED EXP (Anv one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A Y DT22COOS13576ATIL21 02/18/2021 02/18/2022 GEN'LAGGREGATE LIMIT APPLIES PER: X POLICY JEC LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LI Es acddenl $ 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ A OWNED SCHEDULED AUTOS ONLY AUTOS 8100SO955232126G 02/18/2021 02/18/2022 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLYIF.,.. PROPERTY DAMAGE Per accident $ Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,00.0,000 A EXCESS LIAB CLAIMS -MADE CUPOS1373832126 02/18/2021 02/18/2022 DED I RETENTION $ I $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A CSW000024401 09/12/2020 09/12/2021 PER DTN- STATUTE I ER E,L,EACH ACCIDENT $ 1,000,000 E.L,DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ INLAND MARINE C 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: 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 `7✓''�j @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AC"Ra CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 02/19/2021 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 PHONE (619) 295-5155 FAX (619) 291-0912 A No Ext : AEC, Na : INSURANCE SERVICES, INC. ana he acinsurance.com ADDRESS: ) @ p 2747 UNIVERSITYAVENUE INSURER(S) AFFORDING COVERAGE NAIC# SAN DIEGO CA 92104-4068 INSURER A: TRAVELERS PROPERTY & CASUALTY CO OF 25674 INSURED INSURER B : CLEAR SPRING PROPERTY & CASUALTY CO L.C. Paving & Sealing, Inc. INSURER C : PALOMAR SPECIALTY INSURANCE CO 620 Alpine Way INSURER D : INSURER E Escondido CA 92029 INSURERF: COVERAGES CERTIFICATE NUMBER: CL2121968480 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISES JEa occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1.000,000 A Y DT22COOS13576ATIL21 02/18/2021 02/18/2022 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2.000,000 PRO x ❑ 2.000,000 POLICY JECT LOC PRODUCTS $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000.000 BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y 8100S0955232126G 02/18/2021 02/18/2022 BODILY INJURY (Per accident) $ PROPERTY DAMAGE ParElpCEd l $ HIRED HNON-OWNED AUTOS ONLY AUTOS ONLY Medical payments $ 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LAB CLAIMS -MADE CUPOS1373832126 02/18/2021 02/16/2022 DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER E.L.EACH ACCIDENT $ 1,000,000 B ANY PRO PRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A CSWC00024401 09/12/2020 09/12/2021 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 INLAND MARINE C 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 Ur-M I Ir-It,H 1 t ntJLUCK UANULLLA I IUN 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 YYY © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD R CERTIFICATE OF LIABILITY INSURANCE 7DATE(MM/DDfYYYY) 2/19/2021 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 CONTACI NAME: JANA CLARK HARTLEY CYLKE PACIFIC-#0574253 PHONE (619) 295-5155 I 619 291-0912 AfC Na Exl AIC. No : ( ) INSURANCE SERVICES, INC. ADDRESS: jana@hcpacinsurance.com 2747 UNIVERSITY AVENUE INSURER(S) AFFORDING COVERAGE NAIC# SAN DIEGO CA 92104-4068 INSURERA: TRAVELERS PROPERTY & CASUALTY CO OF 25674 INSURED INSURER 8 : CLEAR SPRING PROPERTY & CASUALTY CO L.C, Paving & Sealing, Inc. INSURER C: PALOMAR SPECIALTY INSURANCE CO 620 Alpine Way INSURER D . INSURER E: Escondido CA 92029 INSURER F: COVFRAGFS CFRTIFICATF NI IMRFR• CL2121968480 RF\/I.QIrINI NII InARFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTH E 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM DD/YYYY MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 300,000 ME EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 A Y DT22C0OS13576ATIL21 02/18/2021 02/18/2022 GEOLAGGArGATE LIMIT APPLIES PER: POLICY PROLOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X ANYAUTO BODILY INJURY (Per person) $ A OWNED SCHEDULED AUTOS ONLY AUTOS Y 8100SO955232126G 02/18/2021 02/18/2022 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ Medical payments $ 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 A EXCESS LAB CLAIMS MADE CUPOS1373832126 02/18/2021 02/18/2022 AGGREGATE $ 4,000,000 DIED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- B AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A CSWC00024401 09/12/2020 09/12/2021 STATUTE ER EL. EACH ACCIDENT $ 1,000,000 EL.DISEASE- EAEMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 INLAND MARINE C 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 18-04 - Sun City ADA U IZM I II-lUM I c tiVLUCM L;ANULLLA I IUN 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 ACQR►3® CERTIFICATE OF LIABILITY INSURANCE r DATE(MM/DD/YYYY) 02/19/2021 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 JANA CLARK NAME: HARTLEY CYLKE PACIFIC-#0574253 PHONE (619) 295-5155 AX 619 291-0912 AIC No E,1 • LAC, No : ( ) INSURANCE SERVICES, INC. AI7DRES5: Jana@hcpacinsurance.com 2747 UNIVERSITY AVENUE INSURER(S) AFFORDING COVERAGE NAIC# SAN DIEGO CA 92104-4068 INSURER A: TRAVELERS PROPERTY & CASUALTY CO OF 25674 INSURED INSURER B : CLEAR SPRING PROPERTY & CASUALTY CO L.C. Paving & Sealing, Inc. INSURER C: PALOMAR SPECIALTY INSURANCE CO 620 Alpine Way INSURER D: INSURER E; Escondido CA 92029 NNSURERF: COVERAGES CERTIFICATE NUMBER: CL2121968480 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 LTR TYPE OF INSURANCE JNSD WVD POLICY NUMBER MM/DDYYYY UMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A Y DT22COOS13576ATIL21 02/18/2021 02/18/2022 GEN'LAGGREGATE LIMITAPPLIES PER: POLICY ❑ j LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY CJDMBiNED SINGLE LIMIT Ea anddent $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y 8100SO955232126G 02/18/2021 02/18/2022 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Par:x6dsnl $ Medical payments $ 5,000 X UMBRELLA LOB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LAB CLAIMS -MADE CUPOS1373832126 02/18/2021 02/18/2022 DIED I I RETENTION $ $ WORKERS COMPENSATION PER OTN- B AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A CSWC00024401 09/12/2020 09/12/2021 STATUTE ER E,LEACH ACCIDENT $ 1,00.0.000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 EL DISEASE - POLICY LIMIT $ 1,000,000 INLAND MARINE C IMFLP20202100300 02/18/2020 02/18/2021 LEASED/RENTED EQP $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached I'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 IrCR] Ar1in%1 C rtIJLUr-M L;AINL;tzLLAI IUN 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 -�/j��Q Menifee CA 92586 Y © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD