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2021/10/25 Reliable Concrete Accessories (9)ACORi;CERTIFICATE OF LIABTLITY INSURANCE 9t30t2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE OOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTENO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CO'{TRACT AETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PROOUCER AND THE CERTIFICATE HOLOER. IMPORTANT: ll tho co.tilicate holdor is an ADOITIONAL li{SUREO, tho policy(ios) must have AODITIOIAL INSURED proviaions or be ondorsed. lf SUBROGATION lS WAlvEO, subject to the torms and condition3 o{ the pollcy, cerlain pollcies may requiro an ondoBsment. A statoment on this cortificate dooa not conter righta to tho cortificate holdor in liou or 3uch ondo6emont(s). PRoDUCER Edoewood Partners lnsurance Center tEPIC) 1gdOO MacArthur Blvd. PH Floor lrvine, CA 926'12 E 263,0606 .le4 )?9!:q906 AFFORD IN G COVERA GE www edgev/oodins.com Lumbermens al lnsurance Co. rNsuREnB, securil Nalional lnsurance CoReliable Concrete Accessories 7600 Redondo Circle Huntington Beach CA 92648 rxsuRER c : Greal American lnssance co COVERAGES CERTIFICATE NUMBER: 70624919 REVISION NUMBER: CANC€LLATION o 1988-2015 ACORD CORPORATTON Tho ACORO namo and logo arq rogiatored ma,ks of ACORO Citv of Menifee 29644 Haun Road Menibe CA 92583 SHOULD ANY OF lHE ABOVE DESCRIBEO POLICIES BE CANCELLEO BEFORE THE EXPIRATION OATE THEREOF, NOTICE wlLL BE OELIVEREO IN ACCORDANCE WITH THE POLICY PROVISIONS AUIHORIZED REPRESENTAIIVE WYo*-Anthony D'Asaro CERTIFICATE HOLDER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSURED NAMED AEOVE FOR THE POLICY PERIOD INOICATED NOTWTHSTANDING ANY REOUIREMENT IERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WTIICH THIS CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN lHE INSURANCE AFFOROED BY THE POLICIES OESCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS ANO CONDITIONS OF SUCH POTICIES LIMITS SHOVI,}I MAY HAVE BEEN REDUCED BY PAID CLAIMS OAMAGE TO RENTEOPREMISES (E @(6(!l MEp EXP (A.y on6 p66o.) PERSONAL & ADV INJURY GENERALACGREGATE PROOUCTS COMP/OP AGG t 1,000,000 t'l00.000 15,000 _ i 2.000,000 i 2,000,000 s1 000 000 10t2512021 10t2512022 s COlrI'ERCIAL GENERAf I.IAAIUTY GEN'LAGGREC^TE L UIlAPPLIES PER "o.,"r f -l F& fl.o" 04-R013-01-21 10t25t2021 r 0/2512022 I Egil:lll?rirNctE L Mrr t-otr" .,J,rRY ,P." r". I eoD,rv,,,.runt trr """,d.no -sl.qoqBQL HIREO AU IOMOBILE LIABIfITY 04-R013-02-21 10125t2021 1012512022 SRETENTlON 310.000 EXCESS LIAB 04-R013 03-21 B woRrGRs coxPEftsanot ANO EI'PLOYEFS' LIAStLTY ANYPROPR]E'IOR/PARTNER/EXECUIIVE OFF CERA'EMAEREXCL!OED? oEscRtPTroN oF oPERAIIONS bsf', 30122586 10t1t2022 10t112023 OTH E L EACHACCIOENT E L DISEASE. EA EMPLOYEE E L OISEASE, POLICY LIM]T s1 000 000 $ 1 000 000 s 1,000,000 c lnlard Mafine - Scheduled Equipment Excess Liability $5[rlvl Excess of $sMtu 0+R013-01-21 TAU95OO 10t25t2021 10125t2021 10D512022 10t2512022 $3,807.441.73 $2,500 Oeductiue. ACV $5,000,000 Each Occurrence $5.000.000 Aooreoate Limit OESCRTPTIOT{ O€ OPERAIIO S / IOCATIONS / VEHICLES {ACOFD 101 Add'l'o..| R.m.rt. S.h.dul., m.y b. .t.ch.d il 60r .p.c. i. rqur.d} The City of Menibe,The City of Meni€e Community Services, the lvlenilee Housing Authority and each of lheir ofllcers, offcals employees, agents and volunteers are included as Addilional lnsureds as respecis General Liability and Automobile Liability insurance per attached endorsentents. Primary and Non-Contributory Vlbrdrng applies per attached endorsement (s).\ hi\€r of Subrogation on \,brkers Compensation and Employers Liability insurance as especls to the City of Menrbe, lhe City of Menifee Commundy Servrces Oislrict, the Minifue Housing Aulhority and each of thef officers, employees, agents and volunlee6 per atlached endorsement ACORD 2s (2016/03) All rights reserved 14974 19879 16691 ll .Z f l sa-HEDULED/ auros L/ AUTosoNLY lt tlI I EACH occURRENCE[.""..^*.5.000.000-f-----r5,000,0m lleliahlc ( oncrctc Accessorics LUM-I45 02 06 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 lnsured of Commsrcial General Liability Coverage Form CG 00 0l is amended to add the followang: e. Additional lnsured by Written Contract or Written Agreement The following are insureds under the policy when you have agreed in a written contract 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 advertisrng inJury' arising out of or caused, in whole or in part, by the 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 the equipment lease expires. (2) 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, an 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 land; or (b) Structural alterations, new construction or demolition operations performed by or on behalt 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 morlgagee, 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 or "employees" or labor union, except with respect to work performed by or for you or for such 'employee", associalion of "employees or labor union under direct contract between you as contractor and such "employee , association of "employees' or labor unaon as owners; 9/30i2022 Pennsylvania Lumbermens Mutual lnsurance Company Philadelphia, Pennsylvania Page 1 of 3 0.1-R0I .i-() l-t I 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 company, (iii) Any person or organization whose profession. business or occupalion 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 instructionsl 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.