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INSURANCE 1
CSGCONS-01 MHILL ACORO CERTIFICATE OF LIABILITY INSURANCE DATE IM 2022 ) lzmzozz 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(les) 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 endorsements . PRODUCER License If OC36861 CONTACT Melissa Hill NAME: Alliant Insurance Services, Inc. PHONE I FAX 560 Mission St 6th FI INC, No, Eat): INC. No):_ _ San Francisco, CA 94105 ADDRESS: Melissa.Hill@alliant.com INSURER(3) AFFORDING COVERAGE NAC a _ _ INSURERA; Fireman's Fund Insurance Company 21873 INSURED INSURER B:American Automobile Insurance Company 21849 CSG Consultants, Inc. INSURER C= National_ Surety Corporation _ 21881 550 Pilgrim Dr INSURERD:Pacific Insurance Company, Limited 10046 Foster City, CA 94404 - - INSURERE: _ INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR TYPE OF INSURANCE ADDLsUBR POLICY NUMBER POLICY EFF POLICY E%P LIMITS A X commERCIALGENERALLIASILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE I X I OCCUR USC032778220 121412022 12/4/2023 PRA AGET R NTEnence) 100,000 X _ 3 10,000 M_ED EXP(Anycne Person) 3 1,000,000 _ PERSONAL BADV INJURY 5 G_ENI AGGREGATE LIMIT APP_LI_ES PER: GENERAL AGGREGATE $ 2,000,000 POLICY I. X I JECT I LOC 2'000'000 _ PRODUCTS - COMP/OP AGG $ OTHER: $ B AUTOMOBILE LUUnLITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) 3 X ANYAUTO X SCV013084-22-01 12/4/2022 12/4/2023 BODILY INJURY (Per person) ;$ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY L_ar acdtlent) _$ AUTOS W F AUTOSOJr PROPEddant)AGE $ ONLY _ A X UMSNELLALUIB X OCCUR EACH OCCURRENCE $ 5'0001000 EXCESS LIAR CLAMS -MADE USCO29989221 12/4/2022 121412023 AGGREGATE $ 5.000,000 DED Al RETENTIONS 10,000 g C WORKERS COMPENSATION X I PER OTH- ANDEMPLOYERS'LIABILRY YIN X SCW023953-22.01 12I412022 12I412023 STATUTE ER 1,000,000 ANY PROPRIETO"ARTNERIEXECUTIVE OFpPICEfLMEMBEp EXCLUDED? (Mandatory In NNI NIA E.L. EACH ACCIDENT $ 1'000'000 Iryes.desaibeunder E.L. DISEASE -EA_EMPLOYEE $ - 1,000,000 DE SCRIPTION OF OPERATIONS belay E.L. DISEASE -POLICY LIMIT 3 D (Professional Llab. 83 OH 0489503.22 121412022 121412023 IDed: $50,000; Agg: 5,000,000 D IRetro Date: 1/111991 I 83 OH 0489503.22 1214/2022 12/412023 Occurrence: 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more epo. Is required) City of Eastvale and its respective elected and appointed officers, officials, and employees and volunteers are Inlcuded as Additional Insured as respects General Liability and Auto Liability on a Primary and Non -Contributory basis, as per the attached endosements. Waiver of Subrogation applies to the Additional Insured as respects Workers' Compensation. 30 Day Notice of Cancellation applies, as per attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Eastvale THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Johnny Terfehr, CES Manager 12363 Limonite Ave, Ste 910 AUTHORIZED REPRESENTATIVE 'gyp Q-- Eastvale, CA 91752 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: USC032778220 Allianz ili MultiCover@ - Without Medical Payments - CG 7193 0319 Policy Amendment(s) Commercial General Liability Coverage Form Your Commercial General Liability Coverage Form is revised as follows: Broadened Named Insured A. SECTION It -WHO IS AN INSURED, item 3., is deleted and replaced by the following: 3. Any organization that you own at the inception of this policy, or newly acquire or form during the policy period, and over which you maintain during the policy period majority ownership or majority interest, will qualify as a Named Insured if: a. There is no other similar insurance available to that organization; and b. The first Named Insured shown in the Declarations has the responsibility of placing insurance for that organization; and c. That organization is incorporated or organized under the laws of the United States of America. However: (1) Coverage under this provision 3 is afforded only until the next occurring annual anniversary of the beginning of the policy period shown in the Declarations, or the end of the policy period, whichever is earlier; and (2) Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization; and (3) Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. B. SECTION II -WHO IS AN INSURED, the last paragraph, is deleted and replaced by the following: No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture, or limited liability company that is not shown as a Named Insured in the Declarations. However, this does not apply to a limited liability company that meets all of the conditions in Section II - Who Is An Insured, item 3., above. 2. Additional Insured If an Additional Insured endorsement is attached to this policy that specifically names a person or organization as an additional insured, then this Section 2. Additional Insured does not apply to such person or organization. SECTION II - WHO IS AN INSURED, subsection 2.e., is added as follows: e. Any person or organization is included as an additional insured, but only to the extent such person or organization is legally obligated to pay for bodily injury, property damage or personal and advertising injury caused by your acts or omissions. With respect to the insurance afforded to such additional insured, all of the following additional provisions apply: (1) You have agreed in a written insured contract that such person or organization be added as an additional Insured under this policy; (2) The bodily injury, property damage or personal and advertising injury for which said person or organization is legally obligated to pay occurs subsequent to the execution of such insured contract; (3) The most we will pay is the lesser of either the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or the limits of insurance required by the insured contract; (4) The insurance afforded to such additional insured only applies to the extent permitted by law; Policy Number: USC032778220 Allianz ili (5) Such person or organization is an additional insured only with respect to: (a) Their ownership, maintenance, or use of that part of the premises, or land, owned by, rented to, or leased to you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (b) Your ongoing operations performed for that insured; (c) Their financial control of you, except such person or organization is not an insured with respect to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization; (d) The maintenance, operation or use by you of equipment leased to you by such person or organization; (a) Operations performed by you or on your behalf and for which a state or political subdivision has issued a permit, provided such operations are not performed for such state or political subdivision, and are not included within the products -completed operations hazard; or (f) Their liability as a grantor of a franchise to you. (6) This insurance does not apply to bodily injury, property damage, personal and advertising injury, occurrence or offense: (a) Which takes place at a particular premises after you cease to be a tenant of that premises; (b) Which takes place after all work, including materials, parts or equipment furnished in connection with such work to be performed by or on behalf of the additional insured at the site of the covered operations, has been completed; (c) Which takes place after that portion of your work out of which the injury or damage arises has been put to its intended use by any other person or organization other than another contractor or subcontractor engaged in performing operations for a principal as part of the same project; or (d) Which takes place after the expiration of any equipment lease to which (4)(d) above applies; (7) With respect to architects, engineers or surveyors, coverage does not apply to bodily injury, property damage or personal and advertising injury arising out of the rendering or failure to render any professional services by or for you, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; or (b) Supervisory, inspection, architectural, or engineering services. These exclusions apply even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the occurrence which caused the bodily injury or property damage, or the offense which caused the personal or advertising injury, involved the rendering of or the failure to render any professional services by or for you. 3. Additional Insured -Vendors If an Additional Insured Vendors endorsement is attached to this policy that specifically names a person or organization as an additional insured, then this Section 3. Additional Insured - Vendors does not apply to that person or organization. Unless the products -completed operations hazard is excluded from this policy, SECTION II - WHO IS AN INSURED, item 2.f. is added as follows: f. Any vendor of yours is included as an additional insured, but only with respect to bodily injury or property damage caused by your products which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: Policy Number:USC032778220 Allianz ili (1) The insurance afforded such vendor does not apply to: (a) Bodily injury or property damage for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (a) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed by the vendor in full compliance with the manufacturer's written instructions at the vendor's premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) Bodily injury or property damage arising out of the liability of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. (2) This Insurance does not apply to any insured person or organization from whom you have acquired such products or any ingredient, part or container, entering into, accompanying or containing such products; (3) The most we will pay is the lesser of either the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or the limits of insurance required by the contract or agreement; and (4) The insurance afforded to such vendor only applies to the extent permitted bylaw. 