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2022/10/25 Reliable Concrete AccessoriesCERTIFICATE OF LIABILITY INSUR,ANCE OATE {fII/DO/YYYY) 10t21p022 THIS CERTIFICATE IS ISSUEO AS A MATTER OF INFORi'ATION ONLY AND CONFERS NO RIGHTS UPON IHE CERTIFICATE HOLDER. TTIIS CERTIFIGATE OOES NOT AFFIRiIATIVELY OR NEGAIVELY AITiENO, EXTENO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF IIISURANCE DOES NOT CONSTITUTE A CONTRACT BETMEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, A'{D THE CERTIFICATE HOLDER. IMPORTANT: lf tho certificato holdor l! an ADDITIONAL INSURED, tho policy(ie8) must havo AODITIONAL INSURED provisions or be ondorBod. ll SUBROGATION lS WAIVED, 6ubject to tho terms and condltiona ol tho policy, cort ln policlo8 may rcqulro an endoEomonl. A statomenl on this cortilicate doo3 not conf6r righls to the cortiflcato holdgr in liou of !uch ondoEemont(a). mooucER Edoewood Partners lnsurance Center (EPIC) 19d00 MacArthur Blvd. PH Floor lrvine. CA 92612 www.edgewoodins.com cor'rTAat PIIONE (e49) 263-0606 (949) 263 0906 INSURER(S) AFFOROINO COVERAGE rNsuRER a : Pennsyl\.ania Lumbermens l\rulual lnsurarlcq Co.14974 Reliable Concrete Accessories 7600 Redondo Circle Huntington Beach CA 92648 rNsuRER B: Securilv National lnsurance Company 19879 rNsuRER C i Great American lnsurancE company 16691 COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO IO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWTHSTANDING ANY REOUIREMENT, TERM OR CONOITION OF ANY CONIRACT OR OTHER DOCUMENT WTII RESPECT TO WTIICH THIS CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN, THE INSURANCE AFFOROED BY THE POLICIES DESCRISED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES LIMITS SHOW! MAY HAVE BEEN REOUCEO BY PAIO CLAIMS. COMU E RCIAL GEN ERAf LIA BILITY 6EN'L AGGREGATE LIMII APPLIES PER PoL'cY fl ,c& f] Loc 04-R013-01-22 10t2st2022 1012512023 EACH OCCURRENCE $1 000 000 $100,000PRFMTSESlE,o.cu.ncel MEo EIP (A.y ono p€Bon)s5,000 PERSONAL & ADV ]NJURY s1 000 000 GENE RAL AGGREGAT E r 2,000,000 PRODUCTS. COMP/OPAGG s 2.000,000 s AUIOMOBILE LIAAIL]TY AUTOSONLYHIREO SCHEOULEO AUTOS c 04 R013-02 22 10t25t2022 1012512023 COMSITED SINGLE LIMIT BOD]LY NJURY (P€I p€/son) r 1.000 000 SOOILY NJURY (P.r accd.nl) s s occuR 04 R013-03,22 1012512022 10125t2023 EACH OCCURRENCE r5.000,000 AGGREGATE $ 5.000.000 DED RETEN1ON r10,000 s B \ /oRxERS COitPEt'iSAIOn ANO EMPLOYERS' LIABILITY ANYPROPRI€TO&PARTNER/EXECUTIVE Of FTCER/MEMAEFEXCLUDED' DESCR PTION OF OPERATIONS bd@ s\ c1411494 101112022 10t112023 31,000,000E L EACI]ACCIDENT E L OISEASE. EA EMPLOYE€s 1 000 000 E L OISEASE. POLICY LIMIT $ 1.000.000 c lnland l\4arine - Scheduled Equipment Exc€ss Liability $sMM Excrss of $5irl! 04-R013-01-22 TUE,1189367 10t25t2023 1U25n023 $3,985,650 $2,500 Deducti eiACV $5,000.000 Each Occurrence 55.000.000 Aaqreqate Limit oEscRtPltoN oF oPERATTONS / LOCATTONS / VEH|CIES (ACORO 101 , Addttion.l R.fi.rt. Sch.dut., m.y b. .ttrch.d ll moE .p.c. l. Dqui6d) The City of Menibe,The City of Menitue Communily Services, the Menifre Housing Authonty and each ol their otlicers, ofllcals emDloyaes. aqents and vollinleers are included as pdditional lnsureds as respeds General Liability and Aulomobrl€ Lrabilily insurance per atlached endor6efient; Pnmary and Non-Conlribulory Vvcrdrng applies per attached endorsemenl (s) \ bi\er of SubrogatDn on Vlbikers Compansalron and Employers Liability insurance as respecis to ihe City o:t Menibe, tho City of Menif6e Community Services District, the ldiniee Housing Authority and each of their oflicers, employeos, agents and volunleers per allached endorsemenl CERTIFICATE NUMBER 9236 REVISION NUMBERi CANCELLATION O 1988-2015 ACORO CORPORATION. All rights resorvod Tho ACORD name and logo aro registergd marks ofACORO Crtv of Menifee 29844 Haun Road [Ieniiee CA 92583 SHOULO AIIY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION OATE THEREOF, NOTICE WILL BE DELIVERED It.I ACCOROANCE WITH THE POLICY PROVISIONS, AIJTHORIZEO REPRESENIATIVE YC'^--- Anthony D'Asaro CERTIFICATE HOLDER ACORO 25 (2016/03) tJ.nnrr.r YounqD.rq I totZtt2o2? lr{l:53 fi rpmr I Pro. I of 5cdlF cdniels and supersedes AII p!eviously issued ce!tifrcate3. o.fu I I 1012512022 10t2512022 Rtl iable Concrctc Acccssories tu2t t2022 0.1-R0I .r-{)t-12 COMMERCIAL GENERAL LIABILITY LUM.i45 02 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BROAD FORM ADDITIONAL INSURED This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Broad Form Additional lnsured Paragraph 2. of Section ll -Who ls An lnsurod of Commorcial Gonoral Liability Coverage Form CG 00 01 is amended to add the following: o. Additional lnsured by Written Contract or Written Agreement The following are insureds under the policy when you have agreed in a written conlract or agreement to provide them coverage as additional insureds under your policy: (1) Lessors of Leased Equipment: person(s) or organization(s) who lease equipment to you, but only with respect to their liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of or caused, in whole or in part, by lhe maintenance, operation or use of such equipment by you, your "employees", "temporary workers'or "volunteer workers". With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after lhe equipment lease expires. 