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2022/02/14 Leighton Consulting, Inc. (37)o.ofu CERTIFICATE OF LIABILITY INSURANCE oaIE (u /oo/YYYY) 12tEt2022 THIS CERTIFICATE lS ISSUED AS A MATTER OF lNFORtrlATlOl{ OI{LY ANO CONFERS NO RIGXTS UPON THE CERTIFIGATE HOLOER. THIS CERTIFICATE OOES NOT AFFIRMATIVELY OR NEGATIVELY AMEIID, EXTEND OR ALTER THE COVERAGE AFFOROED BY THE POLICIES BELOW. TH|S CERTTFTCATE OF TNSURANCE DOES NOT COr{STTTUTE A CONTRACT BETWEEI THE TSSUTNG TNSURER{S), AUTHORTZED REPRESENTATIVE OR PROOUCER, A}{O THE CERTIFICATE HOLDER. IMPORTA T: lf tho codlicato holdor is .n ADDITIONAL l SUREo, tho policy(ios) mult havo AOoITIONAL I SURED provisions or bo endor3od. lf SUBROGATION lS WAIVED, subject to lhe tormr and conditlonr ot the pollcy, cortaln policio3 m.y rcqulrc an 6ndorsorhent. A slatom.nt on th13 cortltlcate doea nollconro, righte to tho cortlllcato hotdor tn lou of such ondoEomonqs). PRoDUcER Risk Strateoies Comoanv 2O4O Marn Street. Sriite 450 lrvine, CA 92614 www.risk slrategies.c(m CA DOI License No 0F06675 Risk Slraleqres Comoanv 949 40 nsk s rcs colt) INSURERIS)AFFOROING COVERAGE 31534TNSURERA : Cilizens lnsurance Companv of America Leighton Consulting, lnc. 17781 Cowan, Suite 100 lrvine CA 92614 rrsuRERB: Allmerica Financial Benefit lnsurance Co 41840 rNsuRERc: Travelers Property Casually Co of Amer 25674 TNSURERD : Lexinqlon lnsuranc€ comoanv 19437 INSIJR€R E COVERAGES CERTIFICATE NUMBERI 1 1 626527 REVISION NUMBER: CANCELLATION @ 1988-2015 ACORO CORPORATION. All rights rese.ved The ACORD namo and logo e rsgisbrsd rnarb of ACORD Citv of l\ilenifee 29714 Haun Road Menitue CA 92586 I SHOI,LD A Y OF THE ASOVE DESCRIAEO POLICIES BE CANCELLEO BEFORETHE EXPIRATIOT.{ OATE THEREOF. NOTICE WILL BE OELIVEREO IN ACCORDANCE WITH THE POLICY PROVISIONS, AU IfiORIZED REPRES€N TATIVE RSC lnsurance Brokerage CERTIFICATE HOLDER ACORD 25 (2016/03) THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMEO ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANOING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO \ryHICI-] THIS CERTIFICATE MAY 8E ISSUEO OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIEEO HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOW! MAY HAVE BEEN REOUCEO BY PAID CLAIMS EACHOCCURRENCE $ 1.000.000 PRFMISFS rFa.an6nel $ 1,000,000 MED EY,P (A.y one D€ro.) PERSONAL& AOV NJURY s 1.000 000 s10 000 GENERALAGGREGATE $2,000,000 PROOJCTS COMP/@ AGG 52.000,000 COIIIMERCIAT GENERAL LIABIIITY GEN L AGGREGATE LIM]T APPLIES PERPRo- -lJEcr L l OCCUR POLICY LC]c o83J208488 111112022 11t1t2023 s coi/t8iNEo srNGlE Lll,fi T aOO LY NJURY lPerpe@.1 aOD LY NJURT (Per a-rde.r) S1 000 000 5 S B o9r{€oAUTOS OI!LY HIRED AUTOS OTILY SCHEOULED AU-rOS NON-OlAriJEO AUTOS OTILY AU IOM OBILE LIAAILITY A\^/3J208478 11tlt2022 11t112023 5 S EACHOCG]RRENCE EXCESS UAA occuR AGGREGAI€ s5 000 000 s 5 000,000 DED neren-rout0 11t1t2022 11t112023 s STATUIE OTH ER E L EACHACCIDENT s 1 000 000 E L DISEASE EA EMPLOYEE C WOR(ERSCOMPEN6ATION Al'lD EMPLOYERS LIABILITY ANYPROPR]ETOR/PARTNER/EXECIJTIVE OFFiCER4,IEMBEREXCLUDED? o€siRPTroN oF oPERAToNs bdtu u81R5099812243G 9t112022 91112023 E L OISEASE - POLICY LIMIT s 1.000.000 s 1,000,000 D Probssional Liabilily/Pollution Liab Claims Made 013001524 2t14t2022 2t14t2023 Per Claim Aggregate D€ductiUe i$2,000,000 !$4,000.000 r $100,000 O€SCtuPnol{ Or OPERAIIOI{S, LOCAiO S, VEHICLES (ACORD 101, Aildlirornl R..tr.rt S.h.<lsL. n.y b..tt*n dll md.p.6 r. rqltnd) See Additional Remarks Schedule LCr 20?-i-202r I Sh€rly y6uh9 I 11/A/2O22 6tt9tt6 lX (pST) I p.se 1 o! 3 I loB3J2o8488 I tu AGENCY CUSTOMER IO: LOC i: ACORi}ADDITIONAL REMARKS SCHEDULE ADOITIONAL REMARKS ACORD tU (m08/0.t) @ 2OO8 ACORD CORPORATTON The ACORD namo and logo rs ,eglsterEd marks ot ACORD 6rr3rr6 }x rrsT) .aqe . oa ts Page of Rrsk ies Company tlAMEO INSURED LeiohtonConsullino lnc 17781 Cowan suri-e 100 lrvine CA 92614 NArC COOE THIS ADDITIONAL REMARKS FORM IS A SCHEOULE TO ACORD FORi', FORM NUtt BER: 25 FORtrl TITLE: Cerlilicate of Liabalily (03/16) HOLDER: City of Menibe AODRESS: 29714 Haun Road Menibe CA 92586 Certificate is subject to po.licy linits, conditions and exclusions. Re: Proj +11051.010CIP 21-13 (Mccall Blvd Resur faci.ng-Encanto to Antelope) Materials Testing & GeotechnicalServices. City of Menifee and its officers, employees. agents, and autho!ized vo-Iuntee-rsare included as additional- insured as respects to General Liability and Commercial Autocoverages as required by written Contract. Generaf Liabj.Iity and Auto Liability coveragesare prinary and noncontributory as lequired by written contract. Waiver of Subrogat.ion isiocluded with respect Gener.al Liability. Auto Liability, Workers Conpensation as requlredby !,riitten contract. Unbrefla Liability is follow form subject to policy forms, terms,conditions, exclusions and endolsements. 