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2021/06/29 Clearwater Pipeline, Inc. (3)CLEAPIP-01 'z'#� `J CERTIFICATE OF LIABILITY INSURANCE DA6/28/20221 TE ) 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 # 0757776 A, cr Chad Bill HUB International Insurance Services Inc. PO Box 5345 I , E■n: �9�1j 779-8549 _(A_c_ , Ho_);(951] 742-4679 Riverside, CA 92517 %W&35; chad.hiil@hubintemational.EOrti INSURED Clearwater Pipeline, Inc. P.O. Box 357 Perris, CA 92572 INSURER A: MIQQIeSe,. INSURER B : Benchma INSURER C : INSURER D : INSURER E : INSURER F : f^r%lkIa0A P_CC 9�=0T1CW%ATC klllRARGQ• F]C►►1QIf1N111111ailmr- . 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. INSR TYPE OF INSURANCE ADDLJNSDi SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE !"'! OCCUR PD Ded: $2,000 X 40177373004 6/29/2021 6/29/2022 EACH OCCURRENCE 1,000,000 $ pAEMIG TO RENTED 100,000 X ED EXP JAny oneperson) $ 15,000 PE ONAL&ADV INJURY 1,000,000 GEN'LAGGREWE LIMIT APPLIES PER: PRO- LOC POLICY N JECT OTHER: G NERALAGGREGATE 2,000,000 FJJOPUQTg -COMPJOPAG 2,000,000 POLLUTION 1,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS NON -OWNED AUTOS ONLY N AUTOSPer A0177373001 6129/2021 6129/2022 COMBINED nbSINGLE LIMIT �� „ono 1> 000 >OO O X BODJLY INJURY IPer erson BODJLY INJURY Per accident X PROPERTY DAMAGE acciden UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE 5/1/2021 5/1/2022 EACH OCCURRENCE AGGREGATE DED I I RETENTION $ X PER OTH- B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YrN ANY PROPRIETOR/PARTNER/EXECUTIVE Mandatory in NHR EXCLUDED? If yes, describe under DESCRIPTION OF OPERATIONS below N / A CST5021525 E.L EAGH ACCIDENT 1,000,000 $ E.LDISEASE-EAEMPI.OYE 1,000,000 L.L. DISEASE -POLICY LIMIT 1,000,006 S DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES IACORD 101, Additional Remarks Schedule, may be altached ifnicM space is required) City of Menifee is Additional Insured with regard to General Liability when required by written contract per the attached endorsement form CG2010 04/13. City of Menifee 29714 Haun Road Menifee, CA 92586 ACORD 25 (2016/03) 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 ,X,, - ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: A0177373004 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 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) Location(s) Of Covered Operations Any person or organization you are required to add as All locations per written contract, agreement or an permit. additional insured under a written contract or Description: agreement All jobs performed that have a written contract, in effect prior to any accident, injury, loss or damage. agreement, or permit. 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. CG 2010 0413 A0177373 Middlesex 1 00001 0000000000 21175 0 N 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. © Insurance Services Office, Inc., 2012 7aOa8a1e-2c36-497e-9178-e878e806c08a Page 1 of 2 06/24/2021 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 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. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 A0177373 06/24/2021 Middlesex