2022/07/01 G&A Outsourcing, LLC-^\ "ACORD"
COVEBAGES
CERTlFICATE OF LIABILITY INSURANCE
CEBTIFICATE NUMBER:22TX0381 1 14684 BEVISION NUMBER
oATE (UTTOO.YYYY)
06t1712022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOFMATION ONLY AND CONFERS NO RIGHTS UPON THE CEBTIFICATE HOLDER. THIS
CERTIF]CATE DOES NOT AFFIRMATIVELY OB NEGATIVELY AMEND. EXTENO OR ALTER THE COVENAGE AFFOBDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE OOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTIIOFIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: ll lhe cerllllqate holder ls an AOOITIONAL INSURED, ths pollcy(ies) must have ADDITIONAL INSURED provlslonr or be endorsed.
It SUSROGATION lS WAIVEO, sublect lo the terms.nd condllions ol the pollcy, certaln policles may requlre an endorsemenl. A statemenl on
thls cerllllcste doer not conter rlghts to the cerlltlcate holder ln lleu of such endoEement(s).
PAOOUCEi
J€tftey R€ndel (AJG)
do Arlhur J. Gallagher Risk Management Sorvic€
250 Tequ$la Drivo
Tequesia. FL 33469
I'ISUFED
G&A OulBourclno, LLC dbar GllA Partnel3 Afi. Empl Americen Bamp Company
17220 Kety Frc€ivay Suit. 350
Houslon, TX 77 094
COFTICTt|AiIE:
il-fl,f", ,",, (s61) 746's027
iBHt"", ggb.lequesla.certs@ajg.com
{AC. ro)
IN6U BE H(S) A FFORDING COVENAGE
Zurich-American lnsLrrance Company 16535ItISUFEh A
II{SUFEF B
I SUFEF C
INSUFEF O
INSUFEF E
INSUiEi F
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOF THE POLICY PERIOD
INOICATEO NOTWITHSTANOING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH NESPECT TO WHICH T}IIS
CERTIFICATE MAY BE ISSUED OF MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIB€D HEREIN IS SUBJECT TO ALL THE TERMS
EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE B€EN BEOUCEO BY PAID CLAIMS.
INSF TYPEOF INSURANCE ADUISUBH FOI.ICY N!EEi POLICY EFF POIICY EXP( t,ODiYYYYI (IIIll,!O YYYY)urTs
COT'T'EFCIAL GE EAAL LIABIII?t
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EACHOCCUFAENCEI OAMAOE TONEITTD
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ANYPNOPBIEIOFI PAFINEREXECUTIVE
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o2fzsr2oiz. o&orzo2g I E L' E^cH accroENr t
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E L, OISEASE POLICY LTMII t
!.qqo.09q
1,000,000
1.000,000
A wc 16-90-372-02
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DESCFIPTION 'F OPERATIONS MKIW
Locallon Coverage Perlod: 0710112022 0310112023 Cllent# 010884MO
oEscaPIoN 0F oPEalnoNs / loc^noxg / yE ilclEs tlcoED ior, ddlnon r 8.r5rlr sct|.doh, ltl.y b..iElid ll mor. rFc. h r.quLld)
.. AmEricen Ramp company Proj€clrclP 17-01 (EvANs PARR ASPHALT PUMP TRACKI
ffiJ*""ffiff"fl 5ol McKrnby Ave
or iu rnr r"ocom'r'",r"c Joplln. MO 6,1801
CERTIFICATE HOLDER CANCELLATION
City ol Menrlee
29844 Haun Road
Meoitee. AZ 92586
S}IOULD A?{Y OF THE ABOVE D€SCAIgED POLICIES BE CAIICELLED gEFOfE
THE EXPIRATIOT{ OATE THEBEOF. ONCE WILL BE DELIVEREO IN
ACCOROAT{CE WTH THE POLICY PBOVISIOI{S.
AUTHOFIZE D F€PF ESEIITAIIVE
O 1988-20'15 ACORD CORPORATION. All rlghts reservod.