9o-Day Notice of Cancellation, Except for 1O-Daysfo! Nonpa)ment of Premium applies to General Liability as required by written contract. All rights reserved AOOENOUM Architects and Engineers The following policy language is from Busrnessowners General Liability Coverage Part NAMED INSURED: Leishlon Consulting, lnc. POLICY NUIUBER: o83J208488 The following are mandatory forms on the policy identified on the Certificate of lnsurance 391-1586 (08-16) BUSINESSOWNERS GENERAL LIABILITY SUPPLEMENTARY ENDORSEMENT Additional lnsured by Contract, Agreement or Permit A. Ssction ll - Liability, C - Who is an insured is amended to include as an additional insured any person or organizatron with whom you agreed in a written contracl, written agreement or permil but only 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 behalt, but only with respect to:(i) 'Your work'for the additional insured(s) designaled in the contract, agreemenl or permit including "bodily injury" or "property damage" included in the "products - completed operations hazard" only ifthis Coverage Part provides such coverage;(ii) Premises you own, rent, lease, or occupy; or(iii) Your maintenance, operation or use of equipment leased to you. 'Definition: "Your work" a. Means: (1) Work or operations performed byyouoron behalfi and (2) materials, parts orequipment furnished in connection with such work or operations, b. lncludes (1) warranties or representations made at any time with respect to the flness, quality, durability, performance or use of "your work"i and (2) the providing of or failure to provide warnings or instructions. This provision does not apply: (1) Unless the written contracl or written agreement has been executed or permit has been issued prior to the "bodily lnjury". "property damage", "personal iniury" or'advertising injury". (2) To any person or organization lncluded as an lnsured by an endorsement lssued by us and made part ofthis Coverage Part. (3) To any lessor of equipment (a) After the equipment lease expires; or (b) lf the "bodily lnjury", "property damage", "personal injury" or "advertising lnjury" arises out of sole negligence of the lessor. (4) To any: (a) Owners or other lnterests fiom whom land has been leased which takes place after the lease for the land expires, or (b) Managers or lessors of premises if: (i) The occurrence takes place after you cease to be a tenant in that premisesi or (ii) The'bodily injury', 'property damage", "personal injury' or "advertising injury" arises out of structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor. (5) To'bodily injury', 'property damage' or "personal and advertising injury' arising out of the rendering of or failure to render any professtonal services. 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 iniury" or "property damage" or the offense which caused lhe "personal and advertising injury" involved the rendering of or failure to render any professional services by or for you. Other lnsurance Primary & Non-Contributory The following paragraph is added to SECTION lll - COiTMON POLICY CONDITIONS, H - Othsr lnsurance: Additional lnsurod - Primary and Non-Contibutory. lf you agree in a written conlract, writlen agreement or permit that the insurance provided to any person or organization included as an Additional lnsured under SECTION ll- Liability, C. Who is an lnsured is primary and non-contributory, the following applies: lf other valid and collectible insurance is available to the Additional lnsured for a loss covered under SECTION ll - LIABILITY of this Coverage Part, our obligations are limited as followsl (1 ) Primary lnsurance: This insurance is primary to other insurance that is available to the Additional lnsured which covers the Additional lnsured as a Named lnsured. We will not seek contribution from any other insurance available to the Additional lnsured except: (a) For the sole negligence of the Additional lnsured, (b) When the Additional lnsured is an Additional lnsured under another primary liability policy; or (c) Vvhen b. below applies. lf this insurance is primary, our obligations are not affected unless any ofthe other insurance is also primary. (2) Excess lnsuranco: (a) This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis:(i) That is Fire, Extended Coverage, Builder's Risk, lnstallation Risk or similar coverage for "your work":(ii) That is Fire insurance for premises rented to the Additional lnsured or temporarily occupied by the Additional lnsured with permission of the ownerl No coveaa0e is provided by this Notice, nor can il be construed lo replace any provisions of the policy (including its enclorsements). lf there is any conflicl between lhis Notice and the policy (including the endorsements), lhe provisions ofthe policy (including its endorsements) shall prevail. 