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2023/06/30 Leighton Consulting, Inc. (4)
ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 6/29/2023 (703) 827-2277 (703) 827-2279 19489 Leighton Consulting, Inc. 2600 Michelson Dr. Ste. 400 Irvine, CA 92612 20494 24319 A 1,000,000 0313-8888 6/30/2023 6/30/2024 300,000 25,000 1,000,000 2,000,000 2,000,000 1,000,000B 6080642405 6/30/2023 6/30/2024 10,000,000A 0313-8889 6/30/2023 6/30/2024 10,000,000 10,000 B 7015100423 6/30/2023 6/30/2024 1,000,000 N 1,000,000 1,000,000 C Professional 0313-8886 6/30/2023 Per Claim 2,000,000 C Liability 0313-8886 6/30/2023 6/30/2024 Aggregate 4,000,000 Cyber Liability Policy #C-4LRY-073428-CYBER-2022 (Insurer: Coalition Insurance Solutions, Inc.) – 12/31/22 - 12/31/23 – $5,000,000 Per Claim/Aggregate Re: Proj #11051 City of Menifee Professional Services. City of Menifee are included as additional insured with respect to General Liability, Automobile Liability and Excess Liability when required by written contract. General Liability includes Additional Insured coverage for On-Going & Completed Operations as required by written contract. General Liability, Automobile Liability and Excess Liability are primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured and when required by written contract. General Liability, Automobile Liability, Excess Liability and Workers Compensation policies include a waiver of subrogation in favor of the additional insured where permissible by state law and when SEE ATTACHED ACORD 101 City of Menifee 29714 Haun Road Menifee, CA 92586 VERDALL-01 ABUYTENHUYS Ames & Gough 8300 Greensboro Drive Suite 980 McLean, VA 22102 admin@amesgough.com Allied World Assurance Company (U.S.) Inc. Transportation Insurance Company A(XV) Allied World Surplus Lines Insurance Co. A XV X 6/30/2024 X X X X X X X X X DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 FORM NUMBER: EFFECTIVE DATE: The ACORD name and logo are registered marks of ACORD ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE FORM TITLE: Page of THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 101 (2008/01) AGENCY CUSTOMER ID: LOC #: AGENCY NAMED INSURED POLICY NUMBER CARRIER NAIC CODE © 2008 ACORD CORPORATION. All rights reserved. Ames & Gough VERDALL-01 SEE PAGE 1 1 SEE PAGE 1 ACORD 25 Certificate of Liability Insurance 1 SEE P 1 Leighton Consulting, Inc. 2600 Michelson Dr. Ste. 400 Irvine, CA 92612 SEE PAGE 1 ABUYTENHUYS 1 Description of Operations/Locations/Vehicles: required by written contract. 30-day Notice of Cancellation will be issued on the General Liability, Automobile Liability, Workers Compensation and Professional Liability policies in accordance with policy terms and conditions. DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 ENV-PEP2 01001 00 (01/23) Includes copyrighted material of Insurance Services Offices, Inc., used with its permission Page 1 of 2 ADDITIONAL INSURED - OWNERS, LESSEES, OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Any owner, lessee, or contractor whom you have agreed to include as an additional insured under a fully executed written contract or written agreement, provided that such was executed prior to an "occurrence", loss, injury or damage All locations of the Named Insured Solely with respect to the insurance afforded under SECTION I – COVERAGES, COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY, COVERAGE B – PERSONAL AND ADVERTISING INJURY LIABILITY, and COVERAGE D – GENERAL POLLUTION LIABILITY 1. Insuring Agreements, a. (3) Transported Cargo Pollution Liability and a. (4) Contractors Pollution Liability, it is agreed that the following changes are made to the policy: 1.SECTION II – WHO IS AN INSURED of the policy is amended to 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, environmental damage or personal and advertising injury caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations 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; (2) The insurance afforded to such additional insured does not apply to a claim, suit, damages, loss bodily injury, property damage, personal and advertising injury, environmental damage, or any other injury, damage, loss, cost, or expense for which insurance is afforded under this policy that arises out of the negligence or willful misconduct of the additional insured; and (3) If 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 contract or agreement to provide to such additional insured. 2. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to bodily injury, property damage, environmental damage, or personal and advertising injury occurring after: Main Named Insured: Verdantas LLC Policy #: 0313-8888 DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 ENV-PEP2 01001 00 (01/23) Includes copyrighted material of Insurance Services Offices, Inc., used with its permission Page 2 of 2 a. 