2022/07/01 Andy Gump, Inc.CERTI FICATE OF LIABILITY INSURANCE 6t30t2022
THIS CERTIFICATE IS ISSUEO AS A MATTER OF ITIFORI{ATION ONLY AT{O CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOER. THIS
CERTIFICATE DOES NOT AFFIRf,IATIVELY OR NEGATIVELY AMENO, EXTE}IO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. TH|S CERTTFTCATE OF INSURAT{CE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE |SSU|NG TNSURER(S}, AUTHORTZEO
REPRESENTATIVE OR PRODUCE& AND THE CERTIFICATE HOLDER.
IMPORTAI{T: lf the c6nlficat6 holder iB an AODITIONAL INSUREO, tho policy{ios) must havo ADOITIONAL IIISURED provisions or be endorsed.
l, SUBROGATION lS WAIVED, subject to the torms and condltions ol the policy, certain policigs may requiro an ondoBoment. A statement on
this certificat€ does not conlet .ights to tho corliflcato holdor in liou ol such ondoBomsntls)
PRooucER Venbrook Insurance Services
6320 Canoga Avenue, 'l2th Floor
Woodland Hills, CA 91367
kt
818-598-8900 818-598 8910
INSUR
www venbrook com CA Lic No 0D80832 IN Na ators S lnsura Com 36056
Alaska Nalional lnsurance Co,n 38733And
269
y Gump, lnc.54 Ruether Avenlre rilsuRER c : V1/eslchester S s Lrnes lnsurance Co 10172
Santa Clarita CA 91351 0 AGCS I\,{arine lnsuran 22837
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTEO SELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THE POLICY PERIODINDICATEO NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONIRACT OR OTHER OOCUMENT WTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN, THE INSURANCE AFFOROED AY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOVV.I MAY HAVE BEEN REDUCED BY PAID CLAIMS
COMMERCIAL GENERAL LIABILITY
OCCUR
BFPt]/XCU/OCP
Contraclual
GEN'LAGGREGATE LIM T APPLIES PER
POLICY
OIHER
PRo- TJ.^^JECI I ILA
LA22CGL192250tC
$5,000 Deductible
711t2022 7 /1t2023 EACHOCCURRENCE
PRFMSES lEa o@rencr
s5 000
s1 000 000
s2,000.000
MEO ExP (Any on6 peren)
PERSONAL& ADV NJURY
GENERALAGGREGATE
PROBJCIS COMP/OP AGC
s
B AI]IO OAILELIAAILITY
o\l tED
AUTOS Of,lLY
HIREOAUIOS ONLY
22GAS10585 7 t1t2022
aoolLY TNJURY lPe. o€r$n)9
s
OCCUR
CLAIMS."AOE
7 t1t2022 711t2023 EACHOCCURRENCE 000 000
A6GREGAIE 000 000
OED REIENIION I s
B woRxERsco PE lsAnoN
ANO EI( PLOYEFS' TIABIL
ANYPROPRIETOR/PARTNERJEXECIJT VE
OTFICER/MEMBEREXCLUOEO'
DESCRI PIION OF OPERATIONS bsrtu
N
22G\ /D10585 7t'12022 7 t1t2023 STATUTE oTl.l
ER
31 000 000
s 1 000 000
E L EACHACC]OENI
EL DSEASE EAEMPLOYEE
E L D1SEASE , POLICY LIMIT s'1,000.000
C
D
Pollulion Liability
Conlraclorb Equipmenl
Leased/Renled Equipment
711t2022
711t2022
7 t112023
7 t112023
$2,000,000 Per Occ/General Aggregate
$1 5 075,777 LimiU$2.500 Oeduclible
$1 00.000 LimiU$2.500 Deductible
O€ScRlpnOn OF OP€FAiONS / tOcAnONS / VEHICLES (ACORD 101, Addrdon.l Rmrrk Sch.dub, h.y b..ttsh.d ir non .p.c. I. .qua.d)
REr Encroachment Permil Applic€tion
Cerlifcate holder is named as Additional lnsuredl under tt€ General Liability policy if required by writlen conlract with the Named lnsuredbul only lor co\Erages and hm[s provrded by lhe policy and ttle additional insured endoGemenl.'10 Days Notrce of Cancellation for Non-Payment of Premium. 30 Days All Others.
