2022/06/01 Altec Industries, Inc.CERTIFICATE OF LIABILITY INSURANCE OAIE OI/DD/YYYY)
05t2412022
THIS CERTIFICATE IS ISSUEO AS A MATTER OF INFOBMATION ONLY AND CONFERS NO RIGHTS UPON THE CEFTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENO, EXTENO OR ALTER THE COVEBAGE AFFORDEO BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE OOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREB(S), AUTHORIZEO
REPRESENTATIVE OR PRODUCER, ANOTHE CERTIFICATE HOLDER.
IMPORTANT: ll the certllicato holdor l8 an AOOITIONAL INSURED, the pollcy(les) muat hsvc ADDITIONAL INSURED provisions or be ondoraod.
It SUBAOGATION lS WAIVED, subioct to the term6 and condllions ol tho policy, certaln policies may requlrs an ondoB6menl. A slatemsnt on
thls certlllcate does not confer rlght6 to the certllicale holder ln lleu ol such endoraement(s).
PioDucEn
Mccriff lnsurance Services. lnc.
P.O. Aox 10265
Birminqham AL 35202
Bndgetle Taul
800-476-2211
btaul@mcAnfl com
AFFOFOING COVEBAGE
19437
INSUHEO
Allec lndustri€s. lnc.
1450 N 1sl Slreel
Dixon. CA 95620
TNSUBEB E:Harlford Fir€ lnsurance Co r9682
INSUREFC:AlG 26883
INSUFEF O :Trumbul lnsurance 27120
lNSr.lFER E rHartlord qa:,?1ry-!E9re!99 qg4pely 29424
INSUREF F
COVEBAGES CERTIFICATE N UM BER: r-l32K4wr"1S REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POLICY PERIOD
INOICATED, NOTWITHSTANDING ANY FEQUIREIUENI TERM OR CONDITION OF ANY CONTFACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE I\IAY BE ISSUED OR MAY PERTAIN. THE INSUFANCE AFFORDED BY THE POLICIES OESCRIBEO HEFEIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONOITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED 8Y PAID CLAIMS.
TYPE OF INSI.IBANCE LrMrls
EACH OCCURFENCE 5 000,000s
PAEMISES rEe dcu16nc6r 3 000.000s
s
10.000.000
5.000 000S
SGENEFAL AGGAEGATE
PEFSONAL A AOV IiUUAY
06t412022 06i01/2023
PEOOUCIS. COMP/OP AGG
X
X
X
COMMENClAL GENEFAL LIABILIIY
CLAIMS MADE OCCL'B
GENLAGGFEGATE LIMIT APPLIES PEF
LOCXJECTPOUCY
OTHEB:
10.000.000s
S
COMBINEO SINGLE LIMIT 5.000,000sB
OWNED
AUTOS ONLY
HIBEOAUTOS ONLY X
X
AUTOMOBILE LIABILIIY
SCHEDULEO
AUTOS
NON.OWNEOAUTOS ONLY
1CSFS27903 o6ta12D22 06t01t2023
5
5
s
BODILY INJUFY (P6r person)
BOOILY INJUFY (P6r accrd6n0
10.000.000EACH OCCUBFENCE s
10.000,000
1457UMBRELLA LIAA X
EXCESS LIAB
BEIENIIONDED
OCCUF 06t01Q422 06t01t2423
AGGFEGATE
S
D
E
woFKEls coLPElrs^TroN
AND EUPLOYEFS' UAEIL,TY
ANY PFOPRI6OA/PANTNEREXECUTIVE
OFFICEFA,,EMBEF EXCLUDED?
I]ES'FIIF,II'N OF i ]PEl.A'TIONS SI.d
21XWE527902 (AL.MO,NC)
1
E L DISEASE. EA EMPLOYE€s
, E L JISEASE
1.000,000
1.000.c00
1.000,000
X
E L EACH ACCIDENI s
s
5
S
s
5
OESCRIPTIOII OF OPEFATIOI{S, LOCATIOIIS / VE}i|CLES (ICOFD l0l. Ai,dltldd e.m.r*. Sch.dd., ni.y t rti.clr.dfmorl.pELrlqlrlld)
City ot Menifeo and its ofrcers, employees. agents, and authorized volunl€ers are Additional lnsu.ed under Goneral Liability on a primary and non-contribulory basis as
rcqui€c, by witten contracl.