ACORD 25 (2016i03)The ACoHO name and looo are.esisteted marks of ACORO 2'ol3 7155
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COVERAGES
CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NUMBEB:22TX0381 I 14684 REVISION NIJMBER:
oArE 0t9,oo..YYYr)
06/1712022
TTIIS CERTIFICAYE IS ISSUED AS A MATTER OF INFOBMATION ONLY AND CONFERS NO RIGHTS UPON THE CEFTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AtitEND, EXTEND OR ALTER THE COVEHAGE AFFOBDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSUFANCE OOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOFIZED
BEPRESENTATIVE OR PBODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: ll lhe certllicate holdEr ls an ADDITIONAL INSURED, lhe pollcy(ios) muel hayo ADDITIONAL INSURED p.ovlslon3 or be endorrcd.
lf SUBROGATION lS WAIVEO, lublect lo the lorms and conditions ol ths pollcy, certain policle! .rlay require an endo.semenl. A statement on
lhl3 certlflcate doeg not conler rlghts to lhe cerllllc.te holder ln lleu o, such 6ndorgement(s).
PiOOUCEF
Jsttrey Rend€l (AJG)
cJo Arthur J. Gallagher Risk Management Service
250 Tequesta Drive
Tequesta, FL 33469
cotrTAcr
PHONE
E.UAILa00nEss
(561) 746-5027
ggb.lequesta.certs@aig com
INSUFE RI S) AFFOF OII{G COVENAG€
Zurich-Amencan lnsurance Company
, @!J!ol
16535
T{AUB:O
GEA Out6ourcing. LLC dbe: G&A PartnorB Al|. Emp: American Ramp Company
17220 K.ty Fn6way Suilo 350
Houslon. TX 77004
I}€UFEF A
I SUAEF B:
INSUAEF C:
INSUFEN D:
INSUAEN E :
D|IIUNEB F:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSUREO NAMED ABOVE FOR THE POLICY PERIOO
INOICATED NOTWITHSTANDING ANY REOUIFEMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHEB OOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE ITiAY BE ISSUEO OR MAY PERTAIN THE INSURANCE AFFORDEO BY THE POLICIES OESCFIB€D HENEIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REOUCED BY PAIO CLAIMS
INSF TYPEOF INSUAAIrcE aooL suon POIICY NUMAEA
POLICY EFF POLICY EXPIMMOO YYYY) IMIIDO YYYYI Llltfs
COI'TEACIAL OE'IEFAI LIAEIUIY
CIAIMS MAOE CJCCUH
€ACHOCCUFBENCE
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MED EXP lAry orr€ psrron)
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PROOIICTS - COMP/OP AGG
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POLTCY
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AUTOI/IOBILE LIABILITY COi,IBINED SINGLE LMlE!*sO.rrlt.
BOOILY IiUUFY (Pd F.sonl
BOOILY ITUUFY lPor.ccd.nu
PFOPENTYOAMAGE
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OWNEOAUIOS OI{LYHIA€D
AUTOS OTILY
SCHEOL,,LEO
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OED , NEIENTT]N S
ocxuR
CLAIMS MAD€
EACHOCCUBFENC€
AG6NEGATE
s
WOSKERACOMPEN&TNON
A'TO E PLOYEFS' LiABILITY
ANYPNOPNIEIOF]PAFINEF]EXECUTTVE
OFFICEF,MEMBER€xClUOEo?(l|rnddo.y ln ltt)
otscFtPTroN oa oFEFarroNs :.b*
x3iATIITE OTlr.
A wc 16-90.372,02 0,,23/2022 03101/2023 Et EAoH accroENT r 000,000
1,Q00,900
1.000,000
EL OISEASE EA EMPLOYEE I
EL OTSE SE POLICY LrUrT I
Locltlon Coveraoo Po.lod: 07101t2022 0310112023 Cllrnt* 010884-MO
DEgcBlPIlor{ oF oPEBATiol€ / tocano{s vEHrclE5 {AconD r0l, lrldnol|rr Rdrl. tr scn duL. h.y b. .n.ci.d rl mor..p.c. l. rcqulrtd),, Am€rican Ramp Companyfffi*:f:"ffi$ 60l McKnbyAv€
ot.6!n norlubco;F.cioE Joplin. MO 04801
CERTIFICATE HOLDER CANCELLATION
C[y ot Men(ee
29844 Haun Road
Menitee. CA 92586
ST|oULD A'IY OF THE ABOVE OESCNIBED POLICIS BE CAI{CELLED BEFORE
T}IE EXPIRATIOI{ DAIE THEREOF. I{OTICE IYILL BE DELIVEFEO IN
ACCORDANCE WTH THE POLICY PROVISIONS,
AUIHO fiIZE O FE PF ESE NTATIVE
1
O 1988-2015 ACORD CORPORATION. All rlghts reserved.
ACORD 25 (2016i03)The ACORD name and loqo are leoigtered marks of ACORD 3'ol3 7155