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2021/10/25 Reliable Concrete Accessories (8)o.Ro'CERTIFICATE OF LIABILITY INSURANCE ]HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGANVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDEO 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 certificate holder is an ADDITIONAL INSUREO, the policy(ies) musl have AODITIONAL INSURED provisions or be endorsed. lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer righls to the cenificate holder in lieu of such endorsement(s). Edqewood Partners lnsurance Center (EPIC) 19d00 MacArthur Blvd. PH Floor lrvine, CA 92612 I 263-0906263-0606 wlwv edgewoodins com bermens Mulual lnsurance Co 1497 4 Nalronal lnsurance 19879Reliable Concrete Accessories 7600 Redondo Circle Huntington Beach CA 92&8 Great American lnsurance Co 16691 COVERAGES CERTIFICATE NUMBER: 64667086 REVISIO},I t,IUMBER: COMIUERCIAL GENERAL LIABILIIY GEN'L AGGREGATE LIMIT APPLIES PER 04 R013 01 21 14t25t2021 1At25t2022 91 000 000 1100 000 MED ExP (Any on.patson)r5 000 PERSONAL T ADV INJURY r 1,000,000 CENERAL AGGREGAIE r2.000,000 PROOLICTS COMPIOPAGC s2 000 000 AUIOMOBILE LAAIUTY DOC 04,R013 02-21 10t2512421 10125t2422 COMB|tlEO SINGL€ LIMIT 5t 000 000 AOOILY INJURY (P.r p.don) BODILY INJURY (P.r rcc'd.nr)$ ! EXCESS LIAB 04-R013-03 21 1412512021 1At2512022 r5 000 000 r5 000 000 DEO pg166111gx 310 000 B V!rcRKERg CO PENSATIOIII Al'lD E PLOYERS UABIUW ANYPROPRIETOR/PARTNER/EX€CU'IVE OFFICER/TTEMB€REXCLUOED? DESCR PTloN OFOPERATIONS b.IM svlc1361650 10t1t2021 10t112022 TE E I EACIi ACCIOENI s1 000 000 E L OISEASE , EA EMPLOYEE s 1 000 000 E L OISEASE , POTICY LIMII s1 000 000 c lnland l\,4a.ine - Scheduled Equrpmenl Excess Lrabilily $sMl\, Excess of $5Mir 04-R013,01-21 TAU950O 10t2512421 10t2512021 10125t2022 10t2512022 $3,807,441.73 $2,500 Deduclibl€ ACV $5,000,000 Each Occurrence S5.000.000 Aoqreqale Limil oEscRlPTloN oF oPERATIoNg , LocATloNs I vEHlcLEs (AcoRD 10i, Adddon.l R.d*r sch.dcl., dy b. .n ch..l li m@ rp.r It Dquind) The C,ty of Men.fee.The Crty of Menrbe Community Servrces, lhe Menrlee Housrng Authonly and €ach oflherr ofricers. oflicals employi)es, agents and volLjnteers are rncluded asAdditional lnsureds as respects General Lrabhly and Altomobrle Lrab y rnsurance per altached endorsemenls Primary and Non-Conlnbutory ltbrding apphes per attached endorsemenl (s). \ tsrv€r ot Subrogation on \ brkers Compensaton and Employers Llabrlity insurance as respecls lo ihe Crty o:l Menibe. the Cdy of Menifue Commun(y Services Drslrict, the Mini€e Housrng Authorily and each oflheir offcgrs, employees, agents ancl lolunteers per attached endorsemenl CERTIFICATE HOLOER CANCELLATI N SHOULOANY OT THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE THE EXPIRATION OATE THEREOF, NOTICE WLL BE DELIVERED IN ACCOROANCE WIH THE POLICY PROVISIONS, Citv of lvlenifee 29644 Haun Road [,1enifee CA 92583 g*va* Anlhony D'Asaro O 1968-2015 ACORD CORPORATION. All righb resorvod, ACORD 25 (2016/03) Th6 ACORD nrrrlg and logo arE rEglrtored mrrk! ofACORD ' r", tr; 11/:: Younqbe.q lo/-..1/:0?lIl i:: r,rlrfic.le !:ancels .n.l sur,ersedes Al,! previously rss!ed certificates- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISIEO BELOW HAVE BEEN TSSUED TO THE IIISUREO NAMEO AAOVE FOR THE POLICY PERIOO INDICATED NOTWTHSTANDiNG ANY REOUIREMENT. TERM OR CONOITION OF ANY CONTRACT OR OTHER OOCUMETIT WTH RESPECT TO ll/FilcH THIS CERTIFICATE MAY AE ISSUEO OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDIIIONS OF SUCH POLICIES. LIMITS SHO\^A] MAY HAVE BEEN REDUCED BY PAIO CLAIMS I I h.", €r'. lrr(drc .dncels dnd sup.rs.des A!L p!evrously rssued cert rfrcdr.s. lu22l2o2l 0l-R0It-0t-lI THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BROAD FORM ADDITIONAL INSURED COMMERCIAL GENERAL LIABILIry COVERAGE PART 1. Broad Form Additional lnsured Paragraph 2. of Section ll - Who ls An lnsured of commercial General Liability Coverage Form CG 00 01 is amended to add lhe following: e. Additional