See cancellation endors€ment Iorm altach6d
CERTIFICATE HOLDER CANCELLATION
Cily of Menifee
29844 Haun Rd.
Menifee. CA 92586
SHOULD AT.IY OFTHE ABOVE OESCFIBED POLICIES AE CANCELLED BEFORETHE EXPINATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCOROANCEwlTHTHE POLICY PROVISIONS,
AUTHORIZED FEPFESENTAIIVE ffin-Paselol6 @'1988-2015 ACORD CORPORATION. All rights reaervad.
The ACORD name and logo are reglsterod marks ol ACORDACORD 25 (2016/03)
o.Qo'
o6to1t2022 06to1t2023
tT
H
Altec, lnc.
Policy No. 21CSES27903 #
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTTCE OF CANCELLATTON TO CERTTFTCATE HOLDER(S)
This policy is subject to the following additional
Conditions;
lf this policy is cancelled by the Company, other
than for nonpayment of premium, notice of such
cancellation will be provided to the certificate
holde(s) with mailing addresses on file with the
agent of record. Such notice witl be provided
within 30 days of the Company's receipt of
certificate holder(s) information from the agent of
record.
lf notice is mailed, proof of mailing to the last
known mailing address of the certificate holder(s)
Form lH 03 10 06 11
on file wjth the agent of record will be sufficient
proof of notice.
Any notification rights provided by this
endorsement apply only to active certificate
holde(s) who were issued a certiflcate of
insurance applicable to this policy's term
Failure to provide such notice to the certificate
holder(s) will not amend or extend the date the
cancellation becomes effecttve, nor will it negate
cancellation of the policy. Failure to send notice
shall impose no liability of any kind upon the
Company or ils agents or representatives.
Page 'l of 1
Page 2 of 6
O 2011 , The Hartford
H32K4WMS
ENDORSEMENT.
Form3 a parl ol PolicY No'i 013135094
lssued to: Altec, lnc. Attnt Mark Bertovic
By: LEXINGTON INSURANCE COMPANY
ADDITIONAL INSURED REOUIRED BY WRITTEN CONTRACT
This endorsement modilies insurance provided under tlle tollowing
COMMERCIAL GENERAL LIABILITY POLICY
A, Ssctlon ll - who ls An lnsured is amended to include any person or organizstion you are
required to include 8s an addilional insured on this policy by e written controct or written
agreement in effect during this policy period and €xecuted prior to the "occurrcnco" o{ the
"bodily injury" or "property damage."
B. The insurance providsd to the sbove described additionsl insured under this endorsement is
limit6d as follows:
I.CoVERAGEA.BoDILYINJURYANDPRoPERTYDAMAGE(Sectionl-coversges)only.
2. The person or organization is only an additional insured with Isspect to lisbility srising out
of "your work" or "Your product" lor that additional insured.
3, ln the event that the Limits of lnsurance provided by this policy exceed the Limits of
lnsurance required by the written contract or written Egreement, the insurance plovid0d by
this endorsement shall be limited to the Limits of lnsurance requir€d by the written
contract or written ag.eement. This endorsement sholl not incr66se the Limit6 of
lnsurance stated in the DeclErations und6r ltem 3. Limits ol lnsurance pertsining to th€
coverage provided herein.
4. The insurance provided to such an additional insurBd does not apply to "bodily iniury" or
"property damage" arising out of an architect's, enginoer's or surveyor's rendering ol or
fsilure to rend€r any protessional services including:
I The pteparing. approving or tailing to plepare or approve msps, shop drawings'
opinions, reports, surveys, lield oldors, change orders, or drswings and sp8cifications;
and
ii Supervisory, inspection, architecturalorengineeringactiviti€s'
5, This insurance doBs nol Epply to "bodily injury" or "property damage" arising out of "your
work" or "your product" included in ths "products-completed operations hazsrd" unl€ss
you are required to provide such coverag€ by written contract or writtsn agreemsnt'
6. Any coverage provided by this endorsement to an additional insurod shall b€ excess over
sny other valid and collectible insurance svailsble to the additional insurgd whsther
p(imary, excess, contingent or on any othBr basis unless s written contract or written
agr€ement specificallY requires that this insuranc€ spply on a primary and non-contributory
basis.
