2022/07/07 Tri Pointe Homes IE-SD, Inc.8t30t2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AI.{D CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTENO OR ALTER THE COVERAGE AFFORDEO BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT AETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLOER.
IMPORTANT: lf th6 certiUcale holdor ls an ADDITIONAL INSURED, th6 policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain pollcles may roqulre an endorsoment. A statemant on
this certificate does not confer rights to the c€rtlficat€ holder in lieu of such endorsoment(s).
PRoDUCER Lockton Insuranc€ Brokers, LLC
777 S. Figueroa Street, 52nd Fl.
CA License #0F15767
Los Anoeles CA 90017
(213)669.0065
TNSURERA: Everest Denali Insurance Company 1604.1
rNsuFEo TriPointe Homes lE-sD, lnc.
1452278 Td Poinle Homes,loc.
177 E. Colorado Blvd. Suite 500
Pasadena CA 91'105
lNsuRER B I National Fire and Marine Insurance Co 20079
tNsuRER c : Everest Premier Insumnce Company 16045
ACoRD'
COVERAGES TRI o06
CERTIFICATE HOLDER
CERTIFICATE OF LIABILITY INSURANCE
CANCELLATION SccAttachments
o1 8-201
1 l',7 /2023
N MBE
IHIS IS TO CERTIFY THAT THE POLICiES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AAOVE FOR THE POLICY PERIOO
INDICATED, NOTWITI]STANDING ANY REOUIREMENT, TERI\4 OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIIH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIM1TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAI[,!S,
TYPE OF INSURANCE ADDL SUBR
COMMERCIAL GENERAL LIABILITY
CLA IIS MADE X
GEN'L AGGREGATE L M T APPL ES PER
JECT LOC
OTHER
Y N -11-HBL-150446-01 9t 1i2072 9| t2024 EACH OCCURRENCE s 20.000.000
s 100.000
MED ExP (Any one person){ Included
$
AUTOMOBILE LIABILTTY
x
OWNEDAUTOS ONLY
HiREDAUTOS ONLY
SCHEDULEDAUIOS
x NON.OWNEOAUTOS ONLY
N N cct cA00053-221 7 i1i2022 - I t1)t:s 1.000.000
BODILY INJURY (Per person)$ xxxxxxx
BODILY TNJURY (Per accid6nl $ xxxxxxx
$ xxxxxxx
5 X-XXXXXX
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS.i4ADE NOT APPLICABLE
EACH OCCURRENCE
$ xxxxxxx
DEO RETENT ON $$
('WORXERS COIIPENSATION
AI{O EIIIPLOYERS' L|AALITY
,.}lY PROPR]ETO&PAiTNEfu F,IECIJTIW
OFFICERNTEMBER DrcLUOEO?
Das.RrPr oN oF oPERATToNS eo"
N
N cct wc00050,21l 7 i t i2011 x IOTH
$ I,000.000
s 1.000.000
s 1.000.000
OESCRIPTIOiI OF OPERAIOTIS / LOCATIONS / VEHELES (ACORO '10'1, Ad.lldon.l F.hlrks 6!h.dva.. my 5..tt ch..l tl moo.p.@ l. r.qolnd)
Ciry OfMenifee is Addilional lnsurcd(s)as per the allachcd endorseftenl or policy languagc.
SHOULO ANY OF THE ABOVE OESCRIBEO POLICIES BE CANCELLEO BEFORE
THE O(PIRATION OAIE THEREOF. NOTICE wlLL BE OELIVEREO IN
ACCOROAXCE WITH THE POLICY PROVISIONS
-Mrl*--
AUTHORlzED REPRESENIATIVE
Depadment
14691114
Crty Of Llenifee
ATTN: Engineering
29714 Haun Road
Menifee CA 92586
ACORD 25 (2016/03)
The ACORD name and logo are registered marks ot ACORO
D RPORATION. All rights reserved
XB
'7 t'712023
F xxxxxxx
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Lockton lnsurance Brokers, LLC
777 S. Figueroa Street, 52nd Fl.
CA License #OF 15767
Los Angeles CA 900'17
(213) 689-0065
1oz *10 O14475 ' 892 - 1289
14691114
CITY OF IVENIFEE
ATTN ENGINEERING DEPARTMENT
29714 HAUN RD
MENTFEE CA 92586-6540
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Attachment Code : D568466 Master ID: 1452278, Certificate ID: 14691 114
Named lnsured:Tri Pointe Homes lE-SD, lnc.
L
lo(xrw
City Of Menifee
ATTN: Engineering Department
29714 Haun Road
Menifee, CA 92586
To whom it may concern:
ln our continuing effort to provide timely certificate delivery, Lockton Companies is transitioning
lo paperless delivery of Certificates of lnsurance, thus this is your final hard-copy delivery.
Email: LACertseDelivery@lockton.com
Phone: (213) 334- 4669
lf you received this certificate through an internet Iink where the current certificate is viewable,
we have your email and no further action is needed.
ln the event your mailing address has changed, will change in the future, or you no longer
require this certificate, please let us know using one of the methods above.
The obove [nbox ond phone number is for outomoting electrontc deLivery of ceftificotes only.
Pleose do NOT send future certificote requests fo th6 inbox or contoct the phone number below
with emoil updotes.
Thank you for your cooperation and willingness in reduclng our environmental footprint.
Lockton Companies
Lockton com pa nies
777 South Figueroa Street Los Angeles, cA 90017
To ensure electronic delivery for future renewals of this certificate, we need your email address.
Please contact us via one ofthe methods below, referencing Certificate lD 14691114
Attachment Code : D468061 Certificate ID : 14691 I l4
POLICY NUMBER: 42-HBL-'l 50446-02 COMMERCIAL GENERAL LIABILITY
cG 20 t0 04 t3
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s)Location(s) Of Covered Operations
As required by written contract
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section ll - Who ls An lnsured is amendedto include as an additional insured the
person(s) or organization(s) shown in the
Schedule, but only with respect to liability for"bodily injury", "property damage" or
"personal and advertising injury" caused, in
whole or in part, by:
1. Your acts or omissions: or
2. The acts or omissions of those acting on
your behalf;
in the performance of your ongoing
operalions for the additional insured(s) at the
location(s) designated above.
However:
1. The insurance afforded to such additional
insured only applies to the extent
permitted by law; and2. lf coverage provided to the additional
insured is required by a contract or
agreement, the insurance afforded to
such additional insured will not be
broader than that which you are required
by the conkact or agreement to provide
for such additional insured.
C. With respect to the insurance afforded to
these additional insureds, the following
additional exclusions apply:
This insurance does not apply to "bodily
injury" or "property damage" occurring after:
'1. All work, including materials, parts or
equipment furnished in connection with
such work, on the project (other than
service, maintenance or repairs) to be
performed by or on behalf of the
additional insured(s) at the location of the
covered operations has been completed;
or
2. That portion of "your work" out of which
the iniury or damage arises has been putto its intended use by any person or
organization other than another
contractor or subcontractor engaged in
performing operations for a principal as a
part ol the same project.
cG 20 10 04 13 O lnsurance Services Otfice, 1nc.,2012 Page 'l of 2
Attachrnent Code : Dt168061 Certificate ID: 14691114
D. With respect to the insurance afforded to
these additional insureds, the following is
added to Section lll - Limits Of lnsurance:
lf coverage provided to the additional insured
is required by a contract or agreement, the
most we will pay on behalf of the additional
insured is the amount of insurance:
1. Required by the contract or agreement;
or
2. Available under the applicable Limits of
lnsurance shown in the Declarations;
Whichever is less.
This endorsement shall not increase the
applicable Limits of lnsurance shown in the
Declarations.
ffi
cG 20 10 04 13 O lnsurance Services Office, 1nc.,2012 Page 2 ol 2