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2019/10/08 Beaumont Electric, Inc. Certificate of Liability InsuranceBEAUELE-01 CMOUNTZ CERTIFICATE OF LIABILITY INSURANCE -DATE 10/101201 YY) 10/1412019 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 CONTACT Christina M MountZ , . NAME: Alliant Insurance Services, Inc. PHONE FAx 685 Carnegie Dr Ste 265 (AJC, No, Exs): (909) 886-9861 _ Not909 886-2013 San Bernardino, CA 92408 �A QR'Ess: cmountz@alliant.eom INSURERS AFFORDING COVERAGE NAI _ INSURERA:Allied World Surplus Lines Insurance Company 24319 INSURED INSURER B : Employers Mutual Casual!y Company 21415 Beaumont Electric Inc INSURER C : Benchmark Insurance Company 41394 877 W 4th St Ste A INSURER D : Beaumont, CA 92223 INSURER E INSURER F C C]�IFi7Are 1=R f 1=071 C{P ATa= F11 IRAM Cra• 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. INTRR TYPE OF INSURANCE AODL SUER POLICY NUMBER ` POLICY EFF POLICY EXP IMP YYVY1 LIMITS A X X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X] OCCUR BYPD Ded $2,500 X 5057166502 10/8/2019 10/8/2020 EACH OCCURRENCE $ 1,000,000 50,000 DRMAGE TO RENTED MED EXP none person)$ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: POLICY JE LOC PRODUCTS - COMP/OP AGG $ 2,000,000 IEBL EACH OCCURR 1,000,000 OTHER7 B AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT JEa n $ 1,000,000 X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS 5X7-72-68-20 10/8/2019 10/8/2020 BODILY INJURY er erson $ BODILY INJURY Per accident $ X PeOaPoEcRQ,l GE o $ AUTOS ONLY X AUUTOS ONLY $1,000 Comp Ded X $1,000 Coll Ded X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE $ DIED RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatoryin NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A ICST5017500 10/8/2019 10/8/2020 X PER OTH- 4 EACHAcc1PENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 EL DISEASE - POLICY LIMIT 1 000,000 $ ' DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Menifee Town Center Street Lights on Great Oak Road. Certificate holder is additional insured as respect general liability per endorsements attached. CERTIFICATE HOLDER CANCELLATION CITY OF MEFINANCE FEE City of Menifee 29714 Haun Road OCT 15 2019 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 RECEIVED �7 P �. ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 5057166502 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 Ornanization(s): I Location(s) Of Covered Operations o� �E�EeeEETeiei�e (J�aiN E_ E�86� -i 6iEs—atE6 EaiIi a;E�[IM= Information required to com Ip ete 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", "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 your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. 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 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 0 POLICY NUMBER: 5057166502 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) I 1 Or Organization(s): Location And Description Of Completed Operations ^86-qE UGa 45gi =04 E_ IE 4g=&M �E�e iaa� ei Et�iAgE&— ?6iko Afok5 E���ie�i�� ®iE�Ea E�iI��i �Etr�L1�i= et &j;; -e;th-M iE�=68t&g-4=5Ai 48MK I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I 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 dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 13