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2020/12/30 TNT Blanchard General Engineering, Inc.
TNTBLAN-01 MM RAL CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 71112021 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 endorsements . PRODUCER License # 0525512 CONTACT NAME Teague Insurance Agency, Inc. PHONE FAX 4700 Spring St., #400 (AIC, No, EXt : (619) 464-6851 (AI C , No):(619) 668-4715 La Mesa. CA 91942-0275 s' 6... infolMeaaueins.com INSURED TNT Blanchard General Engineering, Inc. 46750 Rainbow Canyon Road #D Temecula, CA 92592 COVERAGES CERTIFICATE NUMBER: INSURER A: Associated INSURER B : Financial P INSURER C : Redwood F INSURER D : F: EVISiON 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. INSR TYPE OF INSURANCE 12 D &EPOLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE N OCCUR X AES104399405 12/30/2020 12/30/2021 EACH OCCURRENCE $ 1,000,000 PAMAGE TO RENTED 50,000 MED EXP (Anyone erson 5,000 PERSONAL & ADV INJURY 1,000,000 GEWL AGGREGATE LIMIT APPLIES PER: POLICY 1 -- 1 LOC GENERAL AGGREGATE 2,000,000 PRDDUCTS • CD P! A 2'000,000 B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS 160507437 7/7/2021 7/7/2022 Oa.MBINED 5INGLE LIMIT 1,000,000 X BODILY INJURY Per person) BODILY INJURY Per acciden Pe�aoc�t YI AAAGE $ AUTOS ONLY AUUTO ONED UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LIAB CLAIMS -MADE $ DED I I RETENTION$ X PER OTH- STATUTE ER 7/7/2021 7/7/2022 Ci WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y}k ANY CPROPRIETOR/EXCLU R/EXECUTIVE ❑ �Izatorry in NH) EXCLUDED? If yes, describe under DESCRIPTI N OF OPERATIONS beJow N f A TNWC224488 E-L EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOY 1,000,000 E-L DISEASE - POLICY LIMIT 1 3 110001000 DESCRIPTION OF OPERATIONS r LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached_( more :;pace is required) City of Menifee is included when required by written contract/agreement as additional insured for ongoing and completed operations with respects to the general liability, performs attached. City of Menifee 29844 Houn Road 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 LJi- ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AES104399405 COMMERCIAL GENERAL LIABILITY CG20330704 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A,. Section Il — Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an addi- tional insured on your policy. Such person or or- ganization is an additional insured only with re- spect 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. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are com- pleted. B. With respect to the insurance afforded to these additional insureds: the following additional exclu- sions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal anal advertising injury" arising out of the render- ing of, or the failure to render; any professional architectural; engineering or surveying servic- es, iincluding: a. The preparing. approving, or failing to pre- pare or approve, maps, shop drawings, opi- nions, reports, surveys, field orders, change orders or drawings and specifications, or b. Supervisory. inspection, architectural or engineering activities. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice; maintenance or repairs) to be per- formed by or on behalf of the additional in- sureds) at the location of the covered operations has been completed; or b. 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 subcontrac- tor engaged in performing operations for a principal as a part of the same project. CG 20 33 07 04 I ISO Properties, Inc., 2004 Page 1 of 1 ❑ POLICY NUMBER: AES104399404 COMMERCIAL GENERAL LIABILITY CG20370704 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) Or Organ ization(s): Location And Description Of Completed Operations All persons or organizations where written contract with the Named Insured requires additional insured completed operations. This form does not apply to your work on "residential property". Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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 sche- dule of this endorsement performed for that addi- tional insured and include4i in the "products - completed operations. hazard". CG 20 37 07 04 Oc ISO Properties, Inc.. 2004 Page 1 of 1