4. Additional Insured -Limited Primary and Noncontributory Provision The following is added as a second paragraph to Section IV Conditions, Condition 4. Other Insurance, following paragraph b.(2): However, if you have added any person, organization or vendor of yours as an additional insured to this policy by way of this MultiCover® endorsement and have agreed in a written insured contract that this insurance is primary and non-contributory with other insurance available to that additional insured, this insurance is primary and we will not seek contribution from such additional insured's other insurance, provided that the additional insured is a Named Insured under such other insurance. 5. Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 8., is deleted and replaced by the following: 8. Transfer of Rights of Recovery Against Others to Us and Blanket Waiver of Subrogation a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after the loss to impair those rights. At our request, the insured will bring suit or transfer those rights to us and help us enforce them. b. If required by a written insured contract executed prior to the occurrence or offense, we waive any right of recovery we may have against any person or organization named in such insured contract, because of payments we make for injury or damage arising out of your operations or your work for that person or organization. Policy Number: USC032778220 Allianz ili 6. Cancellation - 90 Days Common Policy Conditions endorsement IL0017, A. Cancellation, item 2.b. is deleted and replaced by the following: b. 90 days before the effective date of cancellation if we cancel for any other reason. 7. Liberalization SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added as an additional Condition: Liberalization If we adopt a change in our forms or rules which would broaden the coverage provided by any form that is a part of this policy without an extra premium charge, the broader coverage will apply to this policy. This extension is effective upon the approval of such broader coverage in your state. 8. Fire, Explosion, Sprinkler Leakage, or Lightning Legal Liability Coverage A. SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, the last paragraph, is deleted and replaced by the following: Exclusions c. through n. do not apply to damage by fire, explosion, sprinkler leakage, or lightning to premises while: 1. Rented to you; 2. Temporarily occupied by you with the permission of the owner; or 3. Managed by you under a written agreement with the owner. A separate limit of insurance applies to this coverage as described in Section III -LIMITS OF INSURANCE. B. SECTION III -LIMITS OF INSURANCE, item 6., is deleted and replaced by the following: 6. Subject to 5. above, the Damage to Premises Rented To You Limit shown in the Declarations, for property damage to any one premises while rented to you, or in the case of damage by fire, explosion, sprinkler leakage, or lightning while rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner, is the greater of: a. $1,000,000 Any One Premises; or b. The Damage To Premises Rented To You Limit shown in the Declarations. C. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance, b. Excess Insurance, (1)(a), items (i) and (iii), are deleted and replaced by the following: (i) That is Fire, Explosion, Sprinkler Leakage or Lightning insurance for premises while rented to you, temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner; (!it) That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you, temporarily occupied by you with the permission of the owner, or managed by you under a written agreement with the owner; or D. SECTION V -DEFINITIONS, 9. Insured Contract, item a., is deleted and replaced by the following: (a) A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, explosion, sprinkler leakage, or lightning to premises while rented to you, temporarily occupied by you with permission of the owner, or managed by you under a written agreement with the owner, is not an insured contract; 9. Damage to Invitees' Automobiles from Falling Trees or Tree Limbs -Limited Coverage Policy Number: USC032778220 Allianz ili This coverage applies to direct physical damage to automobiles owned by invitees subject to all of the following: 1. Provided such damage originates from trees on premises owned, managed, leased or rented by an insured; 2. Coverage applies only to invitees of an insured or an insured's tenant; 3. Such damage is directly caused by wind -driven falling trees or tree limbs; 4. The most we will pay for anyone loss is the lowest of: a. the actual cash value of the damaged automobile as of the time of the loss; or b. the cost of repairing the damaged automobile; or c. the cost of replacing the damaged automobile with another automobile of like kind and quality. Regardless of the number of occurrences, losses or claims, this coverage is subject to a limit of $25,000 in any one policy period; 5. This coverage is not subject to the General Liability General Aggregate Limit; and 6. We will make payments under this coverage without regard to fault. 10. Non -Owned or Chartered Watercraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, item g. Aircraft, Auto, or Watercraft, item (2), is deleted and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used for public transportation or as a common carrier; 11. Chartered Aircraft SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, g. Aircraft, Auto Or Watercraft, item (6), is added as follows: (6) An aircraft in which you have no ownership interest and that you have chartered with crew. 12. Coverage Territory -Broadened SECTION V - DEFINITIONS, item 4.a., is deleted and replaced by the following: a. The United States of America (including its territories and possessions), Puerto Rico, Canada, Bermuda, the Bahamas, The Cayman Islands and the British Virgin Islands; 13. Personal and Advertising Injury - Contractual Unless personal and advertising injury is excluded from this policy the following applies: SECTION I - COVERAGES, COVERAGE B, 2. Exclusions, item a., is deleted. 14. Fellow Employee Coverage SECTION II - WHO IS AN INSURED, 2.a., item (1) is deleted and replaced by the following: (1) Personal and advertising injury: However, subsections (a), (b), (c) and (d) of item (1) remain unchanged. 15. Bodily Injury Definition - Broadened SECTION V - DEFINITIONS, 3. Bodily Injury is deleted and replaced by the following: Bodily injury means bodily injury, sickness or disease sustained by a person including death or mental anguish resulting from any of these at any time. Mental anguish means anytype of mental or emotional illness or disease. 16. Expected or Intended Injury - Amendment to Exclusion Policy Number: USC032778220 Allianz ili SECTION I. Coverage A Bodily Injury and Property Damage Liability, 2. EXCLUSIONS, a. Expected or Intended Injury, is deleted and replaced by the following: a. Expected or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury or property damage resulting from the use of reasonable force to protect persons or property. 17. Unintentional Failure to Disclose Hazards SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 6. Representations, the following is added: d. If you unintentionally fail to disclose any hazards existing at the inception date of this policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. 18. Supplementary Payments - Increased Limits SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS - COVERAGES A AND B, items 1.b. and 1.d., are deleted and replaced by the following: b. The cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit, including substantiated loss of earnings up to $500 a day because of time off from work. 19. Duties in the Event of an Occurrence, Offense, Claim or Suit -Amended SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, item 2.a. is deleted and replaced by the following: (1) You must see to it that we or any licensed agent of ours are notified of a General Liability occurrence or offense which may result in a claim as soon as practicable after it becomes known to: (a) You, if you are an individual; (b) Your partner or member, if you area partnership or joint venture; (c) Your member, if you are a limited liability company; (d) Your executive officer if you are an organization other than a partnership, joint venture or limited liability company; or (e) Your authorized representative or insurance manager. Knowledge of an occurrence or offense by persons other than those listed above does not imply that those listed above also have such knowledge. (2) To the extent possible, notice should include: (a) How, when and where the occurrence or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the occurrence or offense. 