12\ Owners. Managers or Lessors of Premises or Land: any owner, manager or lessor of premrses or land, but only with respect to their liability arising out of or caused, in whole or in part, by ownership, maintenance or use of that part of such premises or land leased to you. This insurance does not apply to: (a) Any "occurrence" which takes place after you cease to be a tenant or lessee of such premises or landi or (b) Structural alterations, new construction or demolition operations performed by or on behalf of the owner, manager or lessor of such premises or land. (3) Mortgagees, Assignees or Receivers: any person(s) or organization(s) with respect to their liability as your mortgagee, assignee or receiver and arising out of their ownership, maintenance or use of your premises. This insurance does not apply to: Any structural alterations, new construction or demolition operations performed by you or others for such person or organization. (4) Any person or organization, other than a joint venture, for whom you have agreed by written contract to provide "bodily injury" or "property damage" liability insurance, but only for liability arising out of or caused, in whole or in part, by operation(s) performed by you or on your behalf, provided that: (a) This Subparagraph (4) does not apply to any agreement to provide insurance to: (i) Any "employee", association of "employees" or labor union, except with respect to work performed by or for you or for such "employee", association of "employees" or labor union under direct contract between you as contractor and such "employee", association of "employees" or labor union as owners, LUM-145 02 05 Pennsylvania Lumbermens Mutual lnsurance Company Philadelphia, Pennsylvania J.nnrfer YoJnqb€rq I ra,2t/zoJ! t:t1:53 n4 rp!4, I p,i'd'e .'cr.'els dr,d 5,p6rsedes ALL previously rssued cerrrfrcares, Page I of 3 LUM-145 02 06 (ii) Any railroad company except with respect to work performed by you or for you for such railroad company under direct contract or agreement between you and such railroad companyl (iii) Any person or organization whose profession, business or occupation is that of an architect, surveyor or engineer with respect to liability arising out of preparation or approval of maps, drawings, opinions, reports, surveys, change orders, designs or specifications; giving directions or instructions; failing to give directions or instructions; or the performance of any other professional services by such person or organization; (iv) Any of your contractors or subcontractors or any partner, officer, agent or "employee" of such contractors or subcontractors: and (v) Anyone described in Paragraphs e.( l ) through (3) above. (b) lf a vendor of "your products" is an additional insured under lhis Coverage Form, such insurance as provided to the additional insured applies only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business and subject to the following additional exclusions. This insurance does not apply to: (i) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of assumption of liability in a contract or agreement. Thisexclusion does not apply to liability that the vendor would have in the absence of the contract or agreementi (ii) Any expressed warranty of your "products' unauthorized by youi (iii) Any physical or chemical change in "your products" made intentionally by such vendor; (iv) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing or the substitution of parts under instructions from you or the manufacturer, and then such parts are repackaged in the original container; (v) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make, or normally undertakes to make in the normal course of business, in connection with the distribution or sale of "your products"; (vi) Demonstration, installation, servicing or repair operations except such operations performed at the vendor's premises in connection with the sale of "your products'; or (vii) Any of "your products" which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other item or substance by or for the vendor. This insurance afforded to the vendors in (4Xb) above does not apply to any person or organization from whom you have acquired such products, ingredients, parts or containers entering into, accompanying or containing "your products". No insurance is provided under this vendor's coverage in (4Xb) if "bodily injury" or "property damage" under the "products-completed operations hazard" is excluded by any exclusions or provisions of this Coverage Form or by any endorsement. (c) The insurance afforded to any person or organization as an insured under Paragraph 2.e.