2022/08/01 All American Asphalt (5)7120t2022
T}IIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR IATION ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOER. THIS
CERTIFICATE DOES NOT AFFIRT$ATIVELY OR NEGATIVELY AMEND, EXTENO OR ALTER THE COVERAGE AFFORDEO BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS}, AUTHORIZED
REPRESENTATIVE OR PROOUCER, AND THE CERTIFICATE HOLDER.
TMPORTANT: ll tho cortiticato holdor is an AODITIO AL INSURED, tho pollcy(les) rnust havo ADOlTlOr{AL INSURED p.ovi3iom or bo endoBed.
lf SUBROGATION lS WAIVED, subject to the term3 and condltlorE ol tho pollcy, corlsln policios may requinr an ondorsement. A slatemont on
thb cg(jficato doga not confgr rlghts to tho certlflcato holda. ln llou o, !uch andorsgmont{3).
PRooucFR Edqewood Partners lnsurance CenterPO- Box 5003
San Ramon. CA 94583
www.epicbrokers.com CA LICENSE #0829370
Certif cates Deoarlmenl
559-451 3200 925-901 0671
PI kers
AFFORDING COVERAGE
lnsLrrance Com 2119S
INSUREO
All American AsDhalt
P.O Box 2229
Corona CA 92878
Zurich American lnsurance Co 16535
Great American lnsurance Co 16691
ERE
ACORi'.CERTIFICATE OF LIABILITY INSURANCE
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
CERTIFICATE HOLOER CANCELLATION
@ 1988-2015 ACORD CORPORATION. All rights re3ervod.
ACORD 25 (2016f03) The ACORD nsme and logo are roglstsred ma*s of ACORD
. l!r s!J r'rr Nrih 55hh rs sj!rd LJnlrlrh
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED EELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INOICATED NOTWIHSTANDING ANY REQUIREMENT. fERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO VvllICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONOITIONS OF SUCH POLICIES LIMITS SI]O\A4'{ MAY HAVE BEEN REDUCEO BY PAIO CLAIMS
COiI ME RC'A L GE I.]ERAL LIA BILITY
GEN'L AGGREGATE LIM T APPLIES PER
JECI Loc
DPC100585606 8t1t2022 811t2023 EACH OCCIJRRENCE r 1,000,000
$ 100 000
MED EXP (Anyon€ p66on)
PERSONAL & AOV IN.JL]FY s 1 000.000
GENE RAL AG6REGATE 52,000.000
$2 000.000PRODUCTS COMP/OP AGG
B AUTOMOBILELIABILIry
HIREO
AI]TOSONLY
SCHEDULEO
NON.OWNEO
8AP5571.18810 8t1t2022 8t112023 COMBINEO SINGLE LIMIT s2 000 000
s
t
EODTLY NJURY lPd person)
BODILY INJURY (Ps a.dd6.r)
-lPir-4sE@!L
5
c
EXCESS LIAB
10,000
TUE347483602 811t2022 8t112023 EACH OCCURRENCE
AGGREGATE
!!pq9,qq
!5,000.000
Follo,ving-Form $
B WORXERS CO PEiISATION
ANOE PLOYERS'I|AA|LIIY
ANYPiOPRI€TOR/PARINETI,€)(ECUTIVE
Of FICER/MEMSEREXCLUD€D?
DESCRIPTION OF OPERATIONS bErM
N
\ /c593205709 81112022 8t1t2023
s 1,000,000E L E CH ACC OENT
E L OISE^SE. EA EMPLOYEE s 1 00n ooo
EL OSEASE POLICYLMIT s 1,000.000
oESCRIPnOn OF OPERATIONS / LOCAIONS / VEXICLES IACORo 101 , Add{tlontl R.n.r*. S.h.dul., n.y b. .lt.ch.d It moE .p.c. i. Equind)
RE: Public Vvorks Mainlenance and Operations C€nler, CIP 16-13 /
Cerlifcate Holder is Additional lnsured if Requiled by Wfltten ConlGcl Excluding V\b*ers Compensation
Citv of Menifee
29844 Haun Road
Menifee CA 92586
STIOULD ANY OF THE ABOVE OESCRIAEO POLICIES BE CANCELLED BEFORE
THE EXPIRATION OATE THEREOF, NOTICE WILL BE DELIVEREO IN
ACCORDANCEWITH THEPOLICY PROVISIONS
AUTHORIZED REPRESENTATIVE
Maleah Cantrell
I
I
[ *"r"
ba----
trtrtr9
PO Box 5003
San Ramon, CA 94583
Phone:925.244.7700
Fax:925.901-0244
Email: EPlCcerts@epicbrokers.com
To:
Regarding:
Date lssued:
Named lnsured(s):
Policy Number(s):
Vvhom it may concern
Notice of Cancellation
7 t20t2022
All Amcrican Asphalt
DPC100585606
8AP5571088 r0
wc593205709
1Ut]34748]602CERTIFICATE HOLDER:
( it\ ol l\4enilie
298.14 llaun RoadMcnilic C A 9258(r
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,
Malcirh ( antrell
epicbrokers.com edgewood partners insurance center
693r:r:3 r :a lo| sranddrd vlth ssm )is )/ta/,:o12 atrl:4a a, (pDT) p.qe i of tl
ca license 0829370
ba----
COMMERCIAL GENERAL LIABILITY
cG 20 r0 04 13
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SGHEDULE
Name Of Additional lnsured Person(s)
Or Organization(s):
Location(s) Of Covered 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 localion where required by written contract or
agreement, provided the contract or agreemenl 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 lnsurad 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.