20. Non Employment Discrimination Liability Unless personal and advertising injury is excluded from this policy the following applies: A. SECTION V -DEFINITIONS, 14. Personal and advertising injury, item h. is added as follows: h. Discrimination. B. B. SECTION V - DEFINITIONS, item 23. is added as follows: Policy Number: USC032778220 Allianz ili 23. Discrimination means the unlawful treatment of a person or class of persons because of their specific race, color, religion, gender, age, or national origin in comparison to one or more persons who are not members of the specified class. C. SECTION I - COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY, 2. Exclusions, the following are added: q. Discrimination directly or indirectly related to the past employment, employment or prospective employment of any person or class of persons by any insured; r. Discrimination directly or indirectly related to the sale, rental, lease or sublease or prospective sale, rental, lease or sublease of any dwelling or permanent lodging by or at the direction of any insured; s. Discrimination, if insurance thereof is prohibited by law; or t. Fines, penalties, specific performance, or injunctions levied or imposed by a governmental entity, governmental code, law, or statute because of discrimination. All other terms and conditions of the policy apply. Policy Number: SC V 013084 22 01 FleetCover@ Endorsement — CA 74 18 1014 Policy Amendment This Endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Broadened Named Insured Section II — Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured, the following is added: Any organization you own on the inception of this policy, or newly acquire or form during the policy period, and over which you maintain during the policy period, majority ownership or majority interest will qualify as a Named Insured if: (1) There is no other similar insurance available to that organization; and (2) The first Named Insured shown in the Declarations of this policy has the responsibility of placing insurance for that organization; and (3) The organization is incorporated or organized under the laws of the United States of America. However: (a) Coverage under this provision is afforded only until the next occurring 12 month anniversary of the beginning of the policy period shown in the Declarations, or the end of the policy period, whichever is earlier; and (b) Coverage under this provision does not apply to bodily injury or property damage that results from an accident that occurred before you acquired or formed the organization; and (c) No person or organization is an insured with respect to any current or past partnership, or joint venture that is not shown as a Named Insured in the Declarations; and (d) Coverage under A.(1), (2) and (3) above does not apply to any organization that is covered as an insured under any other automobile liability insurance policy whose limits of insurance have been exhausted or whose insurer has become insolvent. B. Broadened Who Is an Insured 1. Form CA0001 (if attached to this policy), Section II — Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured, item b.(2) is deleted, and d. is added as follows: d. Your employee while using his owned auto, or an auto owned by a member of his or her household, in your business or your personal affairs, provided you do not own, hire or borrow that auto. 2. Form CA0020 (if attached to this policy), Section II — Covered Autos Liability Coverage, A. Coveraqe, 1. Who Is An Insured, item b.(2) is deleted, and f. is added as follows: f. Your employee or agent while using his owned private passenger type auto, or a private passenger type auto owned by a member of his or her household, in your business or personal affairs, provided you do not own, hire, or borrow that auto. This form must be attached to Change Endorsement when issued after the policy is written. One of the Allianz Global Risks US Companies as named in the policy. CA701810-14 Page 1 of 10 Copyright 02014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 C. Additional Insured Coverage and Waiver of Subrogation 1. Form CA0001 (if attached to this policy), Section II — Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured, the following is added as item e.; and form CA0020 (if attached to this policy), Section II — Covered Autos Liability Coverage, A. Coverage, 1. Who Is An Insured; the following is added as item g.: Any person or organization with respect to the operation, maintenance, or use, of a covered auto, provided that you and such person or organization have agreed under an expressed provision in a written insured contract or written agreement, or a written permit issued to you by a governmental or public authority, to add such person, organization, or governmental or public authority to this policy as an insured. However, such person or organization is an insured: (1) Only with respect to the operation, maintenance, or use, of a covered auto; and (2) Only for bodily injury or property damage caused by an accident which takes place after: (a) You executed the insured contract or written agreement; or (b) The permit has been issued to you. 2. Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, A. Loss Conditions, item 5.; and form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, A. Loss Conditions, item 6.; the following is added: Waiver of Subrogation If required by a: a. Written insured contract or written agreement executed prior to the accident; or b. Written permit issued to you by a governmental or public authority prior to the accident; we waive any right of recovery we may have against any person or organization named in such contract, agreement or permit, because of payments we make for injury or damage arising out of the ownership, maintenance or use of a covered auto. D. Auto Medical Payments - Increased Limit For each covered auto described in the Declarations or shown in the Schedule as having Auto Medical Payments Coverage, the Medical Payments Limit of Insurance for those autos is revised to the greater of: 1. $5,000; or 2. The limit shown in the Declarations. E. Hired Auto Physical Damage Coverage and Loss of Use Expenses Hired Auto Physical Damage Coverage CA701810-14 Page 2 of 10 Copyright ©2014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 If Physical Damage Coverage is provided by this policy on your owned covered autos, the following applies: Any auto that you lease, hire, rent or borrow without a driver, will be covered under this policy for Physical Damage Coverage. However any such auto: 1. Will be covered only for the same Physical Damage Coverage that applies to your owned covered autos; 2. Will be subject to the same applicable deductible shown in the Declarations that applies to your most similar owned covered auto, except any Comprehensive Coverage deductible does not apply to loss caused by fire or lightning; and 3. The most we will pay for any one loss in any one accident is the lesser of the following: a. Actual cash value of the damaged or stolen property as of the time of the loss as determined by us; or b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. In addition, we will pay costs and fees associated with such covered loss only for a maximum time period of seven days beginning with the date of loss, subject to a maximum of $500. However: 1. If form CA0001 is attached to this policy, this coverage does not apply to autos you lease, hire, rent or borrow from any of your employees, partners (if you are a partnership), members (if you are a limited liability company) or members of their households; and 2. If form CA0020 is attached to this policy, this coverage does not apply to any private passenger type auto you lease, hire, rent or borrow from any member of your household, any of your employees, partners (if you are a partnership), members (if you are a limited liability company), or agents or members of their households. Hired Auto Loss of Use Expenses Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, 4. Coverage Extension, b. Loss of Use Expenses; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, 4. Coverage Extension, b. Loss of Use Expenses; is deleted and replaced by the following: b. For Hired Auto Physical Damage, we will pay expenses for which an Insured becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use expenses if caused by: (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered auto; (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss is provided for any covered auto; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered auto. CA701810-14 Page 3 of 10 Copyright 02014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $1,000. F. Coverage Territory - Hired Auto 1. Form CA0001, (if attached to this policy), Section IV - Business Auto Conditions, B. General Conditions, 7. Policy Period, Coverage Territory, b.(5) is deleted and replaced by the following: (5) Anywhere in the world if a covered auto of the private passenger type is leased, hired, rented or borrowed without a driver for a period of 180 days or less, 2. Form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, B. General Conditions, 7. Policy Period, Coverage Territory, b.