2021/02/05 Allied Traffic and Equipment Rentals, Inc.aconi:"
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
oArE (ra oo/YYYY)
09/09i2021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NOCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENO, EXTEND OR ALTERBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BEREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
RIGHTS UPON THE CERTIFICATE HOLDER. THIS
THE COVERAGE AFFORDED BY THE POLICIES
TWEEN THE ISSUING INSURER(S), AUTHORIZED
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CM VANTAGE SPECIALTY INSURANE CO
EI\,4PLOYERS MUTUAL CASUALTY COI,4PANY
\7 14) 7 44-6537
ibinc.corn
Carol Knox. Debbie Waller or Kory Butler
4)
INSURER(SI AFFOROING COVE
744-3300
,91@.tgtq ncC DW b Koler@gi.v@
co
INSURER B
PRODUCER
KGIB, INC.
KNOX GENERAL INSURANCE BROKERS
226 SOUTH GLASSELL STREET
ORANGE cA 92866
[,4 URRIETA cA 92s62-8842
Nsunen c: STATE COMPENSATION INSURANCE FUND 35076
INSURER E
15872
21415
nsueen o CERTAIN UNDERWRITERS AT LLOYD'S
F
TH|S rS
INDICAT
CERTIF
EXCLUS
TO CERTIFY THAT THE POLICIES OF INSURANCED, NOTWITHSTANDING ANY REOUIREMENT, T
CATE MAY BE ISSUED OR MAY PERTAIN, THE
IONS AND CONOITIONS OF SUCH POLICIES, LIMIT
E LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEOERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENINSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN
S SHOWN MAY HAVE BEEN REOUCED BY PAIO CLAIMS.
ABOVE FOR THE POLICY PERIOD
T WITH RESPECT TO WHICH THIS
IS SUBJECT TO ALL THE TERMS
X EACH OCCURRENCE
OAMAGE IO RENTEDPREMISES rE6occuii6n.el
MED EXP (Any on. o66on)
PERSONAI & AOV INJURY
X
cMVPLr0010027-04 49t11t2021 09t1112022
PROOUCTS. COMP/OP AGG
x
COMMERCIAL GEI.IERAL LIAEILITY
GEN'L AGGREGATE LIMITAPPLIES PER
,o.,"" f !l"g [ro"
OTHERi
GENERAL AGGREGATE
1,000,000
EXCLUDED
300,000
1,000,000
2,000,000
2.000,000
BODILY INJURY (Por p6rson)s
s 1,000,000c
B OWNEOAIJTOS ONLY
HIREO
AUTOS ONLY
481 33 09X-
Xx
AUTOMOgILE LIABILITY
SCHEOULEO
AUTOS
NON.OWNEOAUIOS ONLY
ozou,ro21I o2/[u,ro.12 EODILY INJURY (Por sccident)S
5
$
X EACH OCCURRENCEI'MBRELLA LIAE
EtcEss LlAa
OED
X CLAIMS.MAOE cMVEXL0011741-04 0911112021 agh 112022 AGGREGATE
loNs s
s 1,000,000
s 1 000,000
XWORKERS COMPENgAlloN
AND EMPIOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUIIVE
OFFICER'MEMBER EXCLUDEO?
DEsaR|PTroN oF opFRAroNs h"r"*
05101t2021 05tolt2022C
TE
Lt ui
E L, EACH ACCIDENT
E L OISEASE. POLICY LIMIT
$ 1,000,000
s 1,000,000
$ 1,000 000
PROFESSIONAL LIABILITY
D
$1,000,000 per any
lncludes all cosls &
on claim
6Xpenses
RIPTION Of OPERATIONS / LOCAIIONS / VEHICLES (ACORD 101 , Addillon.l Rio..l. Sch.dul., h.y b. .tt ch.d lt mor. .p.c. i. r.quird)
REr CITY PERMIT
THE CITY OF MENIFEE IS NAMED AS ADDITIONAL INSURED PER FORM CG2OlO 04 13 WITH RESPECT TO GENERAL LIABILITY
0Esc
CERTIFICATE HOLDER CANCELLATION
CITY OF MENIFEE
ENGINEERING DEPARTMENT
29714 HAUN ROAD
MENIFEE cA 92586
AUII,lORIZED REPRESENTAIIVE
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o '1088-2015 ACORD CORPORATTON. All rights resorvodacoRD 25 (2016i 03)The ACORD namo ahd logo are reglstered marks of ACORD
CERTIFICATE OF LIABILITY INSURANCE
ALLIED TRAFFIC AND EQUIPMENT RENTALS, INC,
41806 IVY STREET
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SHOULO ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLEO BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE OELIVEREO IN
ACCOROANCE WTH THE POLICY PROVISIONS,
POLICY NUMBER: CMv.PLt-0010027-04
This endorsement modifies insurance provided under the following
COMIVIERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
A. Section ll - Who ls An lnsured 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 forthe additional insured(s) at the tocation(s)
designated above.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. lf coverage provided to the additional insured isrequired by a contract or agreement, the
insurance afforded to such additional insuredwill not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
COMMERCIAL GENERAL LIABILITY
cG 20 't0 04 13
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 suchwork, on the project (other than service,
maintenarce or repairs) to be performed by oron 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.
Name Of Additional lnsured Person(s)
OrO anization S Location erationssOf Covered O
Any Persons or Organizations who you are requir6d to add as an
additional insured on this policy und€r a written conkacl or wrillen
agreement in effecl prior lo any loss or damage, but only to the extenl
requir6d in the written contract or written agaeement, including any
amounls or [mits specified.
All Operations as required by written contract
cG 20,t0 04 13 O lnsurance Services Office, lnc.,2012 Page 1 of 2
lnformation required to completq this Schedule, if not shown above, will be shown in the Declarations.
C. With respect to the insurance atforded to these
additional insureds, the following is added to
Section lll - Limits Of lnsurance:
lf 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 agreementi or
2. Available under the applicable Limits
lnsurance shown in the Declarations,
whichever is less.
This endorsement shall not increase
applicable Limits of lnsurance shown in
Declarations.
of
the
the
Page 2 of 2 @ lnsurance Services Office, lnc.,2012 cG 20 10 04 13