COVERAGES CERTIFICATE NUMBER: 69074108 REVISION NUMBER:
CERTIFICITE HOLOER CANCELLATION
O 1988-2015 ACORD CORPORATION. All rights rEerved
ACORO 25 (20'16/03) Ths ACORD narrre and logo re rogisbred .rErks ofACORD
Citv of Menifee29714 Haun RoadMenifee CA 92586
SHOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLEO SEFORETHE EXPIRATION DATE THEREOF. NOTICE WILL BE OELIVEREO IN
ACCOROANCE WITH THE POLICY PROVISIONS,
AIJTHORIZED REPRESENTAIIVE
ACAD'
I
I
$'1,000,000
$ 100,000
a2,qq0,000
[--] SCHEDULEDL I AUro6
I /lAurosor,rlYtt
7/ri2o23 LffiffifllllllLllpqqooo
I BOoILY TNJURY rP a@denrll t
I PROPERTYDAMAGE I.
lLA22EXCZ084BDrC
l(Undedy'nS
GL. AL EL)
I
I I 1G27462017009
I I lrvrxrssorzs+.r
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Adrianna Padilla
Andy Cump.lnc
l.A22CGL 192250tC
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS . AUTOMATIC STATUS FOR OTHER
PARTIES WHEN REQUIRED IN WRITTEN
CONSTRUCTION AGREEMENT
This endorsement modifies insurance provided under the following
COMIVlERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL GENERAL LIABILITY
cc 20 38 04 13
A. Soction ll - Who ls An lnsured is amended to
rnclude as an additional insured:
'1. Any person or organization for whom you
are performing operations when you and
such person or organization have agreed in
writing in a contract or agreemont that such
person or organization be added as an
additional insured on your policy; and
2. Any other person or organization you are
required to add as an additional insured
under the contracl or agreement described
in Paragraph 1. above.
Such person(s) or organization(s) is an
additional insured only with respect to liability
for "bodily iniury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by:
a, Your acts or omissions; or
b. The acts or omissions of those acting
on your behalf;
in the performance of your ongoing operations
for the additional insured.
However. the insurance afforded to such
additional insured described above:
a. Only applies to the extent permitted by
law: and
b. Will not be broader than that which you
are required by the contract or
agreement to provide for such additional
insured.
A person's or organization's status as an
additional insured under this endorsement
ends when your operations Ior the person or
organization described in Paragraph 1. above
are completed.
B. With respecl to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to:
1. "Bodily injury", "property damage" or
"personal and advertising injury" arising
out of the rendering of, or the failure to
render, any professional architectural,
engineering or surveying services,
including:
a. The preparing, approving, or failing
lo prepare or approve, maps, shop
drawings, opinions, reports,
surveys, field orders, change orders
or drawings and specifications; or
b. Supervisory, inspection,
architectural or engineering
activities.
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing in the supervision, hiring,
employment, training or monitoring of others
by that insured, if the "occurrence" which
caused the "bodily injury" or "property
damage", or the offense which caused the
"personal and advertising injury", involved the
rendering of, or the ,ailure to render, any
professional architectural. €ngrneering or
surveying services.
2. "Bodily injury" or "property damage"
occurring after:
a. All work, including materials, parts or
equipmenl 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
CG 20 38 Oil,,1a,, O lnsuranco SoBr'io6s OfEce; tno, 2012 Page 'l of 2
b. 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.
C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section lll - Limits Of lnsurance:
The most we will pay on behalf of the
additional insured is the amount of insurance:
1. Required by the contract or agreement
described in Paragraph A.l., 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 20.38 04,te, .., @ lnsuranes Servicas Of8ce; luc.,2012 Page 2 of 2