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page 2 of 23
a77 -297 -11 01
s1,000,000
r5O,OO0
s EXCLUDED
s1,0{D,0O0
s 2,0O0,000
s2,0O0,000
. s $5,000.000
sl,od),000
s
s
s5,Om,o0O
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5
Cllent#: 1257049 3O5LEIGHGBO
ACORD. CERTIFICATE OF LIABILITY INSURANCE
Lorl McNay
McGrifl lngurance Servlcas
l3oThoory 516 20O
lrvlne, CA 926'17
714 941.2800
INSUCEF(S) AFFi)RDING COVEFAGE
Lcxlng on lnBurancc ComPanY
Travclers lnd6mnlty Co of CT
Leighton Consuhlng lnc
17781 Cowan Sto. 100
lrvlno, CA 92614-6009
INSUREF B
IT{SUFER C
INSUBEF D
IN6UREH E
cLArMs.rrAoE XloccuB
CEBTIFICATE NUMBER
006546318
013001524
FEVISION NUMBEN
4l2OZ2 0211412023 t AcH occuBFENcE
THIS IS TO CEBTIFY THAT IHE POLICIES OF I
INDICAIFI] NOTWITHSTANDING ANY BEOUINE
CEBIIFICATE MAY BE ISSUED OR MAY PENTA
EXCLUSIONS ANO CONDITIONS OF SUCH POLI
NSUBANCE LISTEO BELOW HAVE BEEN
IMENT, TEBM OR CONDITION OF ANY C
IN, THE INSUBANCE ATFOBDED BY TH
CIES. LIMITS SHOWN MAY HAVE AEEN
ISSUEO TO THE INSUFED I'IAMED AAOVE FOBIHE POLICY PERIOD
ONTRACT OR OTHEB DOCI]MENI WTTH RESPECI TO WHICH THIS
E POLICIES DESCFIBED HIBEIN IS SUBJECT TO ALL THE TEFMS.
BEDUCED BY PAID CLAIMS,
A x
ANOLSUBRrYPE oF TNSUnANCE iir-sn wvo PoLICY NITMBEG
coMMEFcrat GETIERAL LrAEtLrrY 065463440
POLICY EFF POLICY EXP
{i/t iootI.r YYY) (MrvDD,"fYYY)
lli2t2 W1 q z0Br! ach occu cRErtcE
, EAI10BEJ?.!'JliP.nu
rrlED EXP t,!Y ont P"mnt '
PERSONALIAOV IN.IJBY
: I ,,ane"ot
^GGREGATELl!a!cI!:!!!a911Gj
Overall Policy
8A3R70843'12243G
enelal A99r69ate
4t2o22 o2114t2023lt9^l?ll,t;l i''o" ''" '
EoolLY INJUFY {P.r pden)
EOOTLY lNJl.lBY (Por accd.nl) S
B
X BYPD Ded:250o0
GEN'L AGGB.GATE L]MIIAPPL ES PEF
,o.,"', x'5I& X roc
ArjtottoErLE L46lLIIY
x
x
OWNEO
HIiEO
SCHEOULEO
NON.OWNEO
UMBFELLA LIAB
EXC€SS LIAB
x
AX x
I oel i!( I aeiqqrloir r1@oo
WOFKERS COiIPENSATIOI{
AIO E{PLOYEFa Ln6(ITY vrN
ANY PFOPRIETOFVPAB'IN EF/E XECUTIV E
OFFICEFUMEMBEF EXCLUOEO?