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 b. That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 3. With respect to the insurance afforded to these additional insureds, the following is added to SECTION III – LIMITS OF INSURANCE: 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 Insurance shown in the Declarations; whichever is less. All other terms and conditions of the Policy remain unchanged. DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 ENV-PEP2 01002 00 (01/23) Includes copyrighted material of Insurance Services Offices, Inc., used with its permission ADDITIONAL INSURED - OWNERS, LESSEES, OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION COMPLETED OPERATIONS SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Any owner, lessee, or contractor whom you have agreed to include as an additional insured under a fully executed written contract or written agreement, provided that such was executed prior to an "occurrence", loss, injury or damage. All locations of the Named Insured Solely with respect to the insurance afforded under SECTION I – COVERAGES, COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY, it is agreed that the following changes are made to the policy: 1.SECTION II – WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily injury or property damage caused, in whole or in part, by your work at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the products-completed operations hazard. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; b. The insurance afforded to such additional insured does not apply to a claim, suit, damages, bodily injury, property damage, or any other injury, damage, loss, cost, or expense for which insurance is afforded under this policy that arises out of the negligence or willful misconduct of the additional insured; and c. If 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 contract or agreement to provide to such additional insured. 2. With respect to the insurance afforded to these additional insureds, the following is added to SECTION III – LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable limits of insurance. All other terms and conditions of the Policy remain unchanged. DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 ENV-PEP2 02008 00 (02/23) WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US – SCHEDULED PERSON OR ORGANIZATION It is hereby agreed that the following is added to SECTION IV - CONDITIONS, 20. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for bodily injury, property damage, or environmental damage arising out of your work done under a written contract or agreement with that person or organization and included in the products-completed operations hazard. This waiver applies only to the person or organization shown in the Schedule below. Schedule Name of Person or Organization: Blanket where required by written contract. All other terms and conditions of this policy remain unchanged. Main Named Insured: Verdantas LLC Policy #: 0313-8888 DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 ENV-PEP2 06015 00 (01/23) Includes copyrighted material of Insurance Services Offices, Inc. with its permission. POLICY ANNUAL AGGREGATE LIMIT – GENERAL AGGREGATE LIMIT(S) – DESIGNATED PROJECT It is hereby agreed that the following changes are made to the policy: 1.Item 3. LIMITS OF INSURANCE of the Declarations is amended to include the following: Policy Annual Aggregate $4,000,000 2.SECTION III – LIMITS OF INSURANCE is amended to include the following additional provision: The Policy Annual Aggregate Limit shown in paragraph 1. above, is the most we will pay under this policy for the sum of all: a. Damages, medical expense, loss, professional damages, or any other injury, damage, loss, cost, or expense for which insurance is afforded under the General Aggregate Limit shown in Item 3. of the Declarations; and b. Damages, medical expense, loss, or any other damage, loss, cost, or expense for which insurance is afforded under the Designated Project General Aggregate Limit provided separately to each designated project pursuant to the Designated Project General Aggregate Limits Endorsement attached to this policy. All other terms and conditions of this policy remain unchanged. Main Named Insured: Verdantas LLC Policy #: 0313-8888 DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 ENV-PEP2 02007 00 (02/23) ADVICE OF CANCELLATION TO OTHERS - DESIGNATED PERSON OR ORGANIZATION It is hereby agreed that SECTION IV – CONDITIONS, 3. Cancellation is amended to add the following: Advice Of Cancellation To Others – Designated Person or Organization In the event that we cancel this policy for any reason other than nonpayment of premium, we will endeavor to mail or deliver by email advice of such cancellation to each person or organization shown in the Schedule below, at the corresponding mailing or email address shown in the Schedule below, at least the number of days shown in the Schedule below prior to the effective date of cancellation, as a courtesy only, provided that the first Named Insured shown in Item 1. of the Declarations: 1. At the time of its receipt of our notice of cancellation is under a written contractual obligation to notify the person or organization of such cancellation; and 2. Has provided us with a valid e-mail or mailing address that is shown in the Schedule below. However, our failure to mail or deliver by email advice such cancellation to the person or organization will not invalidate or otherwise affect the cancellation of this policy or the effective date of cancellation. Schedule Person or Organization E-mail or Address Number of Days Advance Written Notice of Cancellation Blanket where required by written contract. 30 Days All other terms and conditions of this policy remain unchanged. Main Named Insured: Verdantas LLC Policy #: 0313-8888 DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 Business Auto Policy Policy Endorsement ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Person Or Organization ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED BY WRITTEN CONTRACT TO MAKE AN ADDITIONAL INSURED UNDER THIS INSURANCE IS AN "INSURED", BUT ONLY WITH RESPECT TO THAT PERSON OR ORGANIZATION'S LEGAL LIABILITY FOR ACTS OR OMISSIONS OF A PERSON WHO QUALIFIES AS AN "INSURED" FOR LIABILITY COVERAGE UNDER SECTION II WHO IS AN INSURED OF THIS COVERAGE FORM 1.In conformance with paragraph A.1.c. of Who Is An Insured of Section II - LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy. 2.The insurance afforded to the additional insured under this policy will apply on a primary and non-contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the “accident” for which the additional insured seeks coverage under this policy. All other terms and conditions of the policy remain unchanged This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Endorsement No: 16; Page: 1 of 1 Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606 Form No: CNA71527XX (10-2012) Endorsement Effective Date: Policy No: BUA 6080642405 Policy Page: 53 of 79Endorsement Expiration Date: © Copyright CNA All Rights Reserved. DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 Business Auto Policy Policy Endorsement WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: VERDANTAS LLC Endorsement Effective Date: 06/30/2023 SCHEDULE Name(s) Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR TO LOSS. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. Endorsement No: 9; Page: 1 of 1 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: CA 04 44 10 13 Endorsement Effective Date: Policy No: BUA 6080642405 Policy Page: 75 of 383Endorsement Expiration Date: © Copyright Insurance Services Office, Inc., 2011 DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 Business Auto Policy Policy Endorsement NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. All other terms and conditions of the policy remain unchanged This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Endorsement No: 26; Page: 1 of 1 Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606 Form No: CNA68021XX (02-2013) Endorsement Effective Date: Policy No: BUA 6080642405 Endorsement Expiration Date: © Copyright CNA All Rights Reserved. DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 CNA Workers Compensation And Employers Liability Insurance Policy Endorsement II BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement changes the policy to which it is attached. It is agreed that Part One -Workers' Compensation Insurance G. Recovery From Others and Part Two - Employers' Liability Insurance H. Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE -Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure. The amount is 3%. All other terms and conditions of the policy remain unchanged. I This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: G-19160-B (11-1997) Endorsement Effective Date: Endorsement Expiration Date: Endorsement No: 2; Page: 1 of 1 Underwriting Company: Transportation Insurance Company, 151 N Franklin St, Chicago, IL 60606 © Copyright CNA All Rights Reserved. Policy No: WC 7 1 51 00423 Policy Page: 31 of 45 DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9 Workers Compensation And Employers Liability Insurance Policyholder Notice NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificate Holders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificate Holder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No:Policy No: Underwriting Company: WC 6 80642422 Policyholder Notice; Page: 1 of 1 Continental Casualty Company, 151 N Franklin St, Chicago, IL 60606 CC68021A (02-2013) Policy Page: 21 of 208 © Copyright CNA All Rights Reserved. DocuSign Envelope ID: CBF6D4A8-2993-4E52-8D64-D9579AD39DE9