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2021/07/08 TR Design Group, Inc.ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 10/10/2022 License # 0757776 (951) 779-8558 (951) 231-2572 24082 TR Design Group, Inc. 2900 Adams St., Ste. A400 Riverside, CA 92504 34690 19437 A 2,000,000 X BZS (23) 56 41 41 95 5/8/2022 5/8/2023 2,000,000 15,000 2,000,000 4,000,000 4,000,000 2,000,000A X BZS (23) 56 41 41 95 5/8/2022 5/8/2023 B X 72 WEC EV4335 11/22/2021 11/22/2022 1,000,000 Y 1,000,000 1,000,000 C Professional Liab.031711121 7/8/2021 Ded $25K/EAClaim Lmt 1,000,000 C Professional Liab.031711121 7/8/2021 11/22/2022 Aggregate 2,000,000 RE: Architectural & Engineering Services for CIP 21-03 Fire Station No. 68 Improvements Project. The City of Menifee and its officers, employees, agents, authorized volunteers and all persons or entities are Additional Insured with regard to the General Liability and Auto Liability policy, when required by written contract, per the attached endorsement form BP7996 09/16. Coverage is Primary & Non – Contributory with regard to the General Liability policy, when required by written contract, per the attached endorsement form BP1488 07/13. Waiver of Subrogation applies to the Workers Compensation policy, when required by written contract, per the attached endorsement form WC040306(1). Should the policies be cancelled before the expiration date, Hub International Insurance Services Inc. (Hub), independent of any rights which may be afforded SEE ATTACHED ACORD 101 The City of Menifee Attn: Paula Muratore 29844 Haun Road Menifee, CA 92586 TRDESIG-01 KCHINNAVEL HUB International Insurance Services Inc. PO Box 5345 Riverside, CA 92517 Kristie Koehrer Cal.CPU@Hubinternational.com Ohio Security Insurance Company Property and Casualty Insurance Company of Hartford Lexington Insurance Company X 11/22/2022 X X X X X DocuSign Envelope ID: C1FE3DD5-5282-4F10-8EDF-68DEABB7F223 FORM NUMBER: EFFECTIVE DATE: The ACORD name and logo are registered marks of ACORD ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE FORM TITLE: Page of THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 101 (2008/01) AGENCY CUSTOMER ID: LOC #: AGENCY NAMED INSURED POLICY NUMBER CARRIER NAIC CODE © 2008 ACORD CORPORATION. All rights reserved. HUB International Insurance Services Inc. TRDESIG-01 SEE PAGE 1 1 SEE PAGE 1 ACORD 25 Certificate of Liability Insurance License # 0757776 1 SEE P 1 TR Design Group, Inc. 2900 Adams St., Ste. A400 Riverside, CA 92504 SEE PAGE 1 KCHINNAVEL 1 Description of Operations/Locations/Vehicles: 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. DocuSign Envelope ID: C1FE3DD5-5282-4F10-8EDF-68DEABB7F223 128 180ofBUSINESSOWNERS BP 79 96 09 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASEREAD IT CAREFULLY. BUSINESSOWNERS LIABILITY EXTENSION ENDORSEMENT 2016Liberty Mutual Insurance BP 79 96 09 16 Page 1 of 4Includes copyrighted material of Insurance Services Office, Inc.,with its permission. This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGEFORM Below is a summarization of the coverages provided by this endorsement. No coverages are given by this summary. Actual coverage descriptions are within this endorsement. SECTION SUBJECT A.Supplementary Payments Bail Bonds Loss Of Earnings B.Broadened Coverage For Damage To Premises Rented To You C.Incidental Medical Malpractice Injury D.Mobile Equipment E.Blanket Additional Insured (Owners, Contractors Or Lessors) F.Newly Formed Or Acquired Organizations G.Aggregate Limits H.Duties In The Event Of Occurrence, Offense, Claim Or Suit I.Liability And Medical Expenses Definitions Bodily Injury Insured Contract Personal And Advertising Injury Section II - Liability is amended as follows: A. Supplementary Payments Section A.1. Business Liability is modified as follows: 1.The $250 limit shown in Paragraph A.1.f.(1)(b) Coverage Extension - Supplementary Payments for the cost of bail bonds is replaced by a $3,000 limit. 2.The $250 limit shown in Paragraph A.1.f.(1)(d) Coverage Extension - Supplementary Payments for reasonable expenses and loss of earnings is replaced by a $500 limit. B. Broadened Coverage For Damage To Premises Rented To You 1.The last paragraph of Section B.1. Exclusions - Applicable To Business Liability Coverage is replaced by the following: With respect to the premises which are rented to you or temporarily occupied by you with the permis- sion of the owner, Exclusions c., d., e., g., h., k., l., m., n.and o.do not apply to "property damage". Insured: TR Design Group, Inc. Policy No.: BZS (23) 56 41 41 95 Policy Period: 5/8/2022 to 5/8/2023 DocuSign Envelope ID: C1FE3DD5-5282-4F10-8EDF-68DEABB7F223 129 180of564141950026652802016Liberty Mutual Insurance BP 79 96 09 16 Page 2 of 4Includes copyrighted material of Insurance Services Office, Inc.,with its permission. 2.Paragraph D.2. Liability And Medical Expenses Limits Of Insurance is replaced by the following: The most we will pay under this endorsement for the sum of all damages because of all "property damage" to premises while rented to you or temporarily occupied by you with the permission of the owner is the Limit of Insurance shown in the Declarations. 3.Paragraph D.3. Liability And Medical Expenses Limits Of Insurance does not apply. C. Incidental Medical Malpractice Injury 1.Paragraph (4)under Paragraph B.1.j. Exclusions - Applicable To Business Liability Coverage - Profes- sional Services does not apply to "Incidental Medical Malpractice Injury" coverage. 2.With respect to this endorsement, the following is added to Section F. Liability And Medical Expenses Definitions: a."Incidental Medical Malpractice Injury" means bodily injury arising out of the rendering of or failure to render, during the policy period, the following services: (1)Medical, surgical, dental, x-ray or nursing service or treatment or the furnishing of food or beverages in connection therewith; or (2)The furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances. b.This coverage does not apply to: (1)Expenses incurred by the insured for first-aid to others at the time of an accident and the Duties in the Event of Occurrence, Offense, Claim or Suit Condition is amended accordingly. (2)Any insured engaged in the business or occupation of providing any of the services described under a.above. (3)Injury caused by any indemnitee if such indemnitee is engaged in the business or occupation of providing any of the services described under a.above. D. Mobile Equipment Section C. Who Is An Insured is amended to include any person driving "mobile equipment" with your permission. E. Blanket Additional Insured (Owners, Contractors Or Lessors) 1.Section C. Who Is An Insured is amended to include as an insured any person or organization whom you are required to name as an additional insured on this policy under a written contract or written agreement. The written contract or agreement must be: a.Currently in effect or becoming effective during the term of this policy; and b.Executed prior to the "bodily injury", "property damage", or "personal and advertising injury". 2.The insurance afforded to the additional insured is limited as follows: a.The person or organization is only an additional insured with respect to liability arising out of: (1)Real property, as described in a written contract or written agreement, you own, rent, lease, maintain or occupy; and (2)Caused in whole or in part by your ongoing operations performed for that insured. b.The Limit of Insurance applicable to the additional insured are those specified in the written contract or written agreement or the limits available under this policy, as stated in the Declara- tions, whichever are less. These limits are inclusive of and not in addition to the Limit of Insurance available under this policy. c.The insurance afforded to the additional insured does not apply to: (1)Liability arising out of the sole negligence of the additional insured; (2)"Bodily injury", "property damage", "personal and advertising injury", or defense coverage under the Supplementary Payments section of the policy arising out of an architect’s, en- gineer’s or surveyor’s rendering of or failure to render any professional services including: DocuSign Envelope ID: C1FE3DD5-5282-4F10-8EDF-68DEABB7F223 130 180of2016Liberty Mutual Insurance BP 79 96 09 16 Page 3 of 4Includes copyrighted material of Insurance Services Office, Inc.,with its permission. (a)The preparing or approving of maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and (b)Supervisory, inspection, architectural or engineering activities. (3)Any "occurrence" that takes place after you cease to be a tenant in the premises described in the Declarations; or (4)Structural alterations, new construction or demolition operations performed by or for the person or organization designated in the Declarations. 3.Any coverage provided hereunder shall be excess over any other valid and collectible insurance avail- able to the additional insured whether primary, excess, contingent or on any other basis unless a contract specifically requires that this insurance be primary or you request that it apply on a primary basis. F. Newly Formed Or Acquired Organizations The following is added to Section C. Who Is An Insured: Any business entity acquired by you or incorporated or organized by you under the laws of any individual state of the United States of America over which you maintain majority ownership interest exceeding fifty percent. Such acquired or newly formed organization will qualify as a Named Insured if there is no similar insurance available to that entity. However: 1.Coverage under this provision is afforded only until the 180th day after the entity was acquired or incorporated or organized by you or the end of the policy period, whichever is earlier; 2.Section A.1. Business Liability does not apply to: a."Bodily injury" or "property damage" that occurred before the entity was acquired or incorporated or organized by you; and b."Personal and advertising injury" arising out of an offense committed before the entity was ac- quired or incorporated or organized by you. 3.Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. G. Aggregate Limits The following is added to Paragraph D.4. Aggregate Limits Liability and Medical Expenses Limits Of Insurance: 1.The Aggregate Limits apply separately to each of the "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. 2.The Aggregate Limits also apply separately to each of your projects away from premises owned by or rented to you. For the purpose of this endorsement only, "location" means premises involving the same or connect- ing lots, or premises whose connection is interrupted only by a street, roadway, waterway or right- of-way of a railroad. H. Duties In The Event Of Occurrence, Offense, Claim Or Suit 1.Paragraph E.2.a. Duties In The Event Of Occurrence, Offense, Claim Or Suit Liability And Medical Expenses General Condition applies only when the "occurrence" is known to any insured listed in Paragraph C.1. Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim. 2.Paragraph E.2.b. Duties In The Event Of Occurrence, Offense, Claim Or Suit Liability And Medical Expenses General Condition will not be considered breached unless the breach occurs after such claim or "suit" is known to any insured listed under Paragraph C.1. Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim. DocuSign Envelope ID: C1FE3DD5-5282-4F10-8EDF-68DEABB7F223 131 180of564141950026652802016Liberty Mutual Insurance BP 79 96 09 16 Page 4 of 4Includes copyrighted material of Insurance Services Office, Inc.,with its permission. I.Section F. Liability And Medical Expenses Definitions is modified as follows: 1.Paragraph F.3.is replaced by the following: 3."Bodily Injury" means bodily injury, sickness, disease, or incidental medical malpractice injury sustained by a person, and includes mental anguish resulting from any of these; and including death resulting from any of these at any time. 2.Paragraph F.9.is replaced by the following: 9."Insured contract" means: a.A contract for a lease of premises. However, that portion of the contract for a lease of prem- ises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b.A sidetrack agreement; c.Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d.An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e.An elevator maintenance agreement; f.That part of any other contract or agreement pertaining to your business (including an indem- nification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization, provided the "bodily injury" or "property damage" is caused, in whole or in part, by you or by those acting on your behalf. However, such part of a contract or agreement shall only be considered an "insured contract" to the extent your assumption of the tort liability is permitted by law. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f.does not include that part of any contract or agreement: (1)That indemnifies a railroad for "bodily injury" or "property damage" arising out of con- struction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing; (2)That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a)Preparing, approving, or failing to prepare or approve, maps, shop drawings, opin- ions, reports, surveys, field orders, change orders or drawings and specifications; or (b)Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3)Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured’s rendering or failure to render professional services, including those listed in (2)above and supervisory, inspection, architectural or engineering activities. 3.Paragraph F.14.b. Personal And Advertising Injury is replaced by the following: b.Malicious prosecution or abuse of process; DocuSign Envelope ID: C1FE3DD5-5282-4F10-8EDF-68DEABB7F223 119 180of56414195002665280BUSINESSOWNERS BP 14 88 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASEREAD IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGEFORM BP 14 88 07 13 Insurance Services Office, Inc., 2012 Page 1 of 1 The following is added to Paragraph H. Other In- surance of Section III - Common Policy Condi- tions and supersedes any provision to the con- trary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance avail- able to an additional insured under your poli- cy provided that: 1.The additional insured is a Named In- sured under such other insurance; and 2.You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribu- tion from any other insurance available to the additional insured. Insured: TR Design Group, Inc. Policy No.: BZS (23) 56 41 41 95 Policy Period: 5/8/2022 to 5/8/2023 DocuSign Envelope ID: C1FE3DD5-5282-4F10-8EDF-68DEABB7F223 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date:10/07/21 Policy Expiration Date:11/22/22 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number:72 WEC EV4335 Endorsement Number: Effective Date:11/22/21 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address:TR DESIGN GROUP INC 2900 ADAMS ST UNIT A-400 RIVERSIDE CA 92504 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from us DocuSign Envelope ID: C1FE3DD5-5282-4F10-8EDF-68DEABB7F223