{M.nd.rory ln NX)
ESCFIPTION OF OPEEATTolTS b.low
A ProflPolutn Llab
Claims Made
It
0
TpEC T TiH-lsralllE | -EF
!.L.l 9H 4!9lqE]rl
! ,!, qrgEtlE jf\ qlr?loaEE
E,L, DISEASE. POLICYLIMIT
CEHTIFICATE HO R CANCELLATION
m 00O Dsd
@ 19S8-2o15 ACORD COBPOFATION. All rlghts reserued
(LC)Clty ol Menltee
29714 Haun Boad
M6nllee, cA 92586
SHOULDAIiY OF THE ABOVE DES,CFIBED POLICIES SE CATCELLED BEFONE
THE EXPTMTIOI{ OATE THEREOF. NOTTCE WILL BE DELIVEBEO IN
ACCORDANCE IYITH THE POLICY PROVISIONS,
AIITHOFtrEO NEPRESETlATIVE
).*ar.- s^-^q*y
2J1612022
BELOW. THIS CERTIFICATE OF INSUFANCE DOES NOT CONSTITUTE
REPBESENTATIVE OR PRODUCEB. AND THE CENTIFICATE HOLDER'
tMpoBTANT: lt rh. certilicste hotder ls qn AoolTloNAL INSUREO, the policy(lss) muet have aoolTloNAL lNsuBE0 provislons or be endorsod
ll suBBocATloN ls wAlvEo, sublect to the terma and conditlon6 of the policy, certaln policlos may requlfe sn 6ndoraement. A Btatement on
FI HT SEcTRCAETEOLoHRHTSGPUNoETHDNocFNERoNNoMAFtoTONNLMAETTOFBTFTCAEsSSEUASDHTSEcFHTPOLSEFEGFFOADEDFiEBTEBLETHovcEDEEXTDNnoENGTLMENEFaTIVLEoBTIETECAEDONOTScUTHOlZEFDsISUGNNSnUEsBTcBTEEETNEH{HcNo
this cerlillcate doos nol conlor ar|y ri9hts to lhc ccrliflcato holder in lleu of such endorsomcnl(3)
oEscB,PTloN oF oPEnaIlol{6 / tocaIlolls / vEHcLEs (acoF0 101, a.dlllon!l R'm'rt' schedu
Addltlonal lnsursd aPpllss on Goneral Llability por Lexlnglqn's Add
Conlractors endorsernont LX4316 06r'14 and LX96O5 l UOl atlached
by wrinen conlracl.
pilmary wordlng applies to csneral Llability per Lexlngion's ondorsement LX983g O&05 attached to policy.
Addltlonal lnsured and Prlmary wordlng applles on Automobllo Llablllty Per Travelors endorsement cAT474
l.,6ryb..lrrch.d llmor..P.c. l. r.qulr.d)
lllonal lnsurqd Ownors. Lessges ol
to thq Ganoral Liability pollcy as roquir€d
(See Attached Descriptlons)
19t)
ACORD 25 (201d03) 1 ol2
#s2947783&/M29461171
The AcoBD nsm€ 6nd logo aro rcglslared m6rks ot ACoRO
COVEFAGES
19437
256€2
bz'tilzoz. o2J1N2o23 $2,000,000 Per claim
I oo,ooo,ooo aggrogate
LXMCN
l;',Y-,tR:r.t'jEfti}:
page 3 of 23
DESCRIPTIONS (Continued lrom Page 1)
0216, Blankst Addhional lnsur6+PrirEry and Norrcornrlbutory wlth Olher lnsuranco, atlached lo the
Aulomoblle pollcy as requlred by writton conlract.
Re: Proj #1105'l.007 PMP 2002: Ouall valley Streel Flesurtaclng Prolect, Menltoe.
Addltlonal lnsured to lnclude por spoclllcatlons: Clly ol Menllee and lts ofllcers, employses,
ageflt9, and authorlzed volunteerc.