16265:',7 1[C) C-pL I Sh.rry r.r^q I r?/A/2A22 6:13:16 ^x lpSI] I p.q€ I of A (iii) That is insurance purchased by the Additional lnsured to cover the Additional lnsured's liability as a tenant for "property damage" to premises rented to the Additional lnsured or temporarily occupied by the Additional with permission of the o\.yneri or(iv) lf the loss arises out of the maintenance or use of aircraff, "autos" or watercraff to the extent not subject to Exclusion g. of SECTION ll - LIABILITY. B, Exclusions, l. Applicabls to Business Liability Coverage.(Y) That is insurance available to you for your participation in any past or present "unnamed joint venture".(vi) That is any insurance you may have that provides coverage for your professional services. (b) When this insurance is excess, we will have no duty to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". lf no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (c) When this insurance is excess over other lnsurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (i) The total amount that all such other insurance would pay for the loss in the absence of this insurance, and (ii) The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess ofthe Limits of lnsurance shown in the Oeclarations ofthis Coverage part. (3) Mathod Of Sharing lf all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. lf any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. Per Project Aggregate The following changes are made to SECTION ll - LIABILITY: 1. The following is added to SECTION ll - LIABILITY, D. Liability and Medical Expsnses Limits of lnsurance, paragraph 4: The Aggregate Limits of lnsurance apply separately to each of "your projects" or each "location" listed in the Declarations. 2. For the purpose of coverage provided by this endorsement only, the following is added to SECTION ll - LlABlLlW, F. Liability and Modical Expanses Definitions: l. "Your projecl" means: a. Any premises, site or "location" at, on, or in which "your work" is not yet completedi and b. Does not include any "location" listed in the Oeclarations. 2. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. Separation Of lnsureds Except with respect to the Limits of lnsurance, and any rights or duties specifically assigned in this Coverage Part to the first Named lnsured, this insurance applies: a. As if each Named lnsured were the only Named lnsured; and, b. Separately to each insured against whom claim is made or "suit" is brought. Waiver Of Subrogation The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section lV - COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organizalion where required by wriften contract because of paymenls we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization where required by witten contract. Notice Of Cancellation For any statutorily permitted reason olher than non-payment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to 90 Oays. 'tuo,n Hpt,ovq Foms: 3!n-rUB (MC);391.144t (0U1q;391.1$6 (08hq,391-lOtB (N1q No coverage is provided by this Notice, nor can it be constr€d to replace any provisions of tt|e policy (including ats endorsemenls). lf lhere is any coniicl between this Notice and lhe policy (includino the endors6m6nls), the provisions of the policy (incjuding its endorsements) shatl prevait. tor^g )2/a/?022 6:lB;i5 Ax (psT) p.qe I of 3 AUTHORIZED REPRESENTATIVE AW3J208478 Leighton Consulling, lnc THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, BLANKET ADDIT]ONAL INSURED - PRIMARY AND NON-CONTRIBUTORY This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FO RM A. The following is added to SECTION ll -LIABILITY COVERAGE, Paragraph A.'1. Who ls An lnsured: Additional lnsured if Required by Contract lf you agree in a written contract, written agreement or written permit that a person or organization be added as an additional "insured" under this Coverage Part, such person or organization is an "insured"; but only to the extent that such person or organization qualifies as an "insured" under paragraph A.l.c. of this Section. lf you agree in a written contract, wriften agreement or written permit that a person or organization be added as an additional "insured" under this Coverage Part, the most we will pay on behalf of such additional "insured" is the lesser of: (1) The Limits of lnsurance for liability coverage specified in the written contract, written agreement or written permiti or (2) The Limits of lnsurance for Liability Coverage shown in the Declarations applicable to this Coverage Part. Such amount shall be part of and not in addition to the Limits of lnsurance shown in the Oeclarations applicable to this Coverage Part. Regardless ofthe number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident", the most we will pay for the total of all damages and "covered pollution cost or expense" combined resulting from any one "accident" is the Limit of lnsurance for Liability Coverage shown in the Declarations. B. The following is added to SECTION lV -BUSINESS AUTO CONDITIONS, Paragraph B. Goneral Conditions, subparagraph 5. Other lnsurance: Primary and Non -Contributory lf you agree in a written contract, written agreement or written permit that the insurance provided to a person or organization who qualifies as an additional "insured" under SECTION ll - LIABILITY COVERAGE, Paragraph A.l. Who ls An lnsursd, subparagraph Additional lnsured if Roquired by Contract is primary and non- contributory, the following applies: The liability coverage provided by this Coverage Part is primary to any other insurance available to the additional 'insured" as a Named lnsured. We will not seek contribution from any other insurance available to the additional "insured" except: {1) For the sole negligence of the additional "insured": or (2) For negligence arising out of the ownership, maintenance or use of any "auto'not owned by the additional "insured" or by you, unless that "auto'is a "trailer" connected to an "auto" owned by the additional "insured" or by you; or (3) Vvhen the additional "insured" is also an additional "insured' under another liability policy. C. This endorsement will apply only if the "accident" occurs: 1. During the policy period; 2. Subsequent to the execution of the written contract or written agreement or the issuance of the written permit, and 3. Prior to the expiration of the period of time that the written contract, written agreement or written permit requires such insurance to be provided to the additional 'insured". D. Coverage provided to an additional "insured" will not be broader than coverage provided to any other "insured" under this Coverage Part. ALL OTHER TER[ilS. CONDITIONS. AND EXCLUSIONS REMAIN UNCHANGED 461-0178 1212 lncludes copyrighled material of ISO lnsuraace Services Oficr, tnc , with its permission 3 /.'0r 2 5:l0rl6 Page I of I lnsured: Leighton Consulting, lnc. Policy No.: AW3J208478 14 AUTO LOAN PHYSICAL DAMAGE EXTENSION The following is added to SECTION lll - PHYSICAL DAMAGE COVERAGE, C. Limit Of lnsurance provision: When a "loss" results in a total loss to a covered auto you own for which a Loss Payee is designated in this policy, the most we will pay for "ioss" in any one "accident" is the greater of: The actual cash value of the damaged or stolen property as of the time of the "loss": or The outstanding balance of the initial loan, less any amounts for taxes, overdue payments, overdue payment charges, penalties, interest , any charges for early termination of the loan, costs for Credit Life lnsurance, Health, Accident or Disability lnsurance purchased with the loan, and carry-over balances from previous loans. This coverage applies only to the initial lease for the covered "auto" which has not previously been leased. This coverage rs excess over all other collectible insurance. SECTION IV - CONDITIONS .16, DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following is added to SECTION lV - BUSINESS AUTO CONDITIONS. A. Loss Conditions, 2. Duties ln The Event Of Accident, Claim, Suit Or Loss: d. Knowledge of any "accident", claim, "suit" or "loss" will be deemed knowledge by you when notice of such "accident", claim, "suit" or "loss" has been received by: ('1) You, if you are an individual; (2) Any partner or insurance manager if you are a partnershipi or (3) An executive officer or insurance manager if you are a corporation. 