2023/01/01 AAA Paving Company----rA,CORD AA/APAVl.01
CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFOROED BY THE POLICIESBELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
12t29t2022
IMPORTANT: lf lhe cettificate holdor ls an AOOITIONAL INSURED, the policy(ies) must have ADDITIONAL INSUREO provlslons or b€ endoEodlf SUSROGATION lS WAIVEO, subj€ct to the terms and conditlons ofthE policy, certain policles may require an endorsomenl. A statement onthis certificat6 does not conrer ghts to th6 certlficate holdor ln lleu of such endorsement(s)
tNsuRER(S) AFFOROTNG COVERAGE
TNsURERA:United Specialty lnsurance Company
rNsuRER B : Employers Mulual Casualty Company
115gpgp s - Redwood Flre and Casualty lnsurance Company
f#,lo,(909) 886-2013
INSUREO
CONTACT
fI8,NrF., e,tr, (9os) 886's861
AODRESS:
12537
21415
11673AAA Paving Company
3330 N Locust Ave
Rialto, CA 92377 INSURER D
INSURER E
pRoDUcER License # 0C36861
lnland Empire-Alliant lnsurancs Sorvices, lnc
685 E. Carnesie Dr Ste 265San Bernardino, CA 92408
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAI\.,IED ABOVE FOR THE POLICY PERIODINDICATEO, NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR I\{AY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERIVS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIO CIAIMS,
INSR TYPE OF INSURANCE POTICY NUMBER LIMITS(MWDD/YYYY)
1,000,000
50,000
5,000
't,000,000
2,000,000
2,000,000
TN2335619 1l'1t2023 11112024x
$
$
$
A X cormencnr cENERAL LraBrLrrY
I crerus-r'aoe X occun
GEN L AGGREGATE LIMI'TAPPLIES PER:
POLTCY ii.:r LOC
PERSONAL E ADV INJURY
GENERAL AGGREGATE
PRODUCTS COMP/OPAGG
EACH OCCIJRRENCE
DAMAGE TO RENTEO
PREMISES (Ea occurenc€)
MED ExP (A.y one p66on)
COMBINED SINGIE TIMIT
BODILY INJURY (P€r peBon)
BODILY INJURY (Per accideit)
PROPERTY DAMAGE
1,000,000
5X9-51 -72-24 1t1t2024
NON,OWNEO
A
8TN2339626 11112023 1t1t2024
EACH OCCURRENCE
AGGREGATE
SCHEDULEDAUTOS
uMBRELLALTAS X occuq
X ExcEss LtaB cLAtMS MADE
oEo X nererrrolr s 0
5,000,000
5,000,000
B ouro*og,ae a,lg,L,ty
X euvewo
OWNED
AUTOS ONLY
HIREDAUTOS ONLY
\, PER OTH.^ STATUTF FR
E.L, EACH ACCIOENI
'E,L, DISEASE. EA EMPIOYEE I
E.L, DISEASE. POLICY LIMIT I
A4WC449339
c
OF OPERAIIONS below
1,000,000
1,000,000
1,000,000
WORKERS COMPENSATIONAND EfPLOYERS' L|AAIL|TY
ANY PROPRIETOF]PARTNEFYEXECUTIVEOFF CER'MEMBER EXCLUDEO'
DESCRIPIION OF OPERATIOIIS / LOCATIONS /VfHlCl tS IACORO lOl. Addrtio..l R.n!rt. Sch.dul.. m5v b..trr.hed ifm6rc.6ie i! mduiEdrOperations pertaining to named insured for ceriholder. Certholder is add'l insd aa reapecls gen'l liab der end't ana;hed
CERTIFICATE H CANCELLATION
O 1988-2015 ACORD CORPORATION. All rights reserved
The ACORD name and logo are regislered marks of ACORD
SHOULD ANY OF THE AAOVE DESCRIBED POLICIES BE CATCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE wlLL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS,City of Menifee
29714 Haun Rd.
Menifee, CA 92586
d^-n'tl-u-
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
$
I
I
i
'l'12023
s
I
1t'12023 1t1t2024
POLICY NUMBER: ATN233561 I
United Specialty lnsurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
vEN 051 00 (02/20)
PRIMARY ANO NON.CONTRIBUTING INSURANGE 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:
a (1) The Additional lnsured is a Named lnsured under such other insurance;
and
tzt 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 of the claim, "suit," or "occurrence" expressly requires
that this insurance:
(i)apply on a primary and non-contributory basisi
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 Orqanization(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.
b
vEN 051 00 (02/20)Page 1 of 1
POLICY NUMBER: ATN233561 9 COMMERCIAL GENERAL LIABILITY
cG 20 37 04 13
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 LIABILIry COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional lnsured Person(s)
Or Organization(s)Location And Description Of Completed Operations
As Required By Written Confact, 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
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 respecl to liability for "bodily iniury" 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 "producls-completed operations
hazatd" .
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, 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.
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section lll - Limits Of lnsurance:
lf coverage provided lo 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.
cG 20 37 04 13 O lnsurance Services Office, lnc.,2012 Page 1 of I
POLICY NUMBER: ATN2335619
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 LIABILIry 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 location(s)
designated above.
However:
1. The insurance aftorded 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, the
insurance afforded to such additional insured
will not be broader than that which you are
required by lhe contract or agreement to
provide for such additional insured.
COMMERCIAL GENERAL LIABILITY
cc 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
"properly 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 contractor or subcontractor
engaged in performing operations for a
principal as a part of the same project.
Name Of Additional lnsured Person(s)
Or Organization(s)AsRequir@
Executed Prior To The Named lnsured's Work
Location s Of Covered O tions
equ rred v ntten ontract,u ly
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 Page 1 of 2@ lnsurance Services Office, lnc.,2012
C. With respect lo the insurance afforded to these
additional insureds, the following is added to
Soction 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 ol 2 @ lnsurance Services OfIlce, lnc.,2012 cG 20 10 04 13