(5) is deleted and replaced by the following: (5) Anywhere in the world if a covered auto of the private passenger type is leased, hired, rented or borrowed without a driver for a period of 180 days or less, G. Communication Equipment Coverage Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, C. Limits of Insurance, Paragraph 1.b.; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, C. Limits of Insurance, Paragraph 1.b.; is deleted and replaced by the following: b. All electronic equipment that reproduces , receives or transmits audio, visual or data signals in any one loss is $1,500, if, at the time of loss, such electronic equipment is: H. Tapes, Records, CDs and DVD Coverage The Physical Damage Coverage Section is amended as follows: 1. The exclusion referring to tapes, records, discs, or other similar audio, visual or data electronic devices designed for use with audio, visual or data electronic equipment does not apply. 2. Under Comprehensive Coverage - Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage; and form CA0020 (if attached to this policy), Section IV- Physical Damage Coverage, A. Coverage; the following is added: We will pay for loss to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: a. Are your property, or that of a family member; and b. Are in a covered auto at the time of a loss. The most we will pay for loss is $250. No deductible applies to this coverage. I. Personal Effects Coverage Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, 4. Coverage Extensions; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, 4. Coverage Extensions; item c. is added as follows: CA701810-14 Page 4 of 10 Copyright 02014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 c. Personal Effects Coverage We will pay up to $500 for loss for clothing items or other personal effects that are owned by an insured and are in an Owned auto at the time of a covered loss. Personal Effects do not include audio visual or electronic devices, money, giftcards, securities, jewelry, or tools. This coverage is excess over any other collectible insurance. No deductible applies to this coverage. J. Airbag Coverage 1. Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, B. Exclusions, 3.a.; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, B. Exclusions, 3.a.; the following is added: However, mechanical breakdown does not mean the unintended discharge of an airbag, provided that any loss covered under this provision is excess over any other collectable insurance or warranty designed to cover such unintended discharge. K. Rental Reimbursement Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, 4. Coverage Extensions; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, 4. Coverage Extensions; item d. is added as follows: d. Rental Reimbursement or Transportation Expenses If loss occurs to a covered auto described or designated in the Declarations or Schedule and covered for Physical Damage Coverage, we will pay for rental expenses for the rental of a similar replacement auto and additional transportation expenses, incurred by you. This payment applies in addition to the otherwise applicable amount of each coverage you have on the covered auto. No deductible applies to this coverage. However: (1) We will pay only for those expenses incurred by you that begin 24 hours after the covered loss. (2) We will cease paying for those expenses, regardless of the policy's expiration date, at the earlier of the following dates: (a) The number of days reasonably required to repair or replace the covered auto. If loss is caused by theft, this number of days is added to the number of days it takes to locate and return the covered auto to you; or (b) 45 days from the date this coverage begins. (3) Our payment is limited to the lesser of the following amounts: (a) Necessary and actual expenses incurred by you; or (b) $1,500. (4) This coverage does not apply while there are spare or reserve autos available to you for CA7018 10-14 Page 5 of 10 Copyright 02014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 your operations. (5) If loss results from the total theft of a covered private passenger type auto (if CA0020 is attached to this policy), or a covered private passenger auto (if CA0001 is attached to this policy), we will pay under this coverage only that amount of your covered rental expenses or additional transportation expenses which are not already provided for under the Physical Damage Coverage Extensions. L. Extended Towing Coverage 1. Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, 2. Towing, is deleted and replaced by the following: 2. Extended Towing We will pay up to $750 per disablement for towing and labor costs you incur each time your covered auto is disabled. However: a. All labor must be performed at the place of disablement; and b. If the covered auto is of the private passenger type, no deductible applies; and c. If the covered auto is not of the private passenger type, our obligation to pay will be reduced by a $250 deductible per disablement. d. If the covered auto is not of the private passenger type and the disablement results from a loss covered under Section III - Physical Damage Coverage, A. Coverage, Paragraphs 1, a., b., or c., there is no separate deductible for the Extended Towing Coverage. For purposes of this coverage, disablement means a breakdown of the covered auto including mechanical breakdown, engine failure, or tire blowout, where re- pairs cannot be made roadside and a tow is required to remove the auto from the roadway and to seek additional services and repair. 2. Form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, 2. Towing - Private Passenger Autos, is deleted and replaced by the following: 2. Extended Towing We will pay up to $750 per disablement for towing and labor costs you incur each time your covered auto is disabled. However: a. All labor must be performed at the place of disablement; and b. If the covered auto is of the private passenger type no deductible applies; and c. If the covered auto is not of the private passenger type our obligation to pay will be reduced by a $250 deductible per disablement. d. If the covered auto is not of the private passenger type and the disablement results from a loss covered under Section III - Physical Damage Coverage, A. Coverage, Paragraphs 1, a., b., or c., there is no separate deductible for the Extended Towing Coverage. For purposes of this coverage, disablement means a breakdown of the covered auto CA701810-14 Page 6 of 10 Copyright 02014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 including mechanical breakdown, engine failure, or tire blowout, where repairs cannot be made roadside and a tow is required to remove the auto from the roadway and to seek additional services and repair. M. Cancellation - 120 Days Notice If we cancel this policy for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured at the last mailing address known to us, written notice of cancellation at least 120 days prior to the effective date of cancellation. N. Supplementary Payments - Increased Limits Section II - Liability Coverage, 2. Coverage Extensions, a. Supplementary Payments, items (2) and (4) are deleted and replaced by the following: (2) Up to $2,500 for the cost of bail bonds (including bonds for related traffic law violations) required because of an accident we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including substantiated loss of earnings up to $500 a day, because of time off from work. O. Duties in the Event of Accident, Claim, Suit or Loss - Amended Form CA0001 (if attached to this policy) Section IV - Business Auto Conditions, A. Loss Conditions, item 2. a.; and form CA0020 (if attached to this policy) Section V - Motor Carrier Conditions, A. Loss Conditions, item 2. a.; is deleted and replaced by the following: a. In the event of accident, claim, suit or loss, you must promptly notify us or our authorized representative when it becomes known to: (1) You, if you are an individual; (2) Your partner or member, if you are a partnership or joint venture; (3) Your member, if you are a limited liability company; (4) Your executive officer if you are an organization other than a partnership, joint venture or limited liability company; or (5) Your authorized representative or insurance manager. Knowledge of an accident, claim, suit or loss by other persons does not imply that the persons listed above have such knowledge. Notice should include: (1) How, when and where the accident or loss occurred; and (2) The insured's name and address; and (3) To the extent possible, the names and address of any injured persons and witnesses. P. Unintentional Failure to Disclose Hazards Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, B. General CA701810-14 Page 7 of 10 Copyright 02014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 Conditions, item 2.; and form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, B. General Conditions, item 2.; the following is added: However, if you unintentionally fail to disclose any hazards existing at the inception date of this policy, we will not deny coverage under this Coverage Form because of such failure. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. Q. Fellow Employee Coverage Section II - Liability Coverage, B. Exclusions, 5. Fellow Employee, the following is added: However, this exclusion does not apply if the bodily injury results from the use of a covered auto you own or hire, and provided that any coverage under this provision only applies in excess over any other collectible insurance. R. Limited Mexico Coverage WARNING AUTO ACCIDENTS IN MEXICO ARE SUBJECT TO THE LAWS OF MEXICO ONLY - NOT THE LAWS OF THE UNITED STATES OF AMERICA. THE REPUBLIC OF MEXICO CONSIDERS ANY AUTO ACCIDENT A CRIMINAL OFFENSE AS WELL AS A CIVIL MATTER. IN SOME CASES THE COVERAGE PROVIDED HERE MAY NOT BE RECOGNIZED BY THE MEXICAN AUTHORITIES AND WE MAY NOT BE ALLOWED TO IMPLEMENT THIS COVERAGE AT ALL IN MEXICO. YOU SHOULD CONSIDER PURCHASING AUTO COVERAGE FROM A LICENSED MEXICAN INSURANCE COMPANY BEFORE DRIVING IN MEXICO. THIS ENDORSEMENT DOES NOT APPLY TO ACCIDENTS OR LOSSES WHICH OCCUR OUTSIDE OF 25 MILES FROM THE BORDER OF THE UNITED STATES OF AMERICA. Form CA0001 (if attached to this policy), Section IV - Business Auto Conditions, B. General Conditions, item 7.; and form CA0020 (if attached to this policy), Section V - Motor Carrier Conditions, B. General Conditions, item 7.; the following is added: The coverage territory is extended to include Mexico, but only: a. For accidents or losses occurring within 25 miles of the United States border; and b. For trips into Mexico of 10 days or less; and c. If the covered auto is principally garaged and principally used in the United States; and d. If the insured is a resident of the United States. If a loss to a covered auto occurs in Mexico, we pay for such loss in the United States. If the covered auto must be repaired in Mexico in order to be driven, we will not pay for more than the actual cash value of such loss as determined by us at the nearest United States point where the repairs can be made. Any insurance provided under this provision will be excess over any other collectible insurance. CA701810-14 Page 8 of 10 Copyright ©2014 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 S. Extended Glass Coverage Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, A. Coverage, item 3.a.; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, A. Coverage, item 3.a.; is deleted and replaced by the following: a. Glass breakage. If glass must be replaced, the deductible will be $100 or the deductible shown in the Declarations, whichever is less. If glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. T. Broadened Definition of Bodily Injury Form CA0001 (if attached to this policy), Section V - Definitions, item C.; and Form CA0020 (if attached to this policy), SECTION VI - DEFINITIONS, item C.; is deleted and replaced by the following: C. Bodily Injury means bodily injury, sickness or disease sustained by a person including death or mental anguish resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. U. Customer Lease or Loan Physical Damage Coverage Extension Form CA0001 (if attached to this policy), Section III - Physical Damage Coverage, C. Limit Of Insurance; and form CA0020 (if attached to this policy), Section IV - Physical Damage Coverage, C. Limits Of Insurance; item 4. is added as follows: 4. If your covered owned auto is: (1) Shown in the Schedule and designated as covered for Physical Damage Coverage; and (2) Shown in this policy as having a loss payee or additional -insured -lessor; and (3) Incurs a covered total loss; we will pay the greater of: (a) The actual cash value, as determined by us, of the damaged or stolen property as of the time of the total loss; or (b) The outstanding indebtedness under the initial finance agreement for the covered auto and its equipment. As used here, outstanding indebtedness means the amount you owe on the finance agreement at the time of total loss: (i) Less any amounts representing taxes, overdue payments, penalties, interest, or charges resulting from overdue payments, additional mileage, excess wear and tear, or lease termination fees; and (ii) Less any administrative costs or overhead fees assessed by the finance company who has leased the covered auto to you; and (iii) Less security deposits not returned by the lessor; and (iv) Less costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and CA7018 07-17 Page 9 of 10 Copyright© 2017 Allianz Global Risks US Insurance Company. All rights reserved. Policy Number: SC V 013084 22 01 (v) Less carry-over balances from previous loans or leases. V. Two or More Deductibles 1. Section III - Physical Damage Coverage, D. Deductible, of form CA0001 (if attached to this policy), the following is added: If another Allianz Global Risks US Insurance Company policy or coverage form that is not an automobile policy or coverage form applies to the same accident or loss, the following applies: (1) If the deductible under this Business Auto Coverage Form is the lesser of (or least) deductible, it will be waived. (2) If the deductible under this Business Auto Coverage Form is not the lesser, (or least) deductible, it will be reduced by the amount of the lesser (or least) deductible. 2. Section IV - Physical Damage Coverage, D. Deductible, of form CA0020 (if attached to this policy), the following is added: If another Allianz Global Risks US Insurance Company policy or coverage form that is not an automobile policy or coverage form applies to the same accident or loss, the following applies: (1) If the deductible under this Business Auto Coverage Form is the lesser of (or least) deductible, it will be waived. (2) If the deductible under this Business Auto Coverage Form is not the lesser, (or least) deductible, it will be reduced by the amount of the lesser (or least) deductible. All other terms and conditions of the policy remain unchanged. CA7018 07-17 Page 10 of 10 Copyright © 2017 Allianz Global Risks US Insurance Company. All rights reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA WC 04 03 06 (Ed. 04-84) 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. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2.00% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Blanket Waiver of Subrogation as required by written contract. Associated Job Premium This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 12/04/2022 Insured CSG Consultants, Inc. WC 04 03 06 (Ed. 04-84) Policy No. SCW0239532201 Endorsement No. Insurance Company National Surety Premium Corporation Countersigned By -10 ACCMEY CERTIFICATE OF LIABILITY INSURANCE 111%�. DATE (MM/DD/YYYY) 12/27/2022 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). PRODUCER USA Inc. 333 South 7th Street, Suite 1400 Minneapolis, MN 55402-2400 CONT CT Marsh I U.S. Operations NAMMarsh PHONE . 86fi-966-0fi64 FAX No): 212-948-5382 EDMDAIL MDU.CertRequest@marsh.com INSURERS AFFORDING COVERAGE NAIC 0 INSURER A: Liberty Mutual Fire Ins Co 23035 CN102299309-ILBR-GAWX-23-24 ILBRiV INSURED International Line Builders, Inc. 2520 Rubidoux Blvd. INSURER B : Associated Electric 8 Gas Ins Services Ltd 3190004 INSURER C : Liberty Insurance Corporation 42404 INSURER D : PO Box 3039 Riverside, CA 92509 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-008259443-24 REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADD UBR POLICY NUMBER MMIDDIIYYYY CY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY TB2-641-445905-323 01101/2023 01/01/2024 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE Fx-1 OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $ 1,000,000 MED EXP (Any oneperson) $ 10,0W PERSONAL & ADV INJURY $ MOM PER: GEN'L AGGREGATE LIMIT APPO- GENERAL AGGREGATE $ 4,000,000 FLIES POLICY[fl JECT LOC PRODUCTS - COMPIOP AGG $ 4,000,000 $ OTHER: A AUTOMOBILE LIABILITY AI2-641-005097-053 01/01/2023 01/01/2024 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED - SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR XL5063412P 01/01/2023 01/01/2024 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N ANYPROPRIETOR/PARTNER/EXECUTIVE FN YIN EXCLUDED? (Mandatory In NH) N / A WA7-64D-005097-013 (AOS) "Includes -Gap*-Gap- 11 1 X STATUTE ER E.L. EACH ACCIDENT $ 1,000,0001,000,000OFFICER/MEMBER E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be attached If more space Is required) Re: All Operations City of Eastvale is/are included as additional insured under general liability per the attached CG 2010 and CG 2037 endorsements and does not include processional liability ooverage. Blanket Additional Insured for Automobile Liability is included per attached designated Insured Endorsement CA 20 48. Primary and Non -Contributory applies for General Liability per LN 20 01 attached. Excess liability applies to general liability, products and completed operations, automobile liability, and employers liability. City of Eastvale 12363 Limonite Ave, Ste 910 Eastvale, CA 91752 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc 9)1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 0003778 SP 0529 -COI-PO3779-1 City of Eastvale 12363 Limonite Ave, Ste 910 Eastvale, CA 91752 0529-01.00-0003778-0001-0017603 Client#: 1723042 WESTECON11 ACOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYM 12/27/202; 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 any rights to the certificate holder in lieu- of such endorsement(s). PRODUCER0NTACT_ NAME: USI Insurance Services, LLC/CL A/C, o Ext : 305 669-6000 FAX A/C, No : 305 669-6060 201 Alhambra Circle Suite 1401 E-MAIL Ss: cgb.certs@usi.com Coral Gables, FL 33134-5108 305 669-6000 1INSURER(S) AFFORDING COVERAGE NAIC # INSURED Western Concrete Pumping, Inc. 2181 La Mirada Dr Vista, CA 92081-8830 INSURER A: United Specialty Insurance Company 12537 INSURER B : Harleysville Insurance Company 23582 INSURER C : Hartford Casualty Insurance Company 29424 INSURER D : Pennsylvania Manufacturers Assoc. Ins. 112262 INSURER E : General Security Indemnity Co of Arizon 120559 COVFRAnFS ec0--1C1rrATM s11 rReoco. 