lnsured byWritten Contract or Written Agreement The following are insureds under the policy when you have agreed in a written contract or agreement to provide them coverage as addilional insureds under your policy: (1) Lessors of Leased Equipment: person(s) or organization(s) who lease equipmenl to you, but only with respect to their liability for "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", 'lemporary workers" or "volunteer workers'. With resped to the insurance afforded to hese additional insureds, lhis insurance does not apply to any "occurrence' which takes place afler the equipment lease expires. l2l Owners, l\,4anagers or Lessors of 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, mainlenance or use of that part of such premises or land leased to you. This insurance does not apply to: (a) Any "occunence' which takes place afrer you cease to be a tenant or lessee of such premises or landl or (b) Structural allerations, new construction or demolition operations performed by or on behalf of the owner, manager or lessor of such premises or land. (3) lvlortgagees, 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 operations performed by you or others for such person or organization. (4) Any person or organizalion, other lhan a .ioint venlure, for whom you have agreed by written contract to provide "bodily injury" or "property damage' liability insurance, but only for liability arising oul of or caused, in whole or in part, by operation(s) performed by you or on your behalr, provided lhat: (a) This Subparagraph (4) does not apply to any agreement to provide insuranceto: (i) Any "employee", association of "employees" or labor union, except with respect lo work performed by or for you or for such "employee", association of'employees' or labor union under direct conlract between you as conlractor and such "employee", association of "employees" or labor union as owners; LUM-'I45 02 06 Pennsylvania Lumbermens Mutual lnsurarce Company Philadelphia, Pennsylvania COMMERCIAL GENERAL LIABILITY LUM-145 02 06 Page I of 3 Ilcliahlc ( oncrctc Acccssorics This endorsement modifies insurance provided under the following: LUM-145 02 06 (ii) Any railroad company except with respect to work performed by you or for you for such railroad company under direcl contract or agreement between you and such railroad company; (iii) Any person or organization whose profession, business or occupation is that of an architect, surveyor or engineer with respect to liability arising out of preparation or approval of maps, drawings, opinions, reports, surveys, change orders, designs or specilications; giving direclions or instructions; failing to give directions or instruclions; or the performance of any other professional services by such person or organization, (iv) Any of your contractors or subcontractors or any partner, offlcer, agent or "employee" of such contractors or subcontractorsl and (v) Anyone described in Paragraphs e.('l) through (3) above. (b) lf a vendor of "your products" is an additional insured under this Coverage Form, such insuran@ as provided to the additional insured applies only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of lhe vendo/s business and subiecl to 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 ofassumption of liability in a contract or agreement. This exclusion does not apply to liability that the vendor would have in the absence of the contract or agreement; (ii) Any expressed warranty ofyour "products" unauthorized by you, (iii) Any physical or chemical change in 'your products' made intentionally by such vendor; (iv) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing or the substitution of parts under instructions from you or the manufacturer, and then such parts are repackaged in the original container; (v) Any failure to make such inspections, adjustments, 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 prodrcts", (vi) Demonskation. inslallation, servicing or repair operations except