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2021/10/25 Reliable Concrete Accessories (6),A<:C)Ri}CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGAI1VELY 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 HOLOER. IMPORTANT: lf the certificat€ holder is an ADOITIONAL INSUREO, th€ policy(ios) must have ADDITIONAL INSUREO provisions or be endorsed. lf SUBROGATION lS WAIVED, subject to the terms and condilions of lhe policy, ce(ain polici* may requir6 an endorsement. A statement on thi6 certificate does not confor rights to the certificale holder in lieu of Buch endo.sement(s)- PRooucER Edoewood Partners lnsurance Center {EPIC)19d00 MacArthur Blvd. PH Floor Irvine, CA 92612 www edgewood ns com (949)263-0606 (949) 263-0906 INSURER(S) AFFOROING COVERAGE TNSURERA: Pennsylvanra Lumbermens Mutual lnsurance Co.1497 4 rNsuirER s, Security Natonal lnsurance Conrpany 19879 TNSURERC: Grcat American lnsurance company 16691 COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY TIIAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED MMED ABOVE FOR TI.]E POLICY PERIOD INDICATED NOTWTHSTANOING ANY REOU REMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO W}IICH THIS CERTIFICATE I\,IAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCR1BED HEREIN IS SUSJECT TO ALL THE TERMS, EXCLUSIONS AND CONO1TIONS OF SUCH POLICIES, LIMITS SHOVIN MAY HAVE EEEN REOUCEO AY PAIO CLAIMS. r 1,000 000 i 100 000PREM SES (E. o.cufl6^c.) s5 000MED ExP (Any on. p.6on) s1 000 000PERSONALAAOVINJURY s2 000.000GENERAL AGGRECAIE ,2 000 000PRODIJCTS . COM P/OP AGG COMMERCIAL GENERAL LIABILITY GEN L AGGREGAIE LIMIIAPPL]ES PER JECT 04,R013-01-21 14t2512021 10t25t2422 COMB]ITEO S]NGLE L M'I sl 000 000 BODILY INJURY (P'I PdsON) BoDILY NJURY (P6r.cc'd.n0 10t25t2022 s SCHEOULED AIJTOMOBILE LlAAIL]lY a4-R413 02 21 1012512021 t5 000,000 t5 000.000 I 04-R013-03-21 10t2512421 1At2512422 errror.r t 1o 000 s $ 1.000 000 s 1 000 000E L OISEASE , EA EM PLOYEE E L OISEASE. POLICY LIMIT t 1,000 000 IIDR(ERSCOMPENSATION ANO EIIPLOYENS' LIAAIuIY ANYPROPRIETOR/PARTNER/EXECUTVE OFf ICER/MEiTBER EXCLUOED? nFs.R PrnN oF oPFRAroNs eh* s\ ,c1361650 1011t2022 1011t2023B 10t2512022 10125n022 $3.807,441 73 $2,500 Oeductible; ACV $5,000.000 Each Occurence $5.000.000 Aooreoate Limit C lnland Ma.rne ' Scheduled Equipmeni Excess Liabrlity $sMM Excess of $sMIv 04-R013-01-21 TAU95OO 10t2512021 10t25t2021 DESCRTPITON OF OPERATTONS I LOCATTONS ' VEH|CIE9 (ACORD r0r, Addl onrl R.mrtr sch.dul., dy b. .ir.ch.d n l]ld .p.c. ir Gquindl The Crly of Menrfee The City of l\,,tenifee Community Servrces the Menifte Housing Authonty and each of therr officers offlcals empby6es. agents and \,olu'nteers are included asAddrtronal lnsureds as respecticeneral Lrabrl[y and Aulomobrle Lrabrlrty rnsurance per attached endor&menti Pnmary and Non-Contnbutory l /brdrng apphes per atlached endorsement {s) \ brver of Sqbrogalron on vlbrkers Compensation and Efirployers Llabil y insirrance as respects lo ihe City o:f Menilbe, the Cily of Menfee Community Servrces Districl. the Minilbe Housing Aulhority and each oftheir officers, employees, agents and volunleers per a(eched endorsement Citv of lvlenifee 29844 Haun Road Menifee CA 92583 SHOULO ANY OF THE ABOVE OESCRIBEO POLICIES AE CANCELLEO BEFORE T}tE EXPIRATION DATE THEREOF. NOTICE wlLL BE DELIVEREO IN ACCOROANCE wlTH TTIE POLICY PROVISIONS, Y8'*- - CERTIFICATE HOLDER acoRD 25 (2016/03) CANC LATION O'1988-2015 AcORD CORPORATION. All rights resorved Tho ACORD namo and logo aro rogiato,od marks ofACORD 'ncels and supersedes ArL ple;iou'sly lssued celtificates Reliable Concrete Accessories 7600 Redondo Circle Huntington Beach CA 92648 f o""r^ I ,.'d,p 'dncels dnd sJpers.des AII prevrously rssued certrrr.aEes. tot22t20)t THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BROAD FORM ADDITIONAL INSURED COMN,4ERCIAL GENERAL LIABILITY COVERAGE PART 1. Broad Form Additional lnsured Paragraph 2. of Section ll - Who ls An lnsured of Commercial General Liatility Coverage Form CG 00 01 is amended to add rle following: e. Additional lnsured byWritten Contract orWritten Agreement The tollowing are insureds under the policy when you have agreed in a written contract or agreement to provide them coverage as additional insureds under your policy: (1) Lessors of Leased Equipment: person(s) or organization(s) who lease equipment to you, but only with respect to their liability ,or "bodily injury", "property damage" or "personal and advertising injury" arising out of or caused, in whole or in part, by the maintenance, operation or use of such equipment by you, your "employees', "temporary workers" or "volunteer workers". With resped to the insurance atforded to hese additional insureds, this insurance does not apply to any "occurrene' which takes place afler the equipment lease expires. (21 Owners, Managers or Lessors oI Premises or Land: any owner, manager or lessor of premises or land, but only with respect to their liability arising out of or caused, in whole or in part, by ownership, maintenance or use ofthat part of such premises or land leased to you. This insurance does not apply to: (a) Any "occunence" which takes place after you cease to be a lenant or lessee of such premises or landt or (b) Structural alterations, new construction or demolition operations performed by or on behalf of the owner, manager or lessor of such premises or land. (3) Mortgagees, Assignees or Receivers: any person(s) or organization(s) with respect to their liability as your mortgagee, assignee or receiver and arising out of their ownership, maintenance or use of your premises. This insurance does not apply to: Any structural alterations, new construction or demolition operalions performed by you or others for such person or organization. (4) Any person or organizalion, other than a joint venture, for whom you have agreed by written contract to provide "bodily injury" or "property damage' liability insurance, but only for liability arising out of or caused, in whole or in part, by operation(s) performed by you or on your behalf, provided that: (a) This Subparagraph (4) does not apply to any agreement to provide insurance to: (i) Any "employee", associalion of "employees" or labor union, except with respect to work performed by or for you or for such "employee", association of "employees'or labor union under direct conlract between you as contractor and such "employee", association of "employees" or labor union as ownersi LUM-145 02 06 Rcliablc ( oncrete Accessorics 01-tt0t3l)t-2 t COMMERCIAL GENERAL LIABILITY LUM-145 02 06 This endorsement modifies insurance provided under the following; Pennsylvania Lumbermens lvlutual lnsurance Company Philadelphia. Pennsylvania Page I of 3 (ii) Any railroad company except with respect lo work performed by you or for you for such railroad company under direct contEct or agreement between you and such raalroad company; (iii) Any person or organization whose profession, business or occupation is that of an architect, surveyor or engineer with respeci to liability arising out of preparation or approval of maps, drawings, opinions, reports, surveys, change orders, designs or speciflcations; giving directions or instructions; failing to give directions or instructions: or the performance of any other professional services by such person or organization; (iv) Any of your contractors or subcontractors or any parher, oflicer, agenl or "employee" of such conlraclors or subcontraclors; and (v) Anyone described in Paragraphse.(1) through (3) above. (b) lf a vendor of 'your producls' is an additional insured under this Coverage Form, such insurance as provided to the additional insured applies only with respect to "bodily injury" or "properly damage" arising out of "your products'which are distributed or sold in the regular course of the vendois business and subjec{ lo the following additional exclusions. This insurance does not apply to; (i) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of assumption of liability in a conlract or agreemenl. This exclusion does not apply to liability that the vendor would have in the absence of the contract or agreement; (ii) Any expressed warranty of your 'products" unauthorized by youi (iii) Any physical or chemicalchange in 'your products" made intentionally by such vendori (iv) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing or the substitution of parts under instructions from you or the manufaclurer, and then such parb are repackaged in the original container; (v) Any failure to make such inspeclions. adjustrnents, tests or servicing as the vendor has agreed to make, or normally undertakes to make in the normal