2 15, AUTO LEASE PHYSICAL DAMAGE EXTENSION The following is added to SECTION lll - PHYSICAL DAMAGE COVERAGE, C. Limit Of lnsurance provision: lf, because of damage, destruclion or theft of a covered "auto", which is a long-term leased "auto", the lease agreement between you and the lessor is terminated. "we" will pay the difference between the amount paid under paragraph C. Ll lT OF INSURANCE 1. or 2. and the amount due at the time of "loss" under the terms of the lease agreement applicable to the leased "auto" which you are required to pay: Iess any fees to dispose of the auto, any overdue payments, fi nancial penalties 17 BLANKET WAIVER OF SUBROGATION lncludes copyrighted material of lnsurance Services Office, lnc. with its permission Copyright, lnsurance Services Office, lnc., '1996461-01s5 (9-97) 17626521 tLC\ 202:-202r GL-IUTO-WB-rr-pl, I Sh.r!y tonns | 12/A/2012 6:lA:16 A* lps,r) I p.9. 6 0f s imposed under a lease for excessive use, abnormal wear and tear or high mileage, security deposits not refunded by the lessor, cost for extended warranties, Credit Life lnsurance, Health, Accident or Disability lnsurance purchased with the loan, and carry over balances from previous leases. Paragraph 5. Transfer Of Rights Of Recovery Against Others To Us, SECTION IV. BUSINESS AUTO CONDITIONS, A. Loss Conditions rs replaced by the following: Insured: Leighton Consulting, lnc Policy No.: AW3J208478 18 UNINTENTIONAL FAILURE TO DISCLOSE INFORMATION 5 TransferOf Rights Of Recovsry Against Others To Us lf any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, which have not been waived through the execution of an "insured contract", written agreement, or permit, prior to the "accident" or "loss" giving rise to the payment, those rights to recover damages from another are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after the "accident" or "loss" to impair them. The following is added to SECTION lV BUSINESS AUTO CONDITIOITIS, B. General Conditions, paragraph 2. Concealment, Misrepresentation Or Frau d: The following is added to SECTION lV - Businoss Auto Conditions, B. General Conditions, paragraph 7. Policy Period, Covorage Territory provrsion: Outside the coverage territory described in a., b., c., and d. above for an "accident" or "loss" resulting from the use of a covered "auto" you hire, without a driver, or your employee hires without a driver, at your direction. for the purpose of conducting your business, for a period of 30 days or less, provided the suit is brought within The United States of America or its territories or possessions. SECTION V - DEFINITIONS Paragraph C. "Bodily iniury", SECTION V - DEFINITIONS is replaced by the following. C. "Bodily injury" means bodily injury, sickness or disease sustained by a person including death or mental anguish resulting from any of these e Your unintentional error in disclosing, or farlure to drsclose. any material fact existing after the effective date of this Coverage Form shall not prejudice your rights under this Coverage Form. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or nonrenewal. lncludes copyrighted material of lnsurance Services Office, lnc. with its permission Copyright, lnsurance Services Office, lnc., 1996 461{1 5s (9-97) 7r62652r I {!c) 20;?-?023 6L AUTo-UtlB-tirc-Pl- sh.r!y younq ) t2/ts/2022 6:ratfi llt (psT) I p.ge 19 HIRED AUTO - WORLDWIDE COVERAGE 20. MENTAL ANGUISH TRAVEtER6?WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICYONE TOT'ER SQUI.RE ITARTFORD CT 06183 ENDORSEMENT WC990376( A). oo1 POLICY NUMBER: tJIl tRsoe98 t22tlG WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WATVER) We have the right to recover our paymenG from ayme liable fo. an hjury covered by this policy. We will not enforce our right against the perscl or orgaizatio named a1 the Schedule. The addfifial premium for this endorsem€nt shall be 2 . oo % of the Califomia workers' compensation pre- mlum. Schcdule Pcrsoh or Organlzatlon A.!I'Y PERSO}I OR ORGTXIZATION FOR I{BICTI TIIE IXSURBD It}S AGRBED BY XRIITEIT COITTRTCA BXECTITED PRIOR TO IJOSS TO FI'R}IIsH TIIISwtlvtR. Job Dcscriplion All Opcretions This endorsement chanqes the policy to which it is attached and is effective on the date issued rnless otherwse stated. (Th€ lnformauon below ls requircd only whcn thlr andoElmrnt Ir issuGd rubsequcnt to prcparltlon olth. pollcy.) Endorsement Eftective 09kt /2022 lnsured 1_e1gh1.. C.r.rtt,.*. 1r. lnsurdrce Company Allmerica t-rnancral Bmclit InsurancE Co Policy No. un truso99tt t:2+;tj DATE OF ISSUEi ST ASSIGN: Cot,ltersi9ed by Page 1 of 1 g<-y',*^lU--*l-. 3/2021 6:r3rr6 Ax iPST) P.q. 3 or 3