(1) through (4) above: (i) Shall include only that insurance required to be provided by the terms of such agreement, and then only to the extent that such insurance is induded within the terms of this policy, and that person's or organization's status as an additional insured under this endorsement ends: (a) when your operations for that additional insured are completed or (b) when any written contract or agreement with such person or organization is terminated or expires. Pennsylvania Lumbermens Mutual lnsurance Company Philadelphia, Pennsylvania Yourab€rq IOl: r /l022 ",.els dn4 srpersedes A!L ptevrously rssued cerrrfrcates. Page 2 of 3 (ii) Does not apply to "bodily injury" or "property damage" included within the "products- completed operations hazard" unless such coverage is required by an "insured conlracl" belween you and the additional insured. (iii) ls subject to all applicable exclusions of Paragraph 2. Exclusions, Coverage A (Section l). (iv) Does not include any person or organization included as an insured under the provisions of Section ll - Who ls An lnsuod or included as an additional insured by any other endorsement to this policy. (d) The limits of insurance atforded to such additional insureds shall be the lesser of the limits required by any contract or agreement between the parties or provided by this policy. (e) The insurance atforded to any person or organization as an additional insured under this Paragraph 2.o.(1) through (4) does not apply to "bodily injury" or "property damage" which occurs prior to the date of your contract or writlen agreement with such person or organization. 2. Other lnsurance The insurance afiorded to any additional insured under Paragraph 2.s.(1) through (/t) will be primary and non- contributory af required by such contract or agreement with you. 3. Waiver of Right of Rscovery by Written Contract or Agroement We waive any right of recovery to payments we make for injury or damages arising out of your ongorng operations or "your work" included in the "products-completed operations hazard". This applies to any person or organization with whom you have agreed in a written contract or agreement made prior to the date of the "occurrence" to waive your rights of recovery from such person or organization, but only lor payments made under this insurance as a consequence of such contracl or agreemenl. LUM-145 02 06 Pennsylvania Lumbermens lrutual lnsurance Company Philadelphia, Pennsylvania tr{t:1s pfl ,pm, p.gs { o! 6Tr i 'p r.f-'d. ."n:al rld s-peiseoes ArL pret.oJ_s-v rssueo cerLifrcaLes, Page 3 of 3 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY wc 00 03 13 (Ed.04{4) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEIVIENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any person or organization as required by written contract This endorsement changes the policy to which it is attached and is effective on the date issued unless otheMise stated. (The information below is rsquired only whon this endorsomont is issued subsequent to preparation of ths policy.) Endorsement Effecliue1u6112622 Policy No. sv1,c14 494 Endorsement No. lnsured p"113616 666crete Accessories lnsurance Company Security National lnsurance Company Countersigned by wc 00 03 13 (Ed. 04-84) Wyg'"*- ,ounqberq | lO/:L 20.j2 P.qe 5 ot 6I'5is "r' r'-.r e 'rre.s "nd sup-rsedes AIL p!e,;ro)sty rssued cerrrfica!es. Ileliable ( oncrcte Acccssorics POLICY NUMBER: 04-R0 I 3-02-22 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FORM NAME: COMMERCIAL AUTOMOBILE EXTENSTION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A, Any person or organization whom you are required by contract to name as additional insured is an "insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as an "insured" under the WHO lS AN INSURED provision of Section ll- LIABILITY COVERAGE. B. For any person or organization for whom you are required by contract to provide a waiver of subrogalron, the Loss Condition- TRANSFER OF RIGHTS OF RECOVERY AGAINST oTHERS TO US is not applicable. C. The insurance afforded to any additional insured whom you are required by contract to name as an additional insured will be PRIMARY AND NON-CONTRIBUTORY by such contract or agreement with you. /:l 6r' Au!o, I Jannifer Younobero r0/2rl2022 r:{l:5S Rl rPmt ?.o. 6 0f 6 '. dle a1.'pI5 drd rJpprsedes All p etiou'slv issued .errlfrcare3.