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. INSR LTR TYPE OF INSURANCE ADDL lNSR SUB WV I POLICY NUMBER POLICY EFF MMIDO POLICY EXP MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR BI/PD Ded:100000 X X DLJGL0000008302 1/01/2023 01/01/202 EACHOCCURRENCE$1 OOO OOO ppA� PREMISS Ear arcs S3OO OOO X MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY F7X ECT D LOC OTHER: GENERAL AGGREGATE $ 2,000 000 PRODUCTS - COMP/OP AGG s2,000,000 _ $ -p-. E -AUTOMOBILE LIABILITY -- - ANY AUTO OWNED AUTOS AUTOS ONLY HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X X X X 1523011431782A - XA00018200 1/01/2023 1/01/2023 01/01/202 01/01/2024 EaaccideMStNGLELIMIT 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ A B. UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X X X X DLIEX0000001103 EMR000016400 1/01/2023 0110112023 01/01/2024 01/0112024 EACH OCCURRENCE $10 000 000 X AGGREGATE $10 000 000 DED I X I RETENTION $0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYISTATUIE ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y / N [7N (Mandatory In NH) describe under e Ifs y, DESCRIPTION OF OPERATIONS below N / A X 83WEOD1199 1/0112023 01/01/202 X PER OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ A A Inland Marine Excess Liab 00004GIM230 DLJIM0000003502 1/01/2023 01/01/2023 01/01/2024 01/01/2024 PER SCHEDULE ON FILE PER OCCURANCE EXCESS DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of Eastvale is included as Additional Insured when required by written contract. City of Eastvale 12363 Limonite Ave Suite #910 Eastvale, CA 91752 VAIYIrCLLH 11UN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) 1 of 1 #S384693191M38454020 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BBKZP This page has been left blank intentionally. „� BALDIBROSI AWIMPEE DATE 12 2812022Y} 12/2812022 ACORO" CERTIFICATE OF LIABILITY INSURANCE 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(les) 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 endorsements . PRODUCER C AJACT Andrea Wimpee NR Orion Business Insurance and Risk Management Services, Inc. 1250 Corona Pointe Court, Suite 302 Corona, CA 92879 a1c°°, No, Ext : (951) 281-5332 FAX, No):(951) 737-5083 E A . aWimpee@orionins.com INSURERS AFFORDING COVERAGE NAIC ft INSURER A: Travelers Property Casualty Co of Amer 25674 INSURED INSURER B : The Travelers Indm Co of CT 25682 INSURER C: Everest Premier Insurance Compariv 16046 Baldi Bros, Inc. INSURER D : PO BOX 500 Beaumont, CA 92223 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR X DT22-CO-9K395154-TIL-22 6/1/2022 6/1/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrencelMED $ 300,000 EXP (Anv oneperson) $ 6,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑X PECOT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS p AUTOS ONLY X AUTO ONLY 810-4P619749-22-26-G 6/1/2022 6/1/2023 COMBINED SINGLE LIMIT (Ea accident)X S 1,000,000 BODILY INJURY Per on $ BODILY INJURY Per accident BODILY S X Reora ffdTeYnt AMAGE S S A X UMBRELLA LIAB EXCESS UTAB X OCCUR CLAIMS -MADE CUP-91(56238A-22-26 6/1/2022 6M12023 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X I RETENTION $ 10,000 C WORKERS COMPENSATION AN@-MPt�YERS`ttABELfiY- -- E ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFF15ER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A -- 7600622915231 1/1/2023 1/1/2024 X PER OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City Of Eastvale is listed as additional insured as required by written contract per attached form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Eastvale 12363 Limonite Ave THE EXPIRATION DATE THEREOF, ACCORDANCE WITH THE POLICY SY PROVIONSCE WILL BE DELIVERED IN Suite 910 AUTHORIZED REPRESENTATIVE Eastvale, CA 91752 Q UJ.- e ACORD 25 (2016103) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Terra Insurance Company (A Risk Retention Group) Two Fifer Avenue, Suite 100 Corte Madera, CA 94925 DATE 01/01/23 CERTIFICATE HOLDER CERTIFICATE OF INSURANCE City of Eastvale 12363 Limonite Avenue, Suite 910 Eastvale, CA 91752 PFTERRA INSURANCE COMPANY This certifies that the "claims made" insurance policy (described below by policy number) written on forms in use by the Company has been issued. This certificate is not a policy or a binder of insurance and is issued as a matter of information only, and confers no rights upon the certificate holder. This certificate does not alter, amend or extend the coverage afforded by this policy. The policy of insurance listed below has 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 policy described herein is subject to all the terms, exclusions and conditions of such policy. Aggregate limits shown may have been reduced by paid claims. TYPE OF INSURANCE POLICY NUMBER 223133 LIMITS OF LIABILITY PROJECT DESCRIPTION 1-15 Express Lanes I.iMI Project 20-159 Professional Liabilitv EFFECTIVE DATE 01 /01 /23 $1,000,000 EACH CLAIM $1.000,000 ANNUALAGGREGATE EXPIRATION DATE 12/31/2 1 CANCELLATION: If the described policy is cancelled by the Company before its expiration date, the Company will mail written notice to the certificate holder thirty (30) days in advance, or ten (10) days in advance for non-payment of premium. If the described policy is cancelled by the insured before its expiration date, the Company will mail written notice to the certificate holder within thirty (30) days of the notice to the Company from the insured. NAME AND ADDRESS OF INSURED Earth Mechanics, Inc. 17800 Newhope Street, Suite B Fountain Valley_ CA 92708 ISSUING COMPANY: TERRA INSURANCE COMPANY (A Risk Retention Group) 6 ACORU® CERTIFICATE OF LIABILITY INSURANCE DATE (MM1DDNYYY) 12/8/2022 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 endorsemengs). PRODUCER Risk Strategies Company 2040 Main Street, Suite 450 Irvine, CA 92614 CONTACT NAME: Risk Strateaies Company PHONE 94&242-9240 (AICFAX No E-MAIL s oun risk -strata ies.com INSURERS AFFORDING COVERAGE NAIC 0 INSURERA : Citizens Insurance Company of America 31534 www.dsk-strategies.com CA DOI license No. OF06675 INSURED Leighton Consulting, Inc. 17781 Cowan, Suite 100 INSURER B : Allmerica Financial Benefit Insurance Co 41840 INSURER C : Travelers Property Casualty Co of Amer 25674 INSURER D : Lexington Insurance Company 19437 Irvine CA 92614 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 71626496 REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL POLICY NUMBER POLICY EFF M POLICY EXP M IDD LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F✓ OCCUR OB3J208488 11/1/2022 11/1/2023 EACHOCCURRENCE $1000000 DAMAGETO PREMISES (gRF-oNcIM)nce $1 000 000 MED EXP (Any one rson) $10 000 PERSONAL & ADV INJURY $1 000 000 AGGREGATE LIMIT APPLIESPER: POLICY ✓D JECT LOC GENERALAGGREGATE s2,00O,000 GEN'L PRODUCTS - COMP/OP AGG s2,000,000 $ OTHER: B AUTOMOBILE LIABILITY AW3J208478 11/1 /2022 1111 /2023 a 1 COaBBIINa DtSINGLE LIMIT $1 000 000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOSONLY BODILY INJURY (Per accident) $ PeaoadDAMAGE r en $ $ A �/ UMBRELLA UAB OCCUR OB3J208488 11/1/2022 11/1/2023 EACHOCCURRENCE $5 000 000 AGGREGATE $ 5 000 000 EXCESS UAB CLAIMS -MADE •� DED I I RETENTION $0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? N I A UB1R5099812243G 9/1/2022 9/1/2023 ,/ STATUTE ERH E.L. EACHACCIDENT $1 00O 000 E.L. DISEASE- EA EMPLOYEE $1,000,000 (Mandatory In NM If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1 000 000 D Professional Liability/Pollution Liab 013001524 2/14/2022 2/14/2023 Per Claim s $2,000,000 Claims Made Aggregate s $4,000,000 Deductible $ $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N mom space is required) See Additional Remarks Schedule CERTIFICATE HOLDER CANCELLATION City of Eastvale 12363 Limonite Ave Suite 910 Mira Loma CA 91752 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE RSC Insurance Brokerage" ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 71626496 1 MC) 2022-2023 GL-AUTO-UMB-WC-PL I Sherry Young 1 12/8/2022 6:18:16 AM (PST) I Page 1 of 8 AGENCY CUSTOMER ID: LOC #: ACo ADDITIONAL REMARKS SCHEDULE Page of AGENCY Risk Strategies Company NAMED INSURED Leighton Consulting, Inc. 17781 Cowan Suite 100 Irvine CA 92614 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: G10151111V10;11 R THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability (03/16) HOLDER: City of Eastvale ADDRESS: 12363 Limonite Ave Suite 910 Mira Lama CA 91752 Certificate is subject to policy limits, conditions and exclusions. Re: Proj #12672.001 Eastvale/HamnerPlace, Eastvale. City of Eastvale, and its respective elected and appointed officers, officials, and employees and volunteers are included as additional insured as respects to General Liability and Commercial Auto coverages as required by written Contract. General Liability and Auto Liability coverages are primary and noncontributory as required by written contract. Waiver of Subrogation is included with respect General Liability, Auto Liability, Workers Compensation as required by written contract. Umbrella Liability is follow form subject to policy forms, terms, conditions, exclusions and endorsements. 