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 acontracl 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
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
afler:
All work, including materials, parts
or aquipment furn is hed in
connsction with such work, on the
project (other than service,
mainlenance 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 lhe iniury or damage arises
has been put lo its inlended use by
any person or organization other
than another contractor or
s u b contra cto r engaged in
B
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Page 1 ol2
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
However:
1.
performing operations for a
principal as a part of the same
project.
With respect to the insurance atforded 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
agreemenl, the most we will pay on behalf
of the additional insured is the amount of
insurance:
Required by the contract or
agreemenl; or
Available under the applicable
Limits of lnsurance shown in the
Oeclarations;
whichever is less.
This endorsement shall nol increase the
applicable Limits of lnsurance shown in
the Declarations.
1
2c
All other terms and conditions of this policy remain unchanged
Endorsement Number:
This endorsement is effective on the inc€ption date of this policy unless otherwise 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 American Asphall
Endorsement Effective Date: 08/01/2022
REFERENCEi
RE: Public Works Mainlenance and Operations Center, CIP 16-'13 /
SCHEDULE:
City of Menibe
CG 20 10 04 13 @ lnsurance Sorvices Offico, |nc.,2012
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Page 2 ol 2
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:
COIVIMERCIAL GENERAL LIABILIry COVERAGE PART
PROOUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
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 contract or
agreement is executed prior to any "occurrence" or
offense
All locations where required by contract
lnformation requirsd 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 tor "bodily injury" or
"property damage" caused, in whole or in
part, by "your work" al the location
designated and described in the Schedule
of this endorsement performed for that
additional insured and included in the
"products-completed operations hazard'.
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 agreement, theinsurance 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
additional insured
With respect to the insurance afforded to
these additional insureds. lhe followrng is
added to Section lll - Limits Of
ln6urance;
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:
Ava ilable under the applicable
Limits of lnsurance shown in the
Declarations;
This endorsement shall not increase the
applicable Limits of lnsurance shown in
the Declarations.
B
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Page 1 ol 2
Required by the contract or
agreement; or
whichever is less.
All olher lerms 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: Dpc1oos8s6o6
Named lnsured: All American Asphalt
Endorsement Effective Date: 08/01/2022
REFERENCEi
RE: Public\ilbrks Mainlenance and Operations Center, CIP 16-'13/
SCHEDULE:
City of N,lenibe
CG 20 37 04 13 O lnsurance Services Offlce, lnc..2012 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 endoGement modifies insurance provided under the following
The following is added to the Other lnsurance
Condition and supersedes any provision to the
contrary:
Primary And Noncontributory
lnsurance
('l ) The additional insured is a Named
lnsured under such other insurance;
and
This insurance is primary to and will notseek contribution from any other
insurance available to an additional
insured under your policy provided that:
All other terms and conditions of this policy remain unchanged.
REFERENCE: SCHEDULE:
RE: Public lrtrorks Maintenance and Operations Centor, CIP 16-13/ City of trenitue
Endorsement Number:
This endorsement is effective on the inception date of this policy unless otherwise stated herein.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Policy Number: Dpcl 00585606
Named Insured. All American Asphatt
Endorsement Effective Date: 9616172622
cG 20 01 04 13 O lnsurance Services Offlce, lnc.,2012
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Page 1 of 1
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
(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.
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:
COMIVIERCIAL 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 contracl or agreement is executed prior to any occurrence or
oftense
lntormation 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 Recovgry Against 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 operalions
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 othenyise stated herein.
(The information below is required only when this endorsement is issued subsequent to preparation
of the policy.)