SAGITTA 2s.3 (2016r'0q 2 ol2
#s294778391r2946t 171
r9/3
page 4 ot 23
FiiHJ+ffii
ENDORSEMENT
t2t14D@2
Thls ondorsement, effoctive 12:01 AM
Forms r prrt oI poliqy no.: 66ko
lsau6d to: Leighton Consulting lnc
By: LEX I NGT0N I NSURANCE COIIPANY
CANCE LLATION AMENDME NT
ln consideration ol the premium charged, it is hereby agreed that the cancellation provision is amended
to 90 days in lierr ol (30) days, excepl ,or non-psyment o, Dremium vrhich remains {10) days'
Al other terms and condhions remain rlnchanged
t//*-
Auft orized R€Pr.,sentalive OR
Countersignsture lln statas where applicablel
19/4
tx9586 rO2lO3)
pag€ 5 of 23Ft#'+EJ.lit
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This page has been left blank intentionally
r9/5
pag6 6 of 23
ffi
ENDORSEMENT
Th is o nd orsome nt, 6 ffsctivo 12iO1 AM o2t1 412022
Forms a parl ol policY no.: 065463440
lssu6d to: Leighton Consulting lnc
By: LEX INGTON INSURANCE CO|'IPANY
PR IMARY/NON CONTRIBUTORY ENDOFSEMENT
This endorsement modifles insurance provided by the policy:
Norwithsrsnding any other provision of the policY to the contrary, the instrrance aiforded by this policy
tor lhe benefit ol the Adcjitional lnsured shall be primary insurance, but only wirh respect to any claim,
loss or liability arisino out o, the Named lnsured's operations; and any insurarce maintained by the
Additional Insured shall be non-contributing
Al other terms and conditions oI lhe policy remain lhe same.
Authorized Repros€nt tiv€ OR
Count€rsiqnature lln st tos rvhere applicable)
1976
L X9a3a toa05)
ffi
This page has been leti blank intentionally
19/t
page 7 ol 23
ffi
page 8 of 23
LeightonConsulling lnc
8A3R7084312243G
COIVIIVIERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - PRIMARY AND
NON.CONTRIBUTORY WITH OTHER INSURANCE
This endorsement modifies insurance provided under the following
BUSINESS AUTO COVERAGE FORM
2. The follo'irin9 is added to Paragraph 8.5., Other
lnsurance of sEcTlON lV - BUSINESS AUTO
CONOITIONS
Regardless of the provisions of paragraph a and
paragraph d. of this part 5, Other lnsurance, lhis
insurance is primary to and non-contributory with
applicable other insurance under which an
additonal insured person or organization is the
first named insured when lhe writlen contracl or
agreement between you and that person or
organization, that is signed by you before the
"bodrly in,ury" or "property damage" occurs and
lhat is in effect durinll the policy period, requires
this insurance to be p'imary and non-contributory.
U 2Ol6 The Tlavelers lndemnlty Company Alltights re3erved
Includes oopyrighted materielof lnsurance Services Olrice, lnc w[h ls permEslon
PROVISIONS
1. The following is added to Paragraph A.1.c., Who
ls An lnsured, of SECTION ll - COVERED
AUTOS LIABILITY COVERAGE:
This includBs any person or organization who you
are required under a writlen contract or
agreement between you and that peEon ot
organization, that as signed by you before the
"bodily injury" or "property damage" occurs and
that is in effect during the policy period, to name
as an additional insured for Covered Autos
Liability Coverage, but only for damages to which
this insurance applies and only to the extent of
that person's or organization's liability for the
conduct of another "insured"
r9/8
cA T4 74 02 t5 Page 1of I
Firs-.Jt
E*E+tt!\-Lii
This page has been left blank intentionally
page 9 ol 23
r 9/9
Bffii*ffi
A Section ll - Who ls An lnsured is amended
to include as an insured ttle person or organization
sho\Ml in the Schedule, but only \ith respect to
liabllity arising out of your onSoing op€rations
performed for that insured.
L With respect to the insurance afforded to these
addhional lnsureds, the fcllo\in8 e)alusion is
a dde d:
2. Exclus io ns
This insurance does not appv to "bodily in-
jury" or "property damage" occurring after:
page 10 of 23
COMMERCIAL GENERAL LIABILITY
cG 20 lo lo ol
(1) All uork, including materials, parts or
equipment furnished in connection with
such \ork, on the project (other than
seruice, maintenance or repairs) to be
performed by or on behalf of the additional
insured(s) at the site of the covered
operations has been comPleted; or
(2) That portion of "you aork" out of \ hich
the iniury or damage arises has been put
to its intended use bY anY Person or
organlzation other than another contractor
or subcontractor engaged in performing
operations for a principal as a part of the
same projed.
