2022/08/01 Cass Construction, Inc.ACORiJ
COVERAGES
CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NUMBER: 1 1'17918001 REVISION NUiIBER:
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the certlficate holdGr ls an ADDITIONAL INSURED, th6 pollcy(le!) must havo ADDITIONAL INSURED provlrlons or be endo6sd.
lf SUBROGATION lS WAIVED, aubiect to tho tsrmt and condltlon. ot tho pollcy, co.taln pollclgs m.y roqulro an 6ndorr.ment. A tt.tcment on
this corlificato dors not confor rlghtr lo tho cortificato holdor in llou of such andorsemanl(r).
PRODI',CER
Alliant lnsurance Services, lnc
701 B Street, 6th Floor
San Diego CA 92101
License#: 0C36861
Robin Hamilton
Robin.Hami lliant.com
INSURER(S) AFFORDING COVERAGE
TNEURER^: Executive Risk lndemnjty lnc
INSURER B
35181
cAsscoN-04
INSURER C
INSURER O
INSURER E
INSURER F
INSR TYPE OF IllSURANCE SUBR POLICY NUMAER LITITS
X COSSERCIAL GETERAL LIABILITY
CLAIMS,MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER
PoucY lt-l !$t Tl roc
OTTIER:
X
54303117 at1D022 41172023 FACH OCOI]RRFNCE s 1,000.000
5100.000
MED EXP r 5,000
PERSONAL & ADV INJURY $ 1,000 000
GENERAL AGGREGATE t 2,000,000
PRODUCTS, COMP/OP AGG i2 000
OEOUCTIELE s 5,000
AUIOTOBILE LIABILITY
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
I I
SCHEOULEO
AUTOS
NON.OWNED
AUTOS ONLY
COMBINEO S NGLE LIM T 5(
BODILY INJURY (Per pcM.) I
BoolLY INJURY (P6r .@.Lnl) S
PROPERTY DA[[AGE $
s
Uf,BRELLAL|AB
EXCESS L|AA
OCCUR
CLAiMS.MADE
..ACH OCCURRENCE 5
AGGREGATE s
OED RETENIiON 3 s
WORXEiS COXPEiISATION
ANO EXPIOYERS' LIABILTTY
ANYPROPRIEIOR,/PARTNER/EXECIJT VE
OFFICEF'MEMAEREXCLUOED?
DESCRIPTION OF OPERAT ONS b6low
PERSTATUTE olti,ER
EL EACH ACCIOENT S
E I OISEASE, EA EMPLOYEE $
E L. DISEASE. POLICYTIMII $
DEsCRIPIION OF OPERAnOIS / LOCATIOIIS / VEHICLES {ACORO 101. Addldon.l R.m..t Sch.d!|., D.y b. .lt ch.d ll moE .p... l. rqulnd)
Re: Encroachment Permit. Certificate Holder is named as an additional insured (GL) per the atlached CG2012 ondorsement.
CERTIFICATE HOLDER CANCELLATION
City of Menifee
29714 Haun Rd.
Menifee CA 92586-0000
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
TXE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVEREO IN
ACCOROA}{CEWITHTHE POLICYPROVISIONS.
AUTHORIZED REPRESENTATIVE-A
O 1988-2015 ACORD CORPORATION. All rights reserved
The ACORo name and logo are regislerod mark6 of ACORDACORD 25 (2016/03)
OATE (TU/DD/YYYY)
7t25t2022
IIISURED
Cass Construction, lnc.
P.O. Box 309
El Cajon CA 92022
THIS IS TO CERTIF/ THAT THE POLICIES OF INSURANCE LISTEO BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICiES- LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
!lrrr
I
POLICY NUMBER: 543031 17 COMMERCIAL GENERAL LIABILITY
cG 20 12 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - STATE OR GOVERNMENTAL
AGENCY OR SUBDIVISION OR POLITICAL
SUBDIVISION - PERMITS OR AUTHORIZATIONS
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
State Or Governmental Agency Or Subdivision Or Political Subdivision:
AS REQUIRED BY WRITTEN CONTRACT
lnformation required to complete this Schedule, if not shown above, wlll be shown in the Declarations.
A. Section ll - Who ls An lnsured is amended to
include as an additional insured any state or
governmental agency or subdivision or political
subdivision shown in the Schedule, subject to the
following provisions:
'1. This insurance applies only with respect to
operations performed by you or on your behalf
for which the state or governmental agency or
subdivision or political subdivision has issued a
permit or authorization.
However:
a. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
b. lf coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to such
additional insured will not be broader than
that which you are required by the conhact
or agreement to provide for such additional
insured.
2. This insurance does not apply to:
a. "Bodily inJury", "property damage" or
"personal and advertising injury" arising out
of operations performed for the federal
government, state or municiPality; or
b. "Bodily injury" or "property damage"
included within the "products-completed
operations hazard".
B. 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:
1, Required by the contract or agreementi or
2, Available under the applicable limits of
insurancei
whichever is less.
This endorsement shall not increase the
applicable limits of insurance.
@ lnsurance Services Office, |nc.,2018 Page 1 of 1cG 20 12 12 19