such operations performed at the vendor's premises in cmnection \.vith the sale o, "your products"; or (vii) Any of "your products" which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other item or substance 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 products, ingredients, parts or containers entering into, acconpanying or containing "your products". No insurance is provided under this vendor's coverage in (4Xb) if "bodily injury" or "property damage" under the "productscompleted operations hazard'is excluded by any exclusions or provisions ofth's Coverage Form or by any endorsement. (c) The insurance afforded to any person or organization as an insured under Paragraph 2.e.(1) through (4) above: (i) Shall include only that insurance required to be provided by the terms of such agreement, and then only to the extent that such insurance is induded wilhin the terms of this policy, and that person's or organization's status as an additional insured under this endorsement ends: (a) when your operations for that additional insured are completed or (b) when any written contract or agreement with such person or organization is terminated or expires. Pennsylvania Lumbermens lvlutual lnsurance Company Philadelphia, Pennsylvania hb, k r J.nnrl.r Yornob.ra I lo/22l?02I 3:lo:?r,tx rPmr- (ancel5 and supersede3 ALL plevlousry rssueo.crtrfrca es. Page 2 of 3 (ii) Does not apply to 'bodily injury" or "property 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 of 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 oI insurance afforded to 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.(t) 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 organizalion. 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 ContIact orAgreement 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 pelSon or organization with whom you have agreed in a written contract or agreement made prior lo 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 agreernent. LUM-145 02 06 Pennsylvania Lumbermens Mutual lnsurance Company Philadelphia, Pennsylvania T)'.s Ler'rrr.rlp .dn.c-s ..d sJpe!sedes ALL pFvrously r!sued cerrr licares. Page 3 of 3 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 Etfectivelnluns2l Policy No. Sv1c1361650 Endorsement No. lnsured ps116615 g66sret€ Accegsories lnsurance Company Security National lnsurance Company We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our righl agarnst the person or organization named in the Schedule. (This agreement applies only to the extenl that you perform work under a written contract that requires you to obtain this agreemenl from us.) This agreement shall not operate directly or indirectly to benefil anyone not named in the Schedule. v\ya*- Countersigned by - wc 00 03 13 (Ed. 04-84) 64661035 | a!/:r , u!b. lrc I J.ntrr!.. !@nqhrs I r0lu?/102r 0:10:.?l ax (pm) I ?.q.5 or 6This r',er'.frcat. cancpls ahd supersedes AIL prevrously r3sued certrfLcares. Itcl irrhle ( i)ncrclr Acccs\orics POLICY NUMBER: 04-R013{2-21 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FoRM NAME: coMMERcIAL AUTOMOBILE EXTENSTION ENoORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Any person or organization whom you are required by contract to name as additional insured is an "insured" for LIABILITY COVERAGE but only to the extenl that porson or organization qualifies as an "insured'' under the WHO lS AN INSURED provision of Section ll- LIABILITY COVERAGE. 8, For any person or organization for whom you are required by contract to provide a waiver of subrogation, the Loss Condition- TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is not applicable. C. The insurance afforded to any additional insured whom you are required by contract to name as an additional insured will be PRllvlARY AND NON-CONTRIBUTORY by such contract or agreement with you. 64a61o86 r 2Il.'-" , Unb, rc J.nnif.r Youirtb.lq r 10/2?/2021 0:r0:2I rX (Pm)This cer!rrj.dte cancets and supersedes All prevrousty issued certlfrcates.