POLICY NUMBER: 065463440 ENDoRSEMENT# 004
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ 1T CAREFULLY,
ADDIIONAL l]..lStnED - OvI[cRS LESSEES
OR MIIIRACTTRS . SOTTII.ED PERSOT{
OR ORGANTZA]ION
This endorsement modifies Insurance provided under the follo\ ing
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
llame of Person or Organization:
REQUIRED BY WRITTEN CONTRACT
tc)City ol M€nifee
enilee, cA 92586_0000
Projf1L051.0O7 PMP 2G02: QuailVall€y Slre€t R€l
icers emplcrye€s, agents, and authonzed volunteers
surfacinS Project, Meni{ee. Additional nsured to include per sp€cificltions: City of M€nifee ind its
(lf no entry appears above, information required to complete this endorsement will be sho\Ml in the Declarations
as applicable to this endorsement.)
Igilt)
cG 20 I0 lo oI
1x9605
O ISO Properties, lnc.. 2(m Page lofl tr
ffi page 11 of 23
ENDORSEMENT # o21
This endorsement, effective l2O1 AM 0217417022
Forms a partofpolicy no,: o65A63a4o
lssued to: LEIGHTON GROUP, lNC.
By: LEXIN GTON INSURANCE COMPANY
ADDITIONAL INSURED - OWNERS, LESSEES
OR CONTRACTORS. COMPLETED
OPERATIONS
(Based on cc2o37 04/73].
This endorsement modifies insurance provided by the iollo\in8:
COMMERCIAL GEN ERAL LIABILITY POLICY
SCHEDULE
Name of Additional lnsured Person(s)
or Organization(s)
Location of Com pleted Operations
AS REOUIRED BY WRITTEN CONTRACT
(LC)Cily of Menilee
29714 Haun Road
Menifee, CA 92586{000
Re: Pr.i #11051 007 PMP 20-02: Quail Valley Str€el Re6urfacang Project, Monilee. Addilionsl Inaured to include per Bpecifcationo
City of l\4enifee and it8 offceB, employeB, agents, 6nd authodzed volunteer6.
lnformation required to comphte this Schedule, if not sho,Mr above, vull be sho\ n in the Declarations
A Section ll - Who ls An lnsured is amended to include as an additional insured the person(s) or
organization(s) sho\,$ in the Schedule, but only \,ith respect to liability fur "bodily injury", or
" prop€ rtv damage" caused, in v"hole or in part, by "your r,rcrk" at the location desi8nated and
described in the Schedule of this endoBement performed for that additional insured and included rn
the " products-com pleted operations hazard".
HoM€ver:
'1. The insurance afforded to such additional insured onv applies to the e)dent permitEd by law
and
2. lf coverage provided to the additional insured is required by a contract or agreement, the
insurance afforded to such additonal insured v\,ill not be broader than that,tlich you are
required by the contract or agreement to provide for such additional insured.
B. With respect to the insurance afforded to these additional insureds, the follo\ing is added to
Section lll - Limits Of lnsurance:
lf covera8e provided to the additional insured is required by a contract or agreement, the most \,\,E
will pay on behalf of the additional insured is the amount of insurancer
6
rgU,
Offices, ln(., with lts permission. All Rights Reserved
es a8e
page 12 of 23
E,CSE
Ed#r.-r.l':
l. Required by the contract or agreement; or
2. Available under the applicable Limib of lnsurance sho\Ml in the Declarations;
u,hichever is less.
