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2020/08/01 L & S Construction, Inc. Certificate of Liability InsuranceL&SCONS-01 MBRANDMAI+ ,a►� O CERTIFICATE OF LIABILITY INSURANCE DATE71281DDrfYYY) _ r2sr2a2o 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. subiect to the terms and rnnrutinnc of fhe nnn -- --- .-----�. --. ._... r-...............� ..y.... . �.. �.....acnrcn.. rthis certificate does not confer rights to the certificate holder in liea�a�arnenL vn u of such endorsementfsl. PRODUCER License 9 0757776 CONTACT NAME_ _ Newport Beach, CA - HUB International Insurance Services Inc. ° 4695 MacArthur Court tarc_N, _-o_E-e-s}:(948 623-3980 r Suite 600 I Newport Beach, CA 92660 891-0407 maua<nn A: rrce:c:ul1YC iSl.^i11 1I1G7CIrinply Join INSURED INSURER B: Federal Insurance Company 20281 L & S Construction, Inc. I0SVRhFt C: 674 North Batavia Street INSURER D : Orange, CA 92868 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 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. IL TYPE OF INSURANCE AODL SueR POLICY EFF [ POLICY EXP l - - f POLICY NUMBER tMMn)D/YYYYI FMMIDDIYYYYI LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Flo ' A I OCCUR X 54303181 I 8/1/2020 8/1/2021 GEN'L AGGREGATE LIMIT APPLIES PER: , [Li] POLICY � dl:CrE LOC X I OTHER: Per Proj Gal% Agg per contract B I AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUUTOnSyy ❑ AUTOS ONLY AE]TpS 'lRL UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE DED F RETENTION S B WORKERS COMPENSATION AND EMPLOYERS'LIABILMY YIN ANY PROPRIEfOWPARTNERIEXECUTIVE pFFiCandatoryEWMEMgER E_NCLUDED7 N I [Mfn HHJ IF Yes. describe under 1,000 2,000 80 J 8/1/2020 I 8/1/2021 8/1/2020 1 8/1/2021 I E-L1=ACIfacc117FNT __ s 1,000, 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Romarks Schedule, may beattachad IF more space Is required) RE: Encroachment Permit for L & S Construction, Inc. Job #434. Watt Communities at Mosaic, LLC. Project Address: Tract 28206, Garbani Road and Palomar Road, Menifee, CA. glai City of Menifee is included as Additional Insured where required by an executed written contract as respects General Liability per attached endorsements. CERTIFICATE HOLDER City of Menifee 29714 Haun Road Menifee, CA 92586 ACORD 25 (2016/03) CANCELLATION 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 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: L&SCONS-01 MBRANDMAN LOC #: 1 ACQRE)' %.� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY License # 0757776 NAMED INSURED Newport Beach, CA - HUB International Insurance Services Inc. L & S Construction Inc. 1674 North Batavia street POLICY NUMBER Orange, CA 82868 SFF PAGE 1 CARRIER NAIC CODE f EE PAGE 1 _ SEE P I EFFEcTroeDATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Cancellation: Should the policy(ies) be cancelled before the expiration date, Hub International Insurance Services Inc. (Hub), independent of any rights which may be afforded within the policies to the certificate holder named below, will provide to such certificate holder notice of such cancellation within thirty (30) days of the cancellation date, except in the event the cancellation is due to non-payment of premium, in which case Hub will provide to such certificate holder notice of such cancellation within ten (10) days of the cancellation date. __ __ ] ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 54303181 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 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 Organization s Locations Of Covered Operations WHERE REQUIRED BY WRITTEN CONTRACT. ALL LOCATIONS WHERE 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 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) designated above. 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 additional exclusions apply: This insurance does not apply to "bodily injury" 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 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 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 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. 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 rartijirpd by n r..ontrart or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 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. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: 54303181 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations ALL LOCATIONS WHERE REQUIRED BY WRITTEN CONTRACT. WHERE REQUIRED BY WRITTEN CONTRACT, BUT ONLY WHERE THE CONTRACT SPECIFIES COVERAGE FOR COMPLETED OPERATIONS. 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: 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. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1