2022/01/01 AAA Paving Co, Inc.ACORD AAAPAVI.Ol
CERTIFICATE OF LIABILITY INSURANCE 1t6t2022
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 BYTHEPOLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
pRoDUcER License # 0C3686'l
lnland Empire-Alliant lnsurance Services, lnc
685 Carneqle Dr Ste 265
San B€rna.dino, CA 92408
IMPORTANT: lf the certlflcate holder ls an AOOITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provlsions or be endorsed.lf SUBROGATION lS WAIVED, subrect to the terms and conditlons ofthe policy, certaln pollcles may roqulro an endorsement. A statsment on
thls c6rtlficate does not confer rl hts to the certlflcate holder in lleu of such cndorseme s
CONTACT
[I3,NNE . e.rr, (909) 886-986r I fif N.),(gos) ss6-2013
ADDRESSI
tNsuRER(S) AFFOROTNG COVERAGE NAIC 'TNSuRERA,United Specialty lnsurance Company
rNsuRER B : Employers Mutual Casualty Company
tNsuRER c , Redwood Fire and Casualty lnsurance Company
INSUREO
12537
21415
11673AAA Paving Company
3330 N Locust Avg
Rialto, CA 92377
INSURER D
INSURER E
INSURER F
COVERAGES
TYPE OF INSURANCE
A X coirMERctaL GENERAL LtaBlLtrY
CLATMS.MADE X occuR
GEN'L AGGREGATE LIMIT APPTIES PER:
CERTIFICATE NUMBER:
x ArN2221121
5X9 -51 -7 2- -23
POLICY EFF POLICY EXP
1t'12022
11112022 1t',1t2023
1t1t2022 1t1t2023
X Silrur.OTH
ER
COMAINED SINGLE LIMIT
EoorLY NJURY (Per peEon)
BOO LY INJURY (Per accident)
N NUM
THIS IS TO CERTIFY IHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATEO. NOTWTHSTANDING ANY REOUIREI\IENT, TERM OR CONDITION OF ANY CONTRACT OROTHER DOCUiTENTWITH RESPECTTO wHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES, LIIVITS SHOWN MAY HAVE BEEN REDUCED BY PAIO CLAIMS,
porrcY x I !F.o; I
688
1,000,00t
50,00r
5,001
'1,000,00r
2,000,00(
2,000,00r
5,000,00r
5,000,00r
LOC
B AUTOMOAILE LIABILITY
X ery euro
OWNED
AU'TOS ONLY
HIREO
1,000,00(
SCHEDULED
AUTOS
s
s
I
sNON.OWNEOAUTOS ONLY
$
$
c WORKERS COi'PETISATIONANO EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER,'MEMBER EXCLUOEO?
DEscRTPT oN oF oPERATToNs b.ro*
E,L EACH ACCIDENT
E L DISEASE. EA EMPLOYE
E L DISEASE. POLICY LIMIT
5 1,000,00r
r,000,00r
't,000,00t
E$
DESCRIPIION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Ro6arlc Schedulo, may bo altached ifmo,o epaco i. roqunsd)
Operations pertaining to named insuied for certholder. Certholder is add'l insd as respects gen'l liab per end't attached
A
x
X occun
CLAIMS MADE 8TN2228304 11',12022
0oeo X RETENTiON $
UMBRELL.A IIAB
EXCESS LIAB 'l't 12023
EACH OCCURRENCE
AGGREGATE
City of Menifee
29714 Haun Rd.
Menifee, CA 92586
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE wlLL BE DELIVERED IN
ACCORDANCE WTH IHE POLICY PROVISIONS,
AT,THORIZEO REPRESENIAIIVE
C/*Jtu-
ACORo 2s (20r6/03)
EACI] OCCURRENCE $rrzozs BAI0fsEJ?.!ifJ,?"*, $
MEO ExP iAnyone pe6on) $
PERSONAL &ADV NJURY $
GENERAL AGGREGATE $
PRODUCTS COMP/OP AGG $
O '1988-2015 ACORD CORPORATION. All rlghts reserved.
POLICY NUMBER', AT N2221 1 21
United Specialty lnsurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
vEN 051 O0 (02t2O)
PRIMARY AND NON-CONTRIBUTING INSURANCE ENDORSEMENT
This endorsement modifies the Conditions provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following is added to SECTION lV - COMMERCIAL GENERAL LIABILITY
CONDITIONS of the COMMERCIAL GENERAL LIABILITY COVERAGE PART,and
supersedes any provision to the contrary:
Primary and Non-Contributory lnsurance
Any coverage provided to an Additional lnsured under this policy shall be excess over any other
valid and collectible insurance available to such Additional lnsured whether primary, excess,
contingent or on any other basis unless:
(l) The Additional lnsured is a Named lnsured under such other insurance;
and
a
b
(21 A fully written contract fully executed prior to the Named lnsured's
commencement of work for such Additional lnsured for the specific project
that is the subject ofthe claim, "suit," or "occurrence" expressly requires
that this insurance:
(i)apply on a primary and non-contributory basis;
and
would not seek contribution from any other insurance available to
the additional insured.
(ii)
or
Prior to a loss, you request in writing and we agree in writing that this insurance shall apply
on a primary and non-contributory basis.
Name Of Person(s) Or Organization(s)
As Required By Written Contract, Fully Executed Prior To The Named lnsured's
Work.
All other terms, conditions and exclusions under this policy are applicable to this
Endorsement and remain unchanged.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COIVIPLETED OPERATIONS LIABILIry COVERAGE PART
SCHEDULE
POLICY NUMBER: 4rN2221121
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" or
"property damage" caused, in whole or in part, by
"your work" at the location designated and
described in the Schedule of lhis endorsement
performed for that additional insured and
included in the "products-completed operations
hazatd" .
However:
1. The insurance afforded to such additional
insured only applies lo the extent permitted
by law; and
2. lf coverage provided to the additional insured
is required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
COMMERCIAL GENERAL LIABILITY
cG 20 37 04 13
B. With respect to the insurance afforded 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 agreement; or
2. Available under the applicable Limits of
lnsurance shown in the Oeclarations;
whichever is less.
This endorsement shall not increase the applicable
Limits of lnsurance shown in the Declarations.
Name Of Additional lnsured Person(s)
Or Orqanization(s)Location And Description Of Completed Operations
As Required By Written Contract, Fully Executed Prior
To The Named lnsured's Work
As Required By Written Contract, Fully Executed Prior
To The Named lnsured's Work
lnformation required to complete lhis Schedule, if not shown above, will be shown in the Declarations.
cG 20 37 04 13 @ lnsurance Services Offlce, lnc.,2012 Page 1 of 1
POLICY NUMBER: ArN2221121
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
COMMERCIAL GENERAL LIABILITY
cG 20 10 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 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
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 conlractor or subcontractor
engaged in performing operalions for a
principal as a part of the same project.
Name Of Additional lnsured Person(s)
Or Organization(s)Location(s) Of Covered Operations
As Required By Written Contract, Fully
Executed Prior To The Named lnsured's Work
As Required By Written Contract, Fully
Executed Prior To The Named lnsured's
Work
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
cG 20 10 04 13 @ lnsurance Services Office, lnc.,2012 Page 1 of 2
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 location(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 is
required by a contract or agreement, lhe
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
C. With respect to the insurance afforded 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 agreement; or
2. Available under the applicable Limits of
lnsurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of lnsurance shown in the
Declarations.
Page 2 of 2 O lnsurance Services Office, !nc.,2012 cG 20 10 04 13