This endorsement shall not increase the applicable Limits of lnsurance shov.fi in the Declarations
All other terms and conditions of the policY remain the same
r 982
Authorized Representative
LX43 I 6 (06/14)lncludesLopyrlgnreo lnrormat()n oIma! In su rance 5e rv ice s
Ofrlce s, lrr . , wlth its pe r mission.AllRrghts Reserved
Page 7 ol 7
//rz-
page 13 of 23ffi
Cllents: 1257049 3O5LEIGHGRO
ACORD. CERTIFICATE OF LIABILITY !NSURANCE
COVERAGES CERTIFICATE NUMBEF BEVISION NUMBER
2l'ld2t22
THIS CEBTIFICATE IS ISSUEO AS A MATTEB OF INFOBMATION ONLY AND CONFEBS t{O BIGHTS UPON THE CERTIFICATE HOLDER. THIS
CEBTIFICATE DOES NOT AFFIFMATIVELY OB NEGATIVELY AMENO, EXTENO OB ALTEB THE COVERAGE AFFOFOEO BY THE POLICIES
BELOW. THIS CEFTIFICATE OF INSUBANCE DOES NOT CONSTITUTE A CONTBACT BETWEEN THE ISSUING INSUBER(S). AUTHORIZEO
BEPBESENTATIVE OR PBOOUCEB. AND THE CERTIFICATE HOLOEB.
IMPOBTANT: ll lho cenlflcste holder is an ADDITIONAL INSUREO, th6 pollcy(les) muel have AODITIONAL INSUFED pioviiione or boinaorecO
It SUBROGATION lS WAIVED, oubloct to the lerme .nd condltlons ol th. Pollcy. cert!ln pollcler may r.qulro an ondorsemont. A atat.ment on
lhi6 conlflcatq do.s not conlor any righta lo lho ceililicat. holdor ln llou of auch endoraemenl(t)
McGrlll lnsurance Servlc€s
130Theory St6 200
lrvlno, CA 92617
714 041-2800
fi!$[Acr Lort tvtct'tay
I lI8:r{E", E"),714 e41-2s15
[-JHLEss LMcNay@mcgrlfl.com
II{SUFEA(6) AFFOFOING COVERACE
Lcxlngton lnsuranc6 Company
Travclcr! lndGmnlly co ol cT
19437
256€2
fiI.rr") 877-2e7-1101
Lelghton Consulting lnc
17781 Cowan Ste. 1m
lrvlne, CA 92614-6009
THIS IS TO CERIIFY THAT THE POUCIES OF INSUFIAI'JCE LISIED BELOW HAVE BEENISSUED TOTHE INSUBED NAMED AAOVE FOBTHE POLICY PEFIIOD
INDICAIED, NOTWITHSTANDING Airy HEQUIREMENT, TEBM OR CONDITION OF AI,IY CONTRACT OB OTHER DOCUMENT WITH BESPECT TO WHICH IHIS
CEBTIFICATE MAY BE ISSUED ON MAY PEFITAiN THE INSUFANCE AFFORDED BY IHE POUCIES DESCHIBED HEREIN IS SU&JECf TO ALL THE TEBMS,
EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN BEOUCED BY PAiD CLAIMS,
TYPE OF INSUFANCE
x coMuEacraL GENEFAL LlABlflTY
cu us vaor Xioccun
X BUPD Ded:250O0
POLICY NUMBEF
065463440
POLICY EFF POLICY EXP(MWDO/"TYYY) {MM/OO,/YYYY)
A 412022. O2l'l 4lzgyJ EAci o.cLrFFt^cE
BAI,$EE J?eiiiJFP."',r
MED ExP (Any on. p.Eod
PEFSONAL 8}DV INJTJFY
GENERAL AGGFEGATE
PAOOUCTS COMP/OP AGG
sl,OOO,OU)
s5O,mO
sEXCLUDED
s1,(xlo,@o
s 2,O0O,OO0
s2,000,0O0
s$5,mo,000
r't,0oo,0oo
GEN L AGGFEGATE LIM T APPLIES PER
"o,"" x 5l3i X roc
]orxrn
AUIOIIOBILE LlAAILIIY
Ovsrall Pollcy
8A3F7084312243G
oneral .Aggrogate
B 4t 2a,2 u2n 4noz3 EHlI."Prj1":. . *l'
BOOILY INJUFY (Pa P.e.)