Policy Number: oPc100585606
Named lnsu red:All American Asphalt
Endorsement Effective Date: o8/01/2022
REFERENCE
RE: Puuic Vlbrks Maintenance and Operalioos Center, CIP 16-13 /
SCHEDULE:
Cily ot Menibe
cG 24 04 05 09 @ lnsurance Services Office, lnc., 2008
1l standard riLh SsM xs sier. r,.nd!e 4s:i0 lx (PDTI
Page 1 of 1
112012022
POLICY NUMBER. BAPs571O881O COMMERCIAL AUTO
cA 20 48 10 13
Thrs endorsement modifies ansurance provided under the follolving
AUTO DEALERS COVERAGE I.ORII,I
BUSINESS AUTO COVERAGE FORIVl
[,OTOR CARRIER COr'ERAGE FORM
With respect to coverage provided by this endorsement, the provEions of the Coverage Form apply unless
mod red by thrs endorsement
This endorsement identfles person(s) or organization(s)who are 'insureds' for Covered Autos Liablity Coverage
undsr the Who ls An lnsured provrsion of the Coverage Form. This endorsernent does not alter coverageprovrdcd an thc Covcrogc Form
Thts endorsement changes the polrcy efiective on the rnce*pn date of the policy unless another date rs rndtcated
bslow
Named lnsurcd: All American Asphall
End016emont Efoctive Date: O8lO 2022
SCHEDULE
Name Of Personlsl Or Organlzation(r):
Al\lY PERSOhI OR ORGANIZATIOI{ TO WHOIM OR Vvtl ICH YOU ARE REOUIRED TO
PROVIDE ADDITIONAL INSURED STATUS ON A PRIMARY NON-CONTRIBUTORY
BASIS. IN A WRIITEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO
LOSS, EXCEPT WHERE SUCI-I CONTRACT OR AGREEiVIENT lS PROHIBITED BY LAW
lnformation required to complqte thrs Schedule, 'f not shown above, will be shown rn the Declaratrons
Each person or organrzation shovr'n in the Schodule is
an "rnsured'for Cover€d Autos Liabltty Coverag€, but
only to the extent that person or organEation quahftes
as an rnsured under the who ls An lnsured pdovtspn
contained rn Paragraph A'1. ol Sectpn ll - Covered
Autos Liabilrty Coverage in the Business Auto and
Motor Carner Coverage Forms and Paragraph D.2. ofSection I - Covered Autos Coverages of the Auto
Dealers Coverage Form.
CA 20 rlE l0 13 @ lnsurance Servrces Office, lnc , 2011
SCHEDULE:
Caly of Menibe
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Page 1 of I
THIS ENOORSEMENT CHANOES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
712012022
POLICY NUMBER BAP55710881o COMMERCIAL AUTO
cA 04 44 10 13
THIS ENDORSEMENTCHANGESTHE POLICY. PLEASE READ ITCAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGATNST OTHERS TO US (WATVER 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 endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named lnsured: A American Asphatt
Endorsement Effective Date; 6676172622
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN
CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE
ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER
THIS POLICY
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
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
that person or organization.
cA 04 44 10 't3
SCHEDULE:
City of [,,lenitue
@ lnsurance Services Office, lnc., 2011
6Cr?l],:3 23 I0rl 5rand.!d vtrh $5m xs I 5ic!. Lrndrerh I 1/2a/2a22 at45t40 Ix (pDT) I p.qe 1o of rr
Page , of I
WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY wc 04 03 06
(Ed. 4-84)
WAIVER OF OUR RIGHTTO HECOVEH FROM OTHERS ENDORSEMENT_
CAL!FORN!A
We have the right to recover our payrnents lrom anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization narned in the Schedule. (This agreernent 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 oI your employees while engaged in
the work described in the Schedule.
The additional premium for this endorsernent shall be
mium otherwise due on such remuneration.
0.00 % of the Calilornia workers' compensation pre-
SCIII]DULE:
City oI Menil'ec
Person or OrganizationAI,L PERSONS AI{D /OR
ORGANI ZATIONS THAT
ARE REQUIRED BY
WRITTEN CONTRACT OR
AGREEMENT WITH THE
INSURED. EXECUTED
PRIOR TO THE
ACCIDENT OR LOSS,
TITAT WAIVER OE
SUBROGAT ION BE
PROVIDED I'NDER TITIS
POLICY TOR WORK
PEREORMED BY YOU TOR
THAT PERSON AND /OR
ORGANI ZAT ION
PolicyNumber: wc5sl2o57oe
Named lnsured: Al Anrcrcan Asphall
Endorsement Effective Date: 08/0ri20?l
wc 252 (4A4)
wc 04 03 06 (Ed. 4€4)
Schedub
Job Description
AI,L CA OPER,ATIONS
REFERT'NCE:
RI1: Public works Maintcnancc and Opcralions ('cnicr. ( lP
16-13 /
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