course of business, in connection with the distribution or sale of "your prodlcts'i (vi) Demonstralion. installation, servicing or repair operations except such operations performed at the vendor's premises in cmneclion with the sale of "your products ; or (vii) Any of "your products" which, afler distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any olher item or subslance by or for the vendor This insurance afforded to the vendors in (4Xb) above does not apply to any person or organization from whom you have acquired such producls, ingredients, parts or containers entering into, accorpanying or containing "your products". No insurance is provided under this vendor's coverage in (4Xb) if "bodily iniury" or "property damage" under the "productstompleted operations hazard" is excluded by any exclusions or provisions of this Coverage Form or by any endorsement. (c) The insurance afforded to any person or organization as an insured under Paragraph 2.e.(1) lhrough (4)above: (i) Shall include only that insurance required to be provided by the terms of such agreemenl, and then only to the extent that such insurance is induded within the terms of this policy, and that person's or organization's status as an additional insured under this endorsement ends: (a) when your operalions for that additional insured are completed or (b) when any written contracl or agreemenl with such person or organization is terminated or expires. Pennsylvania Lumbermens Mulual lnsurance Company Philadelphia. PennsylvaniaLUM-145 02 06 '' e 'dr .'ct" -nJ su!.rse,es ALL prcvlou€ly tssJ.d cerrl'jcate3. Page 2 of 3 (ii) Does not apply to 'bodily injury" or "prope(y damage" included within the "products- completed operations hazard" unless such coverage is required by an "insured contract" between you and the additional insured. (iii) ls subject to all applicable exclusions o, Paragraph 2. Exclusions, Coverage A (Section l). (iv) Does not include any person or organization included as an insured under the provisions of Section ll - Who ls An lnsued or included as an additional insured by any other endorsement to this policy. (d) The limits of insurance afforded lo such additional insureds shall be the lesser of the limits required by any contract or agreement between the parties or provided by this pdicy. (e) The insurance afforded to any person or organization as an additional insured under this Paragraph 2.e.(1) through (4) does not apply to "bodily injury" or "property damage" which occurs prior to the date of your contract or written agreement with such person or organi2ation. 2. Other lnsurance The insurance afforded to any additional insured under Paragraph 2.e.(1) through (4) will be primary and non- contributory if required by such contract or agreement with you. 3. Waiver of Right of Recovery by Written Contract or Agrcement We waive any right of recovery to payments we make for injury or damages arising out of your ongoing operations or "your work' included in the 'products-completed operations hazard". This applies to any person or organization with whom you have agreed in a written contract or agreemenl made prior to the date of the "occurrence" to waive your rights of recovery from such person or organization, but only for payments made under this insurance as a consequence of such contract or agreenEnt. LUM-l45 02 06 Pennsylvania Lumbermens Mutual lnsurance Company Philadelphia, Pennsylvania 6ii!6r!r r :r/l: y.u.gb.rq I 10/r2l?o?1 3:0r:.rr ax lpol) p.qe 4 0f 5This c-prlrficaLe cancels and supers.des ALt pre;iou-sly issued celrirlcales. Page 3 of3 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY wc 00 03 '13 (Ed.04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Schedule Any person or organization as required by written contract This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Efleclivefi1g112s22 Policy No. s\,c1361650 Endorsement No. lnsured p";;"6" 6on"reteAccessories lnsurance Company Security National lnsurance Company Countersigned by wc 00 03 13 (Ed.04-84) 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 organizalion named in the Schedule. (This agreement applies only to the exlent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Q\Ys*- tatnqLefq I ra/22/zot1 s:01:34 e (pm) I paqe 5 or 5 ''rtd 'd' 'al' drd supe,s.de. Al trevrouql, 'ssred --r...j-drpq.