600ILY INJUEY(Pd@danl)
x
AI]TOSONLY
SrFEO
s
s
s5,00O,00O
s5,000,000
a
SCIEOlJLED
rPracoddnf
1qzAZ) O2l1 MI0|?3J [q99!E!!!9q
AGGFEGATE
A x
EXCE66 LIAB CLAIMS.MAOE
006546318
oro X nererurLoru slO0OO
WOFKERA COMPEI,ISATION
AIID EMPLOYEFS LlAAILllY
ANY PFOPFlETOF/PARTN EF/E XECU NVE
OFFICEFI/MEMAEF EXCLI,]OEO?
oEscRlPTION oF OPEFATTONS b.lol
Pror/Polutn Llab
Claims Mado
IPER T tor+]STAIUTE LEB
EI, EACH ACCIDENT
E.! DrsE4gE, E4l!!!oYE.
EL DISEASE PO(ICY LIMII
s
A 013001524 412022 OA1U2V23 i2,m0,000 Por Claim
$4,000,000 Aggregate
slm 0o0 Ded
oEscRtpTrol oF opERAIofrd / LocATroNs / vEHlcL!6 {acoRo 101, Addr on.r6.m..r. s.h.dul., r.yb..rr..h.d ll mor..p.c. r. r.qvlr.d)
Addlllonal lnsurod applles on Gsnoral Ll8bility per Loxlnglon's Addltlqnal lnsured Ownors, Lessoos or
Contractors endorsoment D(4316 0gl4 end D(9605 1UO attachod to the General Liablllty pollcy as rsqulred
by wrttton contact.
Prlmary wordlng applles to General Liablllty per Lexlngton's endorsemenl LX9838 08/05 sttached to policy.
Addltlonal lneured and Prlmary wordlng appll6s on Aulomoblle Llabllhy por Travolors endorsomont CAT474
(Soe Atl€ched Doscriptlons)
(LC)Clty ol Menilee
29714 Haun Road
Meniles, CA 92596
SHOULDANY OF TIIE AEOVE OESCBIBED POLICIES BE CAIICELLED BEFOAETHE EXPIFATION I'ATE T}IEFEOF. NOTICE WILL BE DELIVEBEO IN
ACCOHDANCE WITH THE POLICY PFOVISIONS,
AUIhOFq€O BEPRESENTAT]VE
I sr' s("-15'
TIF ATE HOLDEB CANCELLATION
!983
ACOHO 2s (2O16,/03) 1 ol2#s29477839/M29461 171
O 196&2015 ACORO COBPOBATION. All rlghtB r.6rrv.d.
The ACORD nrm. !nd logo !re ragltterod mErka ot ACOBD
LXMCN
page'14 of 23
ffi
DESCRIPTIONS (Continued from Page 1)
0216, BlEnkot Addltlonal lnauro*Primary and NoGcontrlbutory wlth other lnsuranco' attached lo tho
Adomoblle pollcy as requljed by wrllten contract.
Ro: Prol *11051.010 CIP 21.13 (Mccall Blvd Bssurlsclng-Encanto to anteloPo) Matedals Testlng &
Geotechnlcal 56rvlces.
Additional lnsured to lnclude Por specillcations: Clty ol Monlloe and h3 otlicers, employe€s'
agents, and authorlzgd volunleels
SAGITTA 25.3 (m16logl 2 ol 2
#s294778:t9/M29461 1 71
t9ll4
page 15 of 23Hi;48ffi
ENDORSEMENT
(Dt1A(p2
This endorssment, oftociivo 12:Ol AM
Forms ! prrt oI policy no.: m546344o
lssued to: Leigtton Consulting lnc
By: LEX INGTON INSURANCE COI{PANY
CANCELLATION AMENOMENT
ln consi.leration o, the premium charged, it is herehy agreed that the cancellalion provision is amended
to 90 davs in liel, o, (30) davs, except lor non-payment ol premitrm wtlich rcmains (10) days-
Al other terms and condilions remain lrnchanged
,Wr----
Auth orized Reptosenta tivo OR
Count6rsignrtu16 lln statas whoro 6pplicsble)
1985
LX95a6 (02lo3)
page 16 of 23
h,riE#EffiStrxlttt:
r986
This page has been left blank intentionally
ffi page 17 of 23
EN DORSE MENT
Thi6 6ndorsomont, affoctive 1ZO1 AM an 4a@2
Forms a part of policy no.: 065463440
lssuod to: Leighlon Consulting lnc
Bv: LEX INGTON INSURANCE COi'IPANY
PR IMARY/NON CONTRIBUTORY E NDORSEMENT
This endorsemenl modiries insurance provided by the policy:
Not\ rilhstanding any other provision ol rhe policy to the contr8ry, the insurance aftorded by rhis policy
lor the benefit ol the Additional lnsured shall be primary insurance, but only with respect to any claim,
loss or li8bility arising out of the Named lnsured's operations; and any insurance maintained by the
Addhion6l lnsured shall be non -contributing.
Al other terms and conditions ol the policy remain lhe same.
Authoriz6d R epr6s6ntEtivo OR
Countersignature (ln stEtss where applicablel
198 /
LX9a3a (04051
v*.*22/a/Z^
page 18 of 23
ffi
This page has been left blank intentionally
rgrJtiI
COl\illl!ERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - PR!MARY AND
NON.CONTRIBUTORY WITH OTHER INSURANCE
This endorsement modif ies insurance provided under the following
BUSINESS AUTO COVERAGE FOR IVI
LeightonConsulting lnc
8A38708431224:)G
PROVtStONS
1. The following is added to Paragraph A.1.c., Who
ls An lnsured, of SECTIoN ll - CoVERED
AUTOS LIABILITY COVERAGE;
This includes any person or organizalion who you
are required under a written contract or
agreement behffeen you and that person or
organization tnat is signed by you before lhe
"bodily injury" or "pmperty damage" occurs and
lhat is in efrect during the policy period, to name
as an additional insured for Covered Autos
Liability Coverage, but only for damages to which
this insurance applies and only to the eient of
that person's or organizationb liability for the
conducl of another "insured"
page 19 of 23
2. The follo ing is added to Paragraph 8.5., other
lnsurance of SECTION lV - BUSINESS AUTO
CONDITIONS:
Regardless of lhe provisions of paragraph a. and
paragraph d. of this part 5. Other lnsurance, this
insurance is primary to and non-contributory with
applicable other irEurance under which an
additional insured person or organization is the
fiIst named insured when the writlen conlracl or
agreemenl between you and lhat person or
organization, that is signed by you betore the
"bodily iniury" 0r "property damage' occurs and
that is in etrect during the policy period, requires
this insurance to be primary and non-conlributory.
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cA 14 74 02 16 u 2016 The Travelels lndemnrv Company All rEhls reservea,
ncluc,es copynghled materialof lnsurance Ssrvlces Offce lnc tytlh ls permission
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PoLlcY NUMBER: 065463440 ENDoRSEMENT# 004 COMMERCIAL CENERAL LIABILITY
cG 20 l0 r0 0r
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AEHTIONIAL IIIISIRED - OvIf[RS LESSEES
OR OI.IIRACT'ORS - SOfII..I.ED PERSOT{
OR ORGAT{ZATIOi{
This endorsement modifies insurance provided under the folloralng:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of P€rson or Organization:
AS REQUIRED BY WRITTEN CONTRACT
(LC)City of Menif€e
29714 Haun Road
Menif€e, CA 92586-0000
Re: Proj fl11051.010 CIP 21-13 (MccallEfud Resu rfa cing-E nc:nt o to Ahtelope) Materjals TestinE & Geotech nical 5e ruices. Additionallnsured to incjude per
tpecifiEations: City of Menifee and its officers, employees, agents, and authorir€d volunteers.