(1) through (3) above. (b) lf a vendor of "your products" is an additional insured under this Coverage Form, such insurance as provided to the additional insured applies only with respect to "bodaly 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. This exclusion does not apply to liability that the vendor would have in the absence of the contract or agreement; (ii) Any expressed warranty of your "products" unauthorized by you; (iii) Any physical or chemical change in "your products" made intentionally by such vendor, (iv) Repackaging, unless unpacked solely for the purpose o, inspection, demonstratron. 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 producls": (vi) Demonskation, 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 atforded to the vendors in (4Xb) above does not apply to any person or organization lrom whom you have acquired such produds, ingredients, parts or containers entering into, accompanying or containang "your products". No insurance is provided under this vendor's coverage in (axb) 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 rnclude only that insurance required to be provjded by the terms of such agreement, and then only to the extent that such insurance is included 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 , oib. N\: lJennrf.r Yor 'te.a.ce1s and supersed.s Al,L pr t 9/30/2022 12:2a:r7 tr t?frly i3sued certi f lcates. 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 contract" between 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 ancluded as an insured under the provisions of Section ll - Who ls An lnsued or included as an additional insured by any other endorsement to this policy. (d) The limits of insurance afforded 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 afforded to any person or organization as an additional insured under this Paragraph 2.e.(l) through (4) does not apply to "bodily injury" or "property damage" whicho€urs prior to the date of your contract or written agreement with such person or organization. 2. Other lnsurance The insurance afforded to any additional insured under Paragraph 2.e.(1) through (4) will be primary and non- contributory if required by such contract or agreement with you. 3. Waiver of Right of Recovery by Written Contract or Agreement We waive any right of recovery to payments we make for injury or damages arising out of your ongoing 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 for payments made under this insurance as a consequence of such contract or agreement. LUM-145 02 06 Pennsylvania Lumbermens lvlutual lnsurance Company Philadelphia, Pennsylvania :dr(rrs aId suFArsedes A-t. p,eviuusty .ss)ed ..prr-fr.a,Fs. Page 3 of 3 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY wc 00 03 13 (Ed.04-84) WAIVER OF OUR RIGHT TO RECOVER F ROI\il OTHERS ENDORSEMENT 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 thatyou 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. This endorsement changes the policy to which it is attached and is effective on the date issued unless otheMise stated. (The information below is required only when this endorsoment is issued subsequent to preparation of the policy.) Endorsement Effectivefi1s112g22 Policy No. 36122556 Endorsement No. lnsured p"1;"61" 66ncrere Accessones . A t()- lnsurance Company Security Nationat lnsurance Company ' (a f "* wc 00 03 13 (Ed.04-84) '06:rr)! .r/-- )ounqD.ro I q/10/:ol- paq.5 of.1h,s :er_'rii"'p rdl,:els.ld superseoes ALL prp\iioLil/ rssued c. r)ljcrLes. Schedule Any person or organization as required by written contract Countersigned by - Itcliublc Concrcte Acccssorics POLICY NUMBER; 04-ltt)l 3-02-2 I COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, FORM NAME: COMMERCIAL AUTOMOBILE EXTENSTION ENDORSEMENT 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 thal 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 subrosation, 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. rosr{cr9 ,r/:: uilb, rc rJ€nnit.r you.gbe.q | 9/lol?02: r::13:t? pt{ lpmr pag.6 ot 6l',nrs cer'.rlr,'arn.dnrals dnd supersedF3 ALt, areviously rssued ce,rLrrcdLes. This 6ndorsement modifies insurance provided under the following: