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2021/07/01 Andy Gump, Inc.DATE (MMIDD/YYYY) ACCW"t CERTIFICATE OF LIABILITY INSURANCE 312a/2021 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 Venbrook Insurance Services NAME: T Venbrook Insurance Services 6320 Canoga Avenue, 12th Floor PHONE FAX Woodland Hills, CA 91367 (ic. Lo.E>t1; 818-598-8900 MC: 818-598-8910 E-MA u www.venbrook.com INSURED Andy Gump, Inc. 26954 Ruether Avenue Santa Clarita CA 91351 CA Lic No. OD80832 INSURER C : Alaska National Insurance Company 38733 INSURER D : Westchester Surplus Lines Insurance Co 10172 INSURER E: AGCS Marine Insurance Company 22837 INCI IRFR F COVFRAGFS r1=RTIFIli NIIMRFR• smaR017Rc RFVICIf1N NIIMRFR- 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 LTR PE ADDL UBR POLICY NUMBER POLICYEFF Y POLICYEXP YY LIMITS A COMMERCIAL GENERAL LIABILITY LA21CGL1922501C 7/1/2021 7/1/2022 EACHOCCURRENCE $1000000 CLAIMS -MADE CI OCCUR PREMl=(EI30=maMJM $ 100 000 V MED EXP (Anyoneperson) $ 5 000 BFPD/XCU/OCP J Contractual PERSONAL &ADV INJURY $ 1 000 000 $5,000 Deductible GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER : POLICY PRO- JECT I:J LOC PRODUCTS -COMP/OP AGG $2,000,000 $ OTHER. B AUTOMOBILE LIABILITY 8106P122534 7/1/2021 7/1/2022 EaMOGderDlt I LIMIT $1 000000 BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAM aCpderd $ HIRED NON -OWNED AUTOS ONLY 11,AUTOS ONLY(Per B UMBRELLA LAB H OCCUR ZUP41M3389921NF 7/1/2021 7/1/2022 EACH OCCURRENCE $7000000 AGGREGATE $ 7 000.000 EXCESS LIAB CLAIMS -MADE DED I I RETENTIONS $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? � NIA 21GWD10585 71112021 7/1/2022 J P T TE 0 ETRH E.L EACH ACCIDENT $ 1 OOO 000 E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If as, describe under DESCRIPTION OF OPERATIONS below E L DISEASE -POLICY LIMIT $ 1 O00 000 D Pollution Liability IG27462017008 7/1/2021 7/1/2022 $2,000,000 Per OcclGeneral Aggregate E Contractor's Equipment SML90342344 7/1/2021 , 7/1/2022 $14,490,139 Limit/$2,500 Deductible Leased/Rented Equipment $100,000 Limit/$2,500 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Encroachment Permit Application Certificate holder is named as Additional Insured's under the General Liability policy if required by written contract with the Named Insured but only for coverages and limits provided by the policy and the additional insured endorsement. *10 Days Notice of Cancellation for Nan -Payment of Premium, 30 Days All Others. CERTIFICATE HOLDER CANCELLATION Cit of Me nifee SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 29 14 Haun Road ACCORDANCE WITH THE POLICY PROVISIONS. Menifee CA 92586 AUTHORIZED REPRESENTATIVEAAa - �W Adrianna Padilla ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 62569785 121-22 GL/AL/EX/WC/CPL I Adrianna Padilla 16/2B/2021 1:38:53 PM (PDT) I Page 1 of 3 Andy Gump, Inc COMMERCIAL GENERAL LIABILITY LA21CGL1922501C CG 20 38 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II - Who Is An Insured is amended to include as an additional insured: 1. Any person or organization 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 additional insured on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 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 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 62569785 IGG2201,W44 , PL I Adrianna Padilla I QAnsuEanea5Sanviws (Mpe; Inc,, 2012 Pagel of 2 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 subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1.; 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. 62569785 IGG220L3aA*W*PL I Adrianna Padilla I (WosuKanGesSewiaes Office, Ne,, 2012 Page 2 of 2