(lf no entry appears above, information required to complete this endorsement will be sho\,wr in the Declarations
as applicable to this endorsement.)
A Section ll - Who ls An lnsured is amended
to include as an insured the person or organization
showl in the Schedule, but only Wth respect to
liability arising out of your ongoing operations
performed for that insured.
B- With respect to the insurance afforded to these
additional insureds, the followng e)€lusion is
addedl
2, Exclus io ns
This insurance does not apply to "bodily in-jury" or "property damage" occurring after:
(l ) All r,rprk, including materials, parts or
equipment furnished in connection with
such \Drk, on the project (other than
seryice, maintenance or repairs) to be
performed by or on behalf of the additional
lnsured(s) at the site of the covered
operations has been completed; or
(2)That portion of "your raork" out of \hich
the injury or damage arises has been put
to its intended use by any person or
organization other than another contractoror subcontractor engaged in performing
operations for a principal as a part of the
same project.
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ENDORSEMENT # O21
This endorsement, effective l2ol Al'll ou$17r]22
Forms a partof policy no.: 0€54€3440
ISSUEd tO: LEIGHTON GROUP, INC'
By: LEXINGTON INSURANCE COMPANY
ADDITIONAL INSURED . OWNERS, LESSEES
OR CONTRACTORS. COMPLETED
OPERATIONS
(Based on cczo37 M/731
This endorsement modifies insurance provided by the follov.inB
COMMERCIAL GEN ERAL LIABILITY POLICY
SCHEDULE
Name ofAdditional lnsured Person(s) Location of Completed Operations
or organization(s)
AS REOUIRED BY WRITTEN CONTRACT
(LC)Cily ol Menifee
29714 Haun Road
Menitee, CA 92586{000n" piq *rrosi.oro ctp 21-13 (Mcca Blvd Resurlacing€ncanto to Antelope) l\,'laterial. Tesling & G€otechnical Sewice. Additional
l;ured'to include per spocilications: City ol Menifee 6nd ito oficers, employe€s, aoent6, arE authorazed volunleels
lnformation required to comphte this Schedule, if not sho',^,n above, \''ll be sho\fl in the Declarations
A Section ll - Who ls An lnsured is amended to include as an additional insured th€ person(s) or
organization(s) showl in the schedule, but onlv \ith rEspect to liability fur "bodily injury"' or
"p-roperty damage" caused, in u'tlole or in part, bv "your \'ork" at the location designated and
a.r..iU"O in th; Schedule of this endorsement performed for that additional insured and included in
the " products-completed operations hazard".
H o\A€ve r:
l. The insurance afforded to such additional insured onv applies to the extent permitEd by law
and2. lf coverage provided to the additional insured is required bY a coniract or aSreement, the
insurance afforded to such additional insured \ill not be broader than that \hich you are
required by the contract or agreement to provide for such additional insured'
B. with respect to the insurance afforded to these additional insureds, the follo\ ing is added to
Section lll - Limits Of lnsurance:
lf coverage provided to the additional insured is required by a contract or agreement, the most !\,/e
will pay on behalf of the additional insured is the amount of insurancei
n(pyrt6
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Offices.lnc..wth its permission. All Rightg Reserved
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l. Required by the contract or agreement; or
2. Available under the applicable Limits of lnsurance sho\,\rr in the Declarationsj
\Ahichever is less.
This endorsement shall not increase the applicable Limits of lnsurance shovm in the Declarations
All other terms and conditions of the policy remain the same.
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Authorized Representative
u(la r6 (06/r4)Lalutlea-opvrioliied Inlorrut ion ol the I nsu ra nae 5e rvice s
Offices,lnc., with lts permission AllRight! Reserved.
P.Be 2 ot 7
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