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2022/08/01 All American Asphalt (4)oiQo'CERTIFICATE OF LIABILITY INSURANCE 712012022 THIS CERTIFICATE IS ISSUEO AS A MATTER OF INFORMATIOT{ ONLY ANO CONFERS t{O RIGHTS UPON THE CERTIFICATE HOLOER. THIS CERTIFICATE OOES I{OT AFFIRTVIATIVELY OR I{EGATIVELY AiiEND, EXTEI{O OR ALTER THE COVERAGE AFFOROED BY THE POLICIES BELOW. IHIS CERTIFICATE OF INSURANCE OOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEO REPRESENTATIVE OR PROOUCER, ANO THE CERTIFICATE HOLDER. IMPORTAIT: lf tho certitlcato holder i! an AODITIONAL INSURED, the pollcy{lor) mu.t havo ADDITIONAL INSUREO provisions or be ondorsed. ll SUBROGATION lS WAIVED, subioct to tho torms and condltlon3 of tho policy, co(ain pollcaea may requlro an ondorsemont. A statoment on th13 cerlificato doe3 not confor righla to tho cortificato holdor ln llou ol tuch endor8omont(r). PRooucER Edoewood Partners lnsurance Center PO- Box 5003 San Ramon, CA 94583 Certiicates rlment 559-451 3200 925,90'1-0671 EPI kers.com AFFORDING COVERAGE www.epicbrokers.com CA LICENSE +0829370 lnsurance Company 21 '1 99 Zurrch nl I Co 16535All American Asphalt P.O. Box 2229 Corona CA 92878 ERC: G al flca 16691 COVERAGES CERTIFICATE NUMBER: 6 REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION Crtv of l\renrfr-.e 29644 Haun Road Meniiee CA 92586 SHOULO AI.IY OF THE AAOVE DESCRIBED POLICIES BE CANCELLEO BEFORE THE EXPIRATION OATE THEREOF. NO]ICE WLL BE OELIVERED IN ACCOROANCE WITII THE POLICY PROVISIONS, AU'IHORIZEO REPRESENTATIVE I\raleah CanAell @ 1988-20'15 ACORD CORPORATION. All right6.eservod ACORD 25 (2016/03) Tho ACORO namo and logo a,o rogisto.od marks ot ACORD THiS IS TO CERTIFY IHAT THE POLICIES OF INSURANCE LISTEO BELOW HAVE AEEN ISSUED TO THE INSURED NAMED AAOVE FOR THE POLICY PERIOO INDICAIED NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OIHER DOCUMENT WTH RESPECT TO YV}IICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE-TERMS, EXCLUSIONS AND CONOITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REOUCED BY PAID CLAIMS $ 1,000,000 $ 100 000PREMTSES (Ea occurence) MEo ExP (any one po.so.) PERSONAL AADV NJURY s $1 000 000 s2.000.000GENERALAGGREGATE s2 000 000 I 8t112022 811t2023 PROOUCTS COMP/OP AGG GEN L AGGR€GATE LIMIT APPL]ES PER JECT DPC100585606 S 6 I2,SSA,000 S B AUIOS ONLY HIREO SCI]EDULED NON-OWNEO AIJIOSONLY AIJIOHOBI!E UAAILITY BAP557108810 I Bt1t2o22 811t2023 BODILY LNJURY (P.T pdson) BODTLY NJURY (Peracc'don0 COMSINEO SINGLE LIMIT PROPERT'/ DAMAGE(f,.r .@'datt llpqa,a00C TI 10.000 EXCESS LIAB occui TUE347483602 at1t2022 81112023 Follo/ving Form oTuSTATUTE s1.000.000 s 1 000.000 !1 000 000 B WORKERSCOMPENSANON ANO E*PLOYERS'LIA6lllIY ANYPfi OPRIEIOR/PARINER/EXECI]I VE OFFICERAllEMBEREXCLIJDEO? DESCRIPTION OF OPERATIONS b.I N Mrc593205709 811t2022 8t1t2023 E L EACH ACC O€NT E L OISEASE, EA EMPLOYEE E L O]SEASE POL CY L MIT oEscRPno of oPERAno{ s / LocAlroNs r vEHrcLEs (acoRD i 01, Addnron.r R.m.rt. s.h.dur., n.y b. .r.ch.d { ror .p.c.I. nqurrd) CIP 20-10 Andalusia/Belcanto Asphalt O',erlay Project / Cerlifcato Holder is Addilional lnsured if Required by Witlen Conlract Excluding \ ,brkers Compensalion tt Loc IV) tl I brZ-- trEtrEI PO Box 5003 5an Ramon, CA 94583 Phone: 925.244.7700 tax: 925.9074244 Email: €Plccerts@epicbrokers.com To: Regarding: Date lssued: Named lnsured(s): Policy Number(s): Vvhom it may concern Notice of Cancellation 't /20/2022 All American Asphalt DPC t00585606 IlAl,557l088l0 wc593205709 t t rtit47483602CERTIFICATE HOLDER: ( it\ ol Mcnilcc 29{.1.1 I laun Roud Me nilcc CA 9251i6 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, 10 days notice for non-payment of premium. Sincerely, lvlalcah ('antrcll epicbrokers.com edgewood partners insurance center I rr I srandard vrrh ttm xs lx 1p!f) p.ge I of rl ca license 0829370 bu--- COMMERCIAL GENERAL LIABILITY cG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modilies 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 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 a contract or agreement, the insurance afforded to such additional insured will not be cG 20 10 04 13 broader than that which you are required by the contract or agreemenl 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 O lnsurance Services Office, lnc.,2012 All work, including materials, partsor equipment 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 other than another contractor or subcontractor engaged in 1 2 Name Of Additional lnsured Person(s) Or Organization(s): Location(s) Of