90-Day Notice of Cancellation, Except for 10-Days for Nonpayment of Premium applies to General Liability as required by written contract. ACORD 101 (2008101) Q 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 71626496 1 (LC) 2022-2023 GL-AUTO-UMB-WC-PL I Sherry Young 1 12/8/2022 6:18,16 AM (PST) I Page 2 of 8 Architects and Engineers The following policy language is from Businessowners General Liability Coverage Part NAMED INSURED: Leighton Consulting, Inc. POLICY NUMBER: OB3J208488 The following are mandatory forms on the policy identified on the Certificate of Insurance: 391-1586 (08-16) BUSINESSOWNERS GENERAL LIABILITY SUPPLEMENTARY ENDORSEMENT Additional Insured by Contract, Agreement or Permit A. Section II — Liability, C — Who is an insured is amended to include as an additional insured any person or organization with whom you agreed in a written contract, written agreement or permit but only respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions; or the acts or omissions of those acting on your behalf, but only with respect to: (i) "Your work" for the additional insured(s) designated in the contract, agreement or permit including "bodily injury" or "property damage" included in the "products - completed operations hazard" only if this Coverage Part provides such coverage; (ii) Premises you own, rent, lease, or occupy; or (iii) Your maintenance, operation or use of equipment leased to you. "Definition: "Your work" a. Means: (1) Work or operations performed by you or on behalf, and (2) materials, parts or equipment furnished in connection with such work or operations; b. Includes (1) warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your work"; and (2) the providing of or failure to provide warnings or instructions. This provision does not apply: (1) Unless the written contract or written agreement has been executed or permit has been issued prior to the "bodily Injury", "property damage", "personal injury" or "advertising injury". (2) To any person or organization Included as an Insured by an endorsement Issued by us and made part of this Coverage Part. (3) To any lessor of equipment (a) After the equipment lease expires; or (b) If the "bodily Injury", "property damage", "personal injury" or "advertising Injury" arises out of sole negligence of the lessor. (4) To any: (a) Owners or other Interests from whom land has been leased which takes place after the lease for the land expires; or (b) Managers or lessors of premises if: (i) The occurrence takes place after you cease to be a tenant in that premises; or (ii) The "bodily injury", "property damage", "personal injury" or "advertising injury" arises out of structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor. (5) To "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" or the offense which caused the "personal and advertising injury" involved the rendering of or failure to render any professional services by or for you. Other Insurance Primary & Non -Contributory The following paragraph is added to SECTION III — COMMON POLICY CONDITIONS, H — Other Insurance: Additional Insured — Primary and Non -Contributory. If you agree in a written contract, written agreement or permit that the insurance provided to any person or organization included as an Additional Insured under SECTION 11— Liability, C. Who is an Insured is primary and non-contributory, the following applies: If other valid and collectible insurance is available to the Additional Insured for a loss covered under SECTION II — LIABILITY of this Coverage Part, our obligations are limited as follows: (1) Primary Insurance: This insurance is primary to other insurance that is available to the Additional Insured which covers the Additional Insured as a Named Insured. We will not seek contribution from any other insurance available to the Additional Insured except: (a) For the sole negligence of the Additional Insured; (b) When the Additional Insured is an Additional Insured under another primary liability policy; or (c) When b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. (2) Excess Insurance: (a) This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: 0) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work`; (11) That is Fire insurance for premises rented to the Additional Insured or temporarily occupied by the Additional Insured with permission of the owner; No coverage is provided by this Notice, nor can it be construed to replace any provisions of the policy (including its endorsements). If there is any conflict between this Notice and the policy (including the endorsements), the provisions of the policy (including its endorsements) shall prevail. 71626496 1 (LC) 2022-2023 GL-AUTO-UMB-WC-PL I Sherry Young 1 12/8/2022 6:18:16 AM (PST) I Page 3 of 8 (iii) That is insurance purchased by the Additional Insured to cover the Additional Insured's liability as a tenant for "property damage" to premises rented to the Additional Insured or temporarily occupied by the Additional with permission of the owner; or (iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION II - LIABILITY. B. Exclusions, 1. Applicable to Business Liability Coverage. (v) That is insurance available to you for your participation in any past or present "unnamed joint venture". (vi) That is any insurance you may have that provides coverage for your professional services. (b) When this insurance is excess, we will have no duty to defend the insured against any "suit' if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (c) When this insurance is excess over other Insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (i) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (ii) The total of all deductible and self -insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage part. (3) Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. Per Project Aggregate The following changes are made to SECTION II - LIABILITY: 1. The following is added to SECTION II - LIABILITY, D. Liability and Medical Expenses Limits of Insurance, paragraph 4: The Aggregate Limits of Insurance apply separately to each of "your projects" or each "location" listed in the Declarations. 2. For the purpose of coverage provided by this endorsement only, the following is added to SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions: I. "Your project" means: a. Any premises, site or "location" at, on, or in which "your work" is not yet completed; and b. Does not include any "location" listed in the Declarations. 2. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and, b. Separately to each insured against whom claim is made or "suit" is brought. Waiver Of Subrogation The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization where required by written contract because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization where required by written contract. Notice Of Cancellation For any statutorily permitted reason other than non-payment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to 90 Days. AUTHORIZED REPRESENTATIVE *From Hanover Forms: 391-1003 (08116); 391-1445 (08116); 391-1586 (08M6), 391-1003 (08116) No coverage is provided by this Notice, nor can it be construed to replace any provisions of the policy (including its endorsements). If there is any conflict between this Notice and the policy (including the endorsements), the provisions of the policy (including its endorsements) shall prevail. 71626496 1 (I,C) 2022-2023 GL-AUTO-UMB-WC-PL I Sherry Young 1 12/8/2022 6:18:16 AM (PST) I Page 4 of 8 AW3J208478 Leighton Consulting, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. The following is added to SECTION II — LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured: Additional Insured if Required by Contract If you agree in a written contract, written agreement or written permit that a person or organization be added as an additional "insured" under this Coverage Part, such person or organization is an "insured"; but only to the extent that such person or organization qualifies as an "insured" under paragraph A.1.c. of this Section. If you agree in a written contract, written agreement or written permit that a person or organization be added as an additional "insured" under this Coverage Part, the most we will pay on behalf of such additional "insured" is the lesser of: (1) The Limits of Insurance for liability coverage specified in the written contract, written agreement or written permit; or (2) The Limits of Insurance for Liability Coverage shown in the Declarations applicable to this Coverage Part. Such amount shall be part of and not in addition to the Limits of Insurance shown in the Declarations applicable to this Coverage Part. Regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident", the most we will pay for the total of all damages and "covered pollution cost or expense" combined resulting from any one "accident" is the Limit of Insurance for Liability Coverage shown in the Declarations. B. The following is added to SECTION IV — BUSINESS AUTO CONDITIONS, Paragraph B. General Conditions, subparagraph 5. Other Insurance: Primary and Non -Contributory If you agree in a written contract, written agreement or written permit that the insurance provided to a person or organization who qualifies as an additional "insured" under SECTION II — LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured, subparagraph Additional Insured if Required by Contract is primary and non- contributory, the following applies: The liability coverage provided by this Coverage Part is primary to any other insurance available to the additional "insured" as a Named Insured. We will not seek contribution from any other insurance available to the additional "insured" except: (1) For the sole negligence of the additional "insured"; or (2) For negligence arising out of the ownership, maintenance or use of any "auto" not owned by the additional "insured" or by you, unless that "auto" is a "trailer" connected to an "auto" owned by the additional "insured" or by you; or (3) When the additional "insured" is also an additional "insured" under another liability policy. C. This endorsement will apply only if the "accident" occurs: 1. During the policy period; 2. Subsequent to the execution of the written contract or written agreement or the issuance of the written permit; and 3. Prior to the expiration of the period of time that the written contract, written agreement or written permit requires such insurance to be provided to the additional "insured". D. Coverage provided to an additional "insured" will not be broader than coverage provided to any other "insured" under this Coverage Part. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. Page 1 of 1 461-0478 12 12 Includes copyrighted material of ISO Insurance Services Office, Inc., with its permission 71626496 1 (LC) 2022-2023 GL-AUTO-UMB-WC-PL I Sherry Young 1 12/8/2022 6:18:16 AM (PST) I Page 5 of 8 Insured: Leighton Consulting, Inc. Policy No.: AW3J208478 14. AUTO LOAN PHYSICAL DAMAGE EXTENSION The following is added to SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance provision: When a "loss" results in a total loss to a covered auto you own for which a Loss Payee is designated in this policy, the most we will pay for "loss" in any one "accident" is the greater of: 1. The actual cash value of the damaged or stolen property as of the time of the "loss`; or 2. The outstanding balance of the initial loan, less any amounts for taxes, overdue payments, overdue payment charges, penalties, interest, any charges for early termination of the loan, costs for Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan, and carry-over balances from previous loans. 15. AUTO LEASE PHYSICAL DAMAGE EXTENSION The following is added to SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance provision: If, because of damage, destruction or theft of a covered "auto", which is a long-term leased "auto", the lease agreement between you and the lessor is terminated, "we" will pay the difference between the amount paid under paragraph C. LIMIT OF INSURANCE 1. or 2. and the amount due at the time of "loss" under the terms of the lease agreement applicable to the leased "auto" which you are required to pay: less any fees to dispose of the auto; any overdue payments; financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; security deposits not refunded by the lessor; cost for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan; and carry over balances from previous leases. This coverage applies only to the initial lease for the covered "auto" which has not previously been leased. This coverage is excess over all other collectible insurance. SECTION IV - CONDITIONS 16. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following is added to SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit Or Loss: d. Knowledge of any "accident", claim, "suit" or "loss" will be deemed knowledge by you when notice of such "accident", claim, "suit" or "loss" has been received by: (1) You, if you are an individual; (2) Any partner or insurance manager if you are a partnership; or (3) An executive officer or insurance manager if you are a corporation. 17. BLANKET WAIVER OF SUBROGATION Paragraph 5. Transfer Of Rights Of Recovery Against Others To Us, SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions is replaced by the following: Includes copyrighted material of Insurance Services Office, Inc. with its permission. Copyright, Insurance Services Office, Inc., 1996 461-0155 (9-97) 71626496 1 (LC) 2022-2023 GL-AUTO-UMB-WC-PL I Sherry Young 1 12/8/2022 6:18:16 AM (PST) I Page 6 of 8 Insured: Leighton Consulting, Inc. Policy No.: AW3J208478 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, which have not been waived through the execution of an "insured contract", written agreement, or permit, prior to the "accident" or "loss" giving rise to the payment, those rights to recover damages from another are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after the "accident" or "loss" to impair them. 18. UNINTENTIONAL FAILURE TO DISCLOSE INFORMATION The following is added to SECTION IV BUSINESS AUTO CONDITIONS. B. General Conditions, paragraph 2. Concealment, Misrepresentation Or Fraud: Your unintentional error in disclosing, or failure to disclose, any material fact existing after the effective date of this Coverage Form shall not prejudice your rights under this Coverage Form. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or nonrenewal. 19. HIRED AUTO - WORLDWIDE COVERAGE The following is added to SECTION IV - Business Auto Conditions, B. General Conditions; paragraph 7. Policy Period, Coverage Territory provision: e. Outside the coverage territory described in a., b., c., and d. above for an "accident" or "loss" resulting from the use of a covered "auto" you hire, without a driver, or your employee hires without a driver, at your direction, for the purpose of conducting your business, for a period of 30 days or less, provided the suit is brought within The United States of America or its territories or possessions. SECTION V - DEFINITIONS 20. MENTAL ANGUISH Paragraph C. "Bodily injury", SECTION V - DEFINITIONS is replaced by the following: C. "Bodily injury" means bodily injury, sickness or disease sustained by a person including death or mental anguish resulting from any of these. Includes copyrighted material of Insurance Services Office, Inc. with its permission. Copyright, Insurance Services Office, Inc., 1996 461-0155 (9-97) 71626496 1 (LC) 2022-2023 GL-AUTO-UMB-WC-PL I Sherry Young 1 12/8/2022 6:18:16 AM (PST) I Page 7 of 8 TRAVELERS ONE TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UBIR5099812243G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be 2.00 °% of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED All Operations BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below Is required only when this endorsement Is issued subsequent to preparation of the policy.) Endorsement Effective 09/01 /2022 Policy No. UB I R5099812243G Insured Leighton Consulting, Inc. Insurance Company Countersigned by Allmerica Financial Benefit Insurance Co DATE OF ISSUE: ST ASSIGN: Page 1 of 1 71626496 1 (LC) 2022-2023 GL-AUTO-UMB-WC-PL I Sherry Young 1 12/8/2022 6:18:16 AM (PST) I Page 8 of 8 AAAP"1-01 MKAISER2 ACOROS CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/29/2022 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 pollcy(les) 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). PRODUCER License # OC36861 C,%TACT ._ NAME:- _ - Inland Empire Alliant Insurance Services, Inc. PHONE - - - -- FAX 685 E. Carnegie Dr Ste 265 twc, No, E�t�: (909) 886-9861 I (,�c, No): (909) 886-2013 San Bernardino, CA 92408 1 7PD RhESS: INSURERS AFFORDING COVERAGE - - _ NAIC 0 - _ - INSURER A: United Specialty Insurance Company 12537 _ INSURED INSURER B: Employers Mutual Casualty Company -- 21415 -- AAA Paving Company INSURER C : Redwood Fire and Casualty Insurance Company 11673 3330 N Locust Ave INSURER D : Rialto, CA 92377 - — — - - INSURER E : INSURER F : rnVC12APCC rC12T1=IrATC 1►1111UCtC12• QCVICIMI M111RA1ICI2- 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 CLAIMS_. -PAID INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 - ❑CLAIMS -MADE X occuR ❑ X TN2335619 1/112023 1/1/2024 - DAMAGE TO RENTED PREMISES (Ea occurrence)— _ _ SO,000 $ - - _ _ MED EXP (Any one person)_ $ 5,000 PERSONAL & ADV- INJURY - $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 POLICY I J jECT ❑1 LOC PRODUCTS - COMP/OP AGG $ - 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea -assent) - - 1,000,000 $ -- - X ANY AUTO SX9-51-72-24 1/1/2023 1/1/2024 BODILY INJURY (Per person) OWNED SCHEDULED AU��T��O��S ONLY AUTOS BODILY INJURY Per accident_ - yy p HMW AUTO dent AMAGE $ ONLY _ ON Y -�PerOe - -- - A UMBRELLA LIAS X OCCUR OCCURRENCE 5,000,000 _EACH AGGREGATE_ _ -- - - X EXCESS UAB CLAIMS -MADE BTN2339626 1/1/2023 1/1/2024 5,000,000 �- DED I X I RETENTION $ 0 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PER OTH- _ TATUTE-- - -ER - -- ANY PROPRIETORIPARTNER/EXECUTIVE Y / N AAWC449339 1/1/2023 11112024 E.L. EACH ACCIDENT 1,000,000 $ OFFICER/MEMgfp EXCLUDED? N 1 A _ 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under -- — 1,000,000 -- DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Rented/Leased Equip 5X9-51-72-24 1/1/2023 1/1/2024 Rented/Leased Equip 200,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more space Is required) RE: Operations pertaining to the named insured for certholder. The City of Eastvale is named as an additional insured as respects to general liability per the attached endorsement f _C12TIIPIf_ATC 1.In1 nC12 rANP_FI I ATlnld SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Eastvale tY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12363 Limonite Ave Suite 910