2022/08/01 All American Asphalt7
THIS CERTIFICATE IS ISSUED AS A iIiATTER OF II{FORMATION ONLY AI{D CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE OOES NOT AFFIRMATIVELY OR NEGATIVELY AT$ENO, EXTENO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETVVEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PROOUCER, AND THE CERTIFICATE HOLDER,
ITIPORTANT: It tho cortiricale holder i8 an AOOITIONAL INSURED, tho pollcylie!) mult havo ADOITIONAL INSURED provision3 or t e ondoBed.
lf SUBROGATION lS WAIVED, subject to the torm. and conditions ol tho policy, certain policio3 may requiro an ondor8emenl. A statomont on
thi3 cortlflcala dooa not confor right3 to the co.tillcate holder in lleu of auch ondo6omont(s).
eRooucER Edgewood Partners lnsurance CenterPO. Box 5003
San Ramon. CA 94583
www.epicbrokers.com cA LtcENSE #0829370
CONTACT Certiicales Deparlment
559-451-3200 925-301 0671
EPI conl
NS AFFORDIN G COVERA GE
nce Com 211S9
Zurich American lnsurance Co 16535
Great American lnsurance Co 16691All American Asphalt
P.O. Box 2229
Corona CA 92878
.acjilo"
COVERAGES CERTIFICATE NUMSER 72126 REVISION NUMBER
CERTIFICATE HOLDER CANCELLATION
@ l98E-2015 ACORD CORPORATION. All ,ights reservqd
ACORO 25 (2016/03) The ACORO name and logo aro rogisto.ed ma.k8 ot ACORD
I L :r riil,r t
THIS IS TO CERTIFY THAT THE POTICIES OF INSURANCE LISTED BELOW HAVE EEEN ISSUEO TO THE INSURED NAMED AEOVE FOR THE POLICY PERIOD
INDICATED NOTWIHSTANDING ANY REQUIREMENl ERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFOROED 8Y THE POLICIES OESCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONOITIONS OF SUCH POTICIES LIMIIS SHOVVN MAY HAVE BEEN REDUCED 8Y PAIO CLAIMS
COMMERCIAL GENERAL LLAAILIIY
GEN L A6GREGATE LIM T APPIIES PER
JEC]LOC
DPC100585606 811t2022 8t1t2023
FAEAGFTIRENIE-
PREMISES rEaoccutr€nc€l
s 1,000,000
s 100,000
MEO EXP (Any 0.6 p6Bon)
PERSOI{AL A AOV INJURY s 1 000.000
GENE RAL AGGREGATE s2.000.000
PRODUCTS COMP/OP AGG s2 000.000
a AUTOMOBILETIAAILITY
AUTOSONLY
r"lrREo
AIJTOSONLY
SCHEDULED
NON.OWNEO
AUTOSONLY
8AP557108810 811t2022 8t112023
AODTLY NJURY rPer pe,son)
000 000
s
s
s
s
EODILY INJURY (Por accrd6.0
-FRoPER
6lfri--
c
RETENTI 10.000
TUE347483602 8t1t2022 8t112023 r5,000,000
s5 000,000
Following-Form
B $,ONXERSCO PENSANON
AI{O EIIPLOYERS' I.IAEIIUTY
ANYMOPRIETORFARlNER/EXECUTIVE
Of f ICER/MEMBEREXCLIJOEO,
DESCRIPIION OF OPERATIONS DoIfu
N
\ /c593205709 8t112022 811t2023 OTH
s 1 000.000E L EACH ACCIOENT
E L DISEASE EA EMPLOYEE s 1.000.000
r 1,000,000E L DISEASE, POLICY LIM T
OESCRPIO OF OPERAIONS / IOCATIONS / VEHICLES {ACORD 101, Additlon.l R.m.*. Sch.dul., 6.y b. .nrcn.d l' ooE .p.c. l. EquiEd)
#32335 / RE: CIP 20-02 Ethanac Road & Sherman Road Street Resurfacing Project /
Cerlifcale Holder is Addilional lnsured if Required by Wrillen Conlract Excluding \ /o*ers Compensation
Citv of Menifee
29644 Haun RoadMenibe CA 92586
I
SHOULD ANY OF THE ABOVE OESCRIBEO POLICIES AE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WLL BE OELIVEREO IN
ACCOROANCE WITH THE POLICY PROVISIONS
AUTHORIZEO REPRESENTATIVE
[raleah Canlrell
CERTIFICATE OF LIABILITY INSURANCE
tl
I
ba----
trtrtr9
PO Box 5003
5an Ramon, CA 94583
Phone: 925.244.7700
Fax: 925.901{244
Emailr EPlCcerts@epicbrokers.€om
To:
Regarding:
Date lssued:
Named lnsured(s):
Policy Number(s):
Vvhom it may concern
Notice of Cancellalion
7 i2U2022
AllAmcrican Asphalt
I)PC t00585606
t]AP557t088r0
w( 593205709
1t ]ll].17483602CERTIFICATE HOLDER:
Citv of Menil'ec
29644 Haun Road
Menifce CA 92586
Should the above described policy be cancelled before the expiration date thereof, we will mail
30 days written notice to the above referenced Certificate Holder; except, i.0 days notice for
non-payment of premium.