Manu!cript Form
Page 3 of 6
Psge 1ol 2
H32K4WMS
C. ln accordance with the terms and conditions of the policy End as more fully oxplained in th€
pollcy, Bs soon as practicoble, each sdditional insurod must givB us promPt notice of any
"occurrencB'which may rosult in a claim, torward all logal papsrs to us, coopo]ato in tho
defonsa of any actions, and otherwise comply with 8ll of th€ pollcy'6 torms End conditions,
All oth€r t€rm6 and conditions ot th€ policy romain the same.
Authoriz€d Rep16sontativB
Manuscrlpt Form
Page 4 of 6
Pige 2 ol 2
I.I32K4WMS
ENDORSEMENT ' 038
Forms o pon ol pollcy no.: ol 3t 30094
lssu.d to: ALTEC, lNC.
ATTN: MARK BERTOVIC
By: LEXINGTON INSURANCE COMPANY
ADVICE OF CANCELLATION TO ENTITIES OTHER THAI{ THE NAT'ED INSURED LII$ITEO TO E{IAIL
NOTIFICATION
This policy is omendBd as tollows:
ln th6 €vont that tho lnsurer concels this policy lot 8nY Ieason othor than non psYmont ol premium, snd
1. Tho concollstion orrsctive date is prior to this Policy's oxpitorion dat€;
Z. Tho Flrll N!m!d lnaurcd is under an oxistlng contoclual obligotion to notllY I conlfic8ts
holdar wh6n this potlcy ls cancclod (hercinsltor, tho 'C€nilicrto Holdorls)'); and'h83 provldod
to tha lnrurcr, Githsr diroctly or through lts brokor ol racord, tho am8ll addross ol tho contact
st such sntitY.
aod th€ ln8urer receiv€d this intormatlon 8ttsr thc Flrsl ftllnrad lntur.d tocoives notico ol
cancellstion o, this policy end pior to thls policy's cancellatlon eltectivs dsta, vir 0n olecttonlc
spro8dsheot that ls occoptoble to tho lnrurrr,
tho rnsuroi witl provide advlce ol cancollEllon {lhs'Advico') Yle 3'mail lo such Canllicalo Hold€rs'
proof of tho lnou,l, smalling the Advic6, uslng th8 lnfolmstion providsd by the Ffust thtnod lntuled, will
serve as proof th6t the lnsuror ho6 futly sstisfiod its obllgsrlons undtr this €ndorsom€nt'
Thl6 sndor6em0nt doas not €rrect, in any way, covologo providod undst lhls policy o, the csncollation of
thls pollcy or rh6 elrectiv€ dats theteol, nor shlll lhls endorsomont lnvost any rlght! in any ontitY not
lnsurad undet this PollcY,
Th6 lolloryinB Oc(initions spply to this endorGom€nt:
L FLsr Nlmod lnrurod mosns th€ N8mcd lnsured shorvn on tho Dcclarotlons Pogo ol lhis policy.
2'lnsurcrmoanslh€insulgncocompsnYEhownlnthehesdoronthaoeclorltlonsPsgoo,thls
PolicY.
All othor terms and conditions remain unchangod.
i),-l B;-
LEXDOCO2l
LX0404
Authoiizsd Repreeentatlve OR
Counlonignalurs (in slrta3 whore appllcsblo)
Page 5 of 6 H32K4WMS
' Altec, lnc.
Policy No. 21WNS27900 #
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTTCE OF CANCELLATTON TO CERTTFTCATE HOLDER(S)
This policy is subjecl to the following additional
Conditions'
lf this policy is cancelled by the Company, other
than for nonpayment of premium, notice of such
cancellation will be provided to the certificate
holde(s) with mailing addresses on file with the
agent of record. Such notice will be provaded
within 30 days of the Company's receipt of
certificate holde(s) information from the agent of
record.
lf notice is mailed, proof of mailing to the last
known mailing address of the certiflcate holde(s)
Form lH 03 10 06 11
on file with the agent of record will be sufficient
proof of notice.
Any notification rights provided by thts
endorsement apply only to active certificateholde(s) who were assued a certificate of
insurance applicable to this policy's term
Failure to provide such notice to the certifcate
holde(s) will not amend or extend the date the
cancellation becomes effechve, nor will it negate
cancellation 0f the policy. Failure to send notice
shall impose no liability of any kind upon the
Company or its agents or representatives.
Page 1 of 1
Page 6 of 6
@ 201 '1, The Hartford
H32K4WMS