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2020/05/01 NV5, Inc. Certificate of Liability Insurance (7)The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $ UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 5/19/2020 Cavignac &Associates 450 B Street,Suite 1800 San Diego CA 92101 Certificate Department 619-744-0574 619-234-8601 certificates@cavignac.com Valley Forge Insurance Company 20508 NV5INC0-01 Continental Casualty Co.20443NV5,Inc. 15092 Avenue of Science,Suite 200 San Diego,CA 92128 Transportation Insurance Co.20494 Berkley Insurance Company 32603 1735012266 A X 1,000,000 X 1,000,000 X Cross Liab 15,000 X $0 Deductible 1,000,000 2,000,000 X X X Y 6057040530 5/1/2020 5/1/2021 2,000,000 Deductible 0 B 1,000,000 X Y 6057040575 5/1/2020 5/1/2021 C N Y WC657040558 5/1/2020 5/1/2021 X 1,000,000 1,000,000 1,000,000 D Professional Liability AEC903639504 5/1/2020 5/1/2021 Each Claim Aggregate $10,000,000 $20,000,000 Re:FY2019/20 ON-CALL ENGINEERING SERVICES (LAND DEVELOPMENT REVIEW).Additional Insured coverage applies to General Liability and Automobile Liability for City of Menifee,its officers,agents,employees and authorized volunteers per policy form.Waiver of subrogation applies to Workers Compensation per policy form.Primary coverage applies to General Liability and Automobile Liability per policy form.If the insurance company elects to cancel or non-renew coverage for any reason other than nonpayment of premium they will provide 30 days notice of such cancellation or nonrenewal.Professional Liability -Claims made form,defense costs included within limit. 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3DJH RI ,QVXUHG 1DPHNV5 Global, Inc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lobal, Inc. &RS\ULJKW&1$$OO5LJKWV5HVHUYHG,QFOXGHVFRS\ULJKWHGPDWHULDORI,QVXUDQFH6HUYLFHV2IILFH,QFZLWKLWVSHUPLVVLRQ This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Information required to complete this Schedule, if not shown above, will be shown in the Declarations. It is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To The Insurer is amended by the addition of the following: Solely with respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured’s ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. SCHEDULE Name Of Person Or Organization: Any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement. Policy No: 6057040530 Policy No: 6057040530; 6057040575CUE6076054554 Form No: CNA68021XX (02-2013) Endorsement Effective Date: 05/01/2020 © Copyright CNA All Rights Reserved. It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS &IVOPI]-RWYVERGI'SQTER]4EKISJ ;LIRIZIVTVMRXIHMRXLMW)RHSVWIQIRXXLIFSPHJEGIX]TIXIVQWWLEPPLEZIXLIWEQIQIERMRKWEWMRHMGEXIHMRXLI4SPMG]*SVQ%PPSXLIVTVSZMWMSRWSJ XLI4SPMG]VIQEMRYRGLERKIH -RWYVIH 2:+PSFEP-RG Policy Number AEC903639504 %YXLSVM^IH6ITVIWIRXEXMZI)JJIGXMZI(EXISJ8LMW)RHSVWIQIRX 05/01/2020 &(4 4SPMG]*SVQ&(4 Policy No: 657040558; 657040561 Form No: CC68021A (02-2013) Endorsement Effective Date: 05/01/2020 © CNA All Rights Reserved. It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS 3ROLF\1R:& 20 Policy No. WC657040558