Sincerely,
Malcah ( antrell
epicbrokers.com edSewood partners insurance center
r rl srdiddrd r/r,o/.rot-. il:!ri{o ax lpoT) paq. : of tt
ca license 0829370
bA----
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
Name Of Additional lnsured Person(s)
Or Organization(s);
Location(s) Of Coverod Operations
Any person or organization where the Named
lnsured has agreed to add as an additional insured
by written contract or agreement, provided the
contract or agreement is executed prior to any
"occurrence" or offense
Any location where required by written contract or
agreement, provided the contract or agreement is
executed prior to any ''occurrence" or offense.
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
respect to liability for "bodily injury",'property damage" or "personal and
advertising injury" caused, in whole or in
part, by:
Your acts or omissions; or
The acts or omissions of those
acting on your behalf;
in the performance of your ongoing
operations for the additional insured(s) at
the location(s) designated above.
However:
The insurance afforded to such
additional insured only applies to
the extent permitted by law; and
lf coverage provided to the
additional insured is required by acontract or agreament, theinsurance afforded to such
additional insured will not be
cG 20 10 04 13
broader than that which you are
required by the contract or
agreement to provide for such
additional insured.
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:
B
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@ lnsurance Services Office, lnc.,2012
All work, including materials, partsor eq u ipme nt fu rn ished in
connection with such work. on theproject (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
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 otherthan another contractor or
s u b conlra cto r engaged in
I
2
2
69312126 ]',! 0rl standard flrh 95m xs I siera rrndreth | -1/?o/2o2? Bt4at40 ix rpoT) I prqe I of 11
Page 1 of 2
COMMERCIAL GENERAL LIABILITY
cG 20 t0 04 t3
t.
perlorming operations for a
principal as a part of the same
project.
With respect to the insurance afforded to
these additional insursds. the following is
added to Section lll - Limita 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:
Required by the contract or
agreement; or
Available under the applicable
Limits of lnsurance shown in the
Declaralions;
whichever is less.
This endorsement shall not increase the
applicable Limits of lnsurance shown in
the Declarations.
1
2
c.
All other terms and condilions of this policy remain unchanged.
Endorsement Number:
This endorsement is effective on the inception date of this policy unless otherwise staled herein.
(The information below is required only when this endorsement is issued subsequenl to prsparation of the
policy. )
Policy Number: DPC'|00585606
Named lnsured: All American Asphalt
Endorsement Effective Date: oEiol/2022
REFERENCE
*32335Resurfu / RE: CIP 20-02 Ethanac Road & Sherman Road Streetcing Project /
SCHEOULE:
City ol Menibe
CG20 1004 13 @ lnsurance Services Office, lnc.,2112
I' r s!,ndard vrrl S5ar xs Ax lpoT) laqe .r .t 1i
Page 2 ol 2
COMMERCIAL GENERAL LIABILITY
cG 20 37 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Name Of Additional lnsured Person(s)
Or Organization(s)Location And Description Of Completed Operations
Any person or organization where the Named lnsured
has agreed to add as an additional insured by written
contract or agreement, provided the coniract or
agreement is execuled prior to any "occurrence" or
offense
All locations where required by contract
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
respect to liability for "bodily injury" or
"property damage" caussd, in whole or inpart, by "your work" at the location
designated and described in the Schedule
of this endorsement performed for that
additional insured and included in the
"products-completed operations hazard".
The insurance afforded to such
additional insured only applies to
the €xtent permitted by law; and
cG 20 37 04 13
additional insured
With respect to the insurance afforded to
these additional insureds, the following is
added to Section lll - Limits Of
lnsurance:
lI 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:
Ava ila ble 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.
B
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1
2
O lnsurance Services Office, lnc.,2012
L.ndr.tn 1/1o/2022 3:l5i{0 r, (PDt) P.q.5 of 1r
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMi,4ERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
However:
lf coverage provided to tho
additional insured is required by acontract or a g ree me nt, the
insurance afforded to such
additional insured will not be
broader than that which you are
required by the contract or
agreemenl to provide for such
Required by the contract or
agreement; or
Page 1 ot 2
All other terms and conditions of this Policy remain unchanged
Endorsement Number:
This endorsement is effsctive on the inception date of this policy unless olherwise stated herein.
(The information below is required only when this endorsement is issued subsequent to preparation of the
policy.)
Policy Number: Dpc1oo5E56o6
Named lnsured: All American Asphatt
Endorsement Effective Date: o8io1/2022
REFERENCE:
#32335 / RE:ClP 20-02 Ethanac Road & Sherman Road StreetResurfacino Projed /
SCHEDULE:
City of Meni6e
CG 20 37 04 13 @ lnsurance Servicss ffice, lnc.,2012
69r?:l:5 I r: IDrl Srdndard yrth s5rn rs 1/20/aa2? stl\t4a Ax lpoT) p.q€ 6 .f tt
Page 2 ol 2
COMMERCIAL GENERAL LIABILITY
cG 20 01 04't3
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance providod under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other lnsurancs
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory
lnsurance
This insurance is primary to and will not
seek contribution from any other
insurance available to an additional
insured under your policy provided that:
(l) The additional insured is a Named
lnsured under such other insurance,
and
(2) You have agreed in writing in a
contract or agroement lhat this
insurance would be primary and
would not seek contribution from
any other insurance available to the
additional insured.
All other terms and conditions of this policy remain unchanged
REFERENCEi
d32335 / RE:ClP 2G02 Ethanac Road & Sherman Road StreetResurbcing P.oject /
SCHEDULE:
Caly of lrenaGe
Endorsement Number:
This endorsement is effective on the inception date of this policy unless othen ise stated herein.
(The information belovv is required only when this endorsemenl is issued subsequent to preparation of the policy.)
Policy Number: Dpcloos856o6
Named InSured. AllAmerican Asphan
Endorsement Effective Date: o8/01/2022
cG 20 01 04 13 O lnsurance Services Office, |nc..2012
loll sr.nd.rd,rrh t5M is /:0..? s:{5:10 ^l, (PDT) Paqe ? of tt
Page 1 of 1
COMMERCIAL GENERAL LIABILITY
cG 24 04 05 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETEO OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Porson Or Organization:
Any person or organization where the waiver of our right to recover is permitted by law and is required by
written contracl or agreement, provided the contract or agreement is executed prior to any occurrence or
offense
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
The following is added to Paragraph 8. Transfer for injury or damage arising out of your ongoing
Of Righb Of Recovory Against Othors To U8 operations or'your work" done under a contract
of Section lV - Conditions: with that person or organization and included inthe "products-completed operations
We waive any right of recovery we may have hazard". This waiver applies only to the person
against the person or organization shown in the or organization shown in the Schedule above.
Schedule above because of payments we make
All other terms and condituons of this poltcy remain unchanged.
Endorsement Number:
This endorsemenl is effective on the inception date of this policy unless otheMise stated herein.
(The information below is required only when this endorsement is issued subsequent to preparation
of the policy.)
Policy Number: DPCl 00585606
Named lnsured:All Amencan Asphatt
Endorsement Effective Date: 06/01/2022
REFERENCE
132335 / RE:ClP 20-02 Ethanac Road & Sherman Road StreetResurhcing Proiecl /
SCHEDULE:
City of Menibe
cG 24 04 05 09 @ lnsurance Services Office, lnc., 2008
69312126 22 i0rl Sr,nd.rd ulrh 9rm x5 sirr. !.ndr.rh 1/70/2022 atl5t4a r!l| (pD,r) paqe 3 of r1
Page 1 of 1
7120t2D22
POLICY NUMBER BAP55710881O COMMERCIAL AUTO
CA 20,18 10 t3
THIS ENOORSEMENT CHANOES THE POLICY. PLEASE REAO IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
Thrs endorsement mgdifles insurance provided under the followtng
Wth resp€ct to coverage providd by this endorsement, the provisions of hs Coverage Form apply unless
mod red by thrs endoEement
This endorsement identfies person(s) or organization(s) who are "ansureds" for Covered Autos Liablity Coverage
under the Who ls An lnsured provision of the Coverag€ Form. This endoEernent &es not alter coverageprovrdcd rn thc Covcrogc Form
This endorsement changes the policy effectrve on the ince ton date of the policy unless another date is mdtcated
below.
Namod lnEuradi All American Asphalt
Endo15emGnt Effq€tive Ozle : o1t1t t zO22
SCHEDULE
Namc Of Pcrson(31 Or Organization(s):
ANY PERSOII OR ORGANIZATIOI{ TO WHOIV1 OR VV]-I ICH YOU ARE REOUIRED TO
PROVIDE ADDITIONAL INSURED STATUS ON A PRIMARY. NON-CONTRIBUTORY
BASIS. IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUIED PRIOR 10
LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBIIED BY LAW
]!&lnation required to complete this Schedule, if not shown above. will be shown in the Declarations.
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORIVl
MOTOR CARRIER CCA,/ERAGE FORM
Each person or organEation sho\nn tn the Schedule tsan insur€d'for Cover€d Autos Liahltty Coverage, but
only to the extent that fErson or organlzation qualifies
as an "rnsured- under the who ls An lnsured provEton
contained rn Paragraph Al. of Section ll - Covered
Autos Lrability Coverage in the Bustness Auto and
Motor Carner Coverage Forms and Paragraph D.2. ofSection I r Covered Autos Coverages of the Auto
Dealers Coverage Form
SCHEDULE
City of Menilbe
ca 20 4E 10 13 @ lnsurance Servrces Offtce, lnc , 2011
l0l I sr.hd.rd Yir h Itm xs sr15:10 Ax (Pm) P.9.9 or 11
Pag€ I of 1
POLICY NUMBER: BAPss7108810
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGATNST OTHERS TO US (WAIVER OF SUBROGATTON)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
This endorsemenl changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named lnSured: A American Asphatt
Endorsement Effectivo Date: 6s76172s22
7120t2022
COMMERCIAL AUTO
CA 04 /14 10 13
I{ame(s) Of Person(s) Or Organization(s):
ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN
CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PR]OR TO THE
ACCIDENT OR LOSS, THAT WAIVER OE SUBROGATION BE PROVIDED UNDER
THIS POIICY
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
@ lnsurance Services Office, lnc., 201 1
SCHEDULE:
City of Menitue
69l7al:5 rr' loll srandard virh s5m xs I sipru Landrslh 6:r5:40 Ax rPDT) r Paqe 10 ot 1l
Page 1 of 1
SCHEDULE
The Transfer Of Righb Of Recovery AgainstOthers To Us condition does not apply to the
person(s) or organization(s) shown in the Schedule,
but only to the extent that subrogation is waived prior
to the "accident" or the "loss" under a contract with
that person or organization.
CA 04 /t4 10 13
WORKERS' COMPENSATION AND EMPLOYEFS' LIABILITY INSURANCE POLICY wc 04 03 06
(Ed. 4-84)
WAIVER OF OUR RIGHTTO RECOVER FROM OTHERS ENDORSEMENT-
CALIFORNIA
VG have the right to recover our payrnents from anyone liable lor an iniury covered by this policy. We will not
enforce our right against the person or organization nanred in the Schedule. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreernent from us.)
You must rnaintain payroll records accurately segregating the remuneration of your employees while engaged in
the work d€scribed in the Schedule.
The additional premium for this endorsenent shall be 0 . 00 % of the California workers' compensation pre-
mium otherwise due on such remuneration.
Schedu b
Job DescriptionAIL CA OPERATIONS
s( l il)t rt.L:
( ily ol McnilLc
RIlFERENCE:
#32335 / RE; Cll'20-{)2 llthanac Road & Shcrman Road
Street Resurlhcing l'roiect /
PolicyNumber: wc5s3205709
Named lnsured: Al American Asphatr
Endorsement Efiective Date: 08i0t/202
wc 252 (4€4)
wc 04 03 06 (Ed 4-84)
691721:6 22 iort sr.ndard rith s5m xs 7/.20/2otz 9:as:t0 r}l {pDT) p.qe rt 61 1r
Page I ol 1
Person or Orgnization
AI.L PERSONS AND/OR
ORGAN I ZATIONS THAT
ARE REQUIRED BY
YIRITTEN CONTRACT OR
AGREEMENT WITH THE
INSURED, EXECUTED
PRIOR TO THE
ACCIDENT OR I.OSS,
TEAT WAIVER OE
SI'BROGAT ION BE
PROVIDED I'NDER THISPOLICY EOR WORK
PERFORMED BY YOU FORTHAT PERSON AND /ORORGANIZATION