Covered Operations Any person or organiza(ion 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 wher6 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 ll sr..da!d yrth 95M xs si.r. Ldndlerr Page 1 o'f 2 t. 2. performing operations for a principal as a part of the same proJect. With respect to the insurance afforded to these additional rnsureds. the following is added to Section lll - Limits Of lnsurance: lf coverage provided to the additional insured is reguired by a contract or agreement, the most we will pay on behalf of the additional insured is lhe amount of insurance: Required by the contract or agreement; or Available under the applicable Limits ol lnsurance shown in the Declarationsi whichever is less This endorsemenl shall not increase the applicable Limits of lnsurance shown in the Declarations. 1 2 c. All other terms and conditions of this policy remain unchanged Endorsement Number: This endorsement is effeclive on the inceplion date of this policy unless otherwise stated herein. (The information below is required only when lhis endorsement is issued subsequBnt to preparation of the policy.) Policy Number: oPCloo58s6o6 Named lnsured: All American Asphalt Endorsement Effective Dat6: o8/01/2022 REFERENCE: CIP 20-10 Andalusia/Belcanto Asphalt Overlay Projecl / SCHEDULE: City of l\4enibe, ils offcers, agenls and employees / CG 20 10 04 13 @ lnsurance Ssrvices Office, 1nc.,2012 r.Lt itand:rc rrr[ ]1.n i. r,,rLt/t t: 3:i5:40 Page 2 of 2 COMMERCIAL GENERAL LIABILITY cG 20 37 04 ',13 THIS ENOORSEMENT 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/COMPLETED OPERATIONS 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" or "property damage" caused, 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 exlent permitted by lawi and lf coverage provided to the additional insured is required by a contract or agreemenl, 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 cG 20 37 04 13 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: Required by the contract or agreement; or 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. B 1 1 2 @ lnsurance Services Office, lnc.,2012 Name Of Additional lnsured Person(s) Or Organizalion(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 contract or agreement is executed 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 r7:rrr 22 lrrtl 95M XS Sr.!. L.^dr.th I 1/2O/2O2? 0:t5:ao lt1 tpDr) I p.g. 5 of 1r Page 1 ot 2 However: additional insured. All other terms and conditions of this Policy remain unchanged Endorsement Number: This endorsement is effective on the inception date of this policy unless otherwise stated herein. (The informalion below is required only when this endorsement is issued subsequent to preparation of the policy.) Policy Number: Dpcl00585606 Named lnSured: All American Asphalt Endorsement Effectiu e Dale: o1tol t2o2z REFERENCEi CIP 20-10 Andalusia/Belcanto Asphalt Overlay Proiect / SCHEDULE: City ot Menifte, its officers, agenls and employees / CG 20 37 04 13 @ lnsurance Services Office, lnc.,20'12 t0 staidard ujth 55m xs 1/.!o/io21 a:45:4a N, lpDr) paqe 6 of Ll Page 2 ol 2 COMMERCIAL GENERAL LIABILITY cG 20 01 04'13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance providad under the following COIVIMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other lnsurance 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; (1) The additional insured is a Named lnsured under such other insurance; and (2) You have agreed in writing in a contract or agreement that 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 rBmain unchanged. REFERENCE: scHEouLEl CIP 20-10 Andalusia/B€lcanto Asphalt O\,Erlay Project / City of M€nifre, its officers, agents and employees / Endorsemenl Number: This endorsement is effective on lhe 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: Dpct oo58s6o6 Named lnsured. All American Asphalt Endorsement Effective Date: 6676172s22 CG 20 0l 04 13 @ tnsurance Services Office, 1nc.,2012 orl sr.ndrrd rlth ssm xs 1/:a/iol? ottr:rc at lpDT) p.q. r of 1l 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 modifres insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization where the waiver of our right to recover is permitted by law and is 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 The following is added to Paragraph 8. Transfsr for injury or damage arising out of your ongoing Of Rights Of Recovory Agsinst Others To Us 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 conditions of this policy remain unchanged. Endorsement Number: This endorsement 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: DPc1005E5606 Named lnsured: All Aherican Asphalt Endorsement Efiective Oale. o8,tol t2022 REFERENCE CIP 20-10 Andalusia/Belcanto Asphalt Oveday Proiect / SCHEDULEI City of Meni€e, ils offcers, agents and employees / cG 24 04 05 09 O lnsurance Services Office, lnc., 2008 l01l sr.ndard virh 55M xs 1/?a/ro:t a.4\t4a al., lpDT) p.se 3 of 1r Page 1 of '1 7120t2422 POLICYNUMBER BAP55710881O COMMERCIAL AUTO cA 20 48 10 t3 THIS ENOORSEMENT CHANOES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modfies insurance provtded under the lollowing 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 unlessmodfled by thrs endolsement. ThE endorsement rdentifies person(s) or organization(s) who are "insureds" for Covered Autos Liablaty coverage under the Who ls An lnsured provrsion of the Coverage Form. This endorsement does not alter coverageprovrdcd in thc Covcrogc Form. This endorsement changes the policy effectrve on the inception date of the policy unless another date rs rndicated below Namod lnsurud; AllAmerican Asphalt Endo6smcnt Efroctiw Datq: oglo.1l2o22 Name Ot Pcrson(s) Or Organizatlon(3): ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS ON A PRIMARY, NON.CONTRIBUTORY BASIS, lN A WRITTEN CONTRACT OR WRITTEN AGREEIVIENT EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMEI{T IS PROHIBITED BY LAW Information requrred lo complete this Schedule, if not shown above, will be shown in the Declardtons Each pe6on or organEation shown ln the Schedule is an'insured' for Cover€d Autos Lrabilfty Coverage, but only to the extent that person or organEatton qualfies as an rnsured under the Who ts An lnsured provEton contained in Paragraph A1. of Section ll - CoveredAutos Lrabrl[y Coverage rn ths Bustness Auto and Motor Carner Coverage Forms and Paragraph D,2. ofSection I - Covered Autos Coverages of the Auto Dealers Coverage Form CA 20 ,lE l0 '13 SCHEDULEI City of Menibe, its officers, agenls and employees / @ lnsurance Services Office, lnc., 201 I 69312t21 | 2? I01t Stand.rd rrrh 55m xs I si.!. L.ndr6r.h I ,/20l?o:? s:{srro A}4 lpDTl pase I of rr Page I of I SCHEDULE POLICY NUMBER: BAPs571o881o THIS ENDORSEMENTCHANGESTHE POLICY. PLEASE READ ITCAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF REGOVERY 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 FORI\4 With respeci to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy etfective on the inception date of the policy unless another date is indicated below. Named lnsured: A1American Asphal Endorsement Effective Dtte: s61s172s22 SCHEDULE Name(s) Of PeEon(s) Or Organization(s): ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT W]TH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OE SUBROGATION BE PROVIDED UNDER THIS POLICY lnformation required to this Schedule, if not shown above, will be shown in the Declarations 7120t2022 COMMERCIAL AUTO CA 04 zl4 '10 13 The Transfor Of Rights Of Recovery Against Others 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 thal person or organization. cA 04 44 10 !3 SCHEDULE: Cily ofMenibe, its oflicers, agents and employees / O lnsurance Services Office, lnc., 201 1 tnddrd vrLh s5m Page 1 of I 3:{5:40 At pDT) I Pdqe WORKERS' COMPENSATION AND EMPLOYEBS' LIABILITY INSURANCE POLICY wc 04 03 06 lEd 4-84) WAIVER OF OUR RIGHTTO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA \/e have the right to recover our payments from anyone liable lor an iniury covered by this policy. We will not enforce our right against the person or organization nanEd 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 described in the Schedule. The additional premium for this endorsenEnt shall be 0 .00 % of the Calitornia workers' compensation pre- mium otherwise due on such remuneration. Person or Organization A',L PERSONS AND /OR ORGANI ZATIONS TITAT ARE REQUIBED BY WRITTEN CONTRACT OR AGREEMENT I{ITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, TTIAT WAIVER OF SUBROGAT ION BE PROVIDED T'NDER THIS POLICY EOR WORK PERFORMED BY YOU TOR THAT PERSON AND/OR ORGANIZATION SCHEDUT,I.]: City of Menil'eq, its omccrs. agents and employees / Policy Number: wc5ql:os7oe Named lnsured: A1 Amcncan Asphatr Endorsement Effective Date; 08/0ril02 wc 252 \4A4)wc 04 03 06 (Ed. 4a4) Schedub Job De$ription AI,L CA OPERATIONS R[I't]RIiNCE: CIP 20- l0 Andalusia,/llclcanlo n sphalt Overla)' l'roicct / 69312121 12 I0rl sland.rd ,rLh S5M xs I siera L.ndrerh t 1/za/2a22 at11:4a Au lpDT) I prq€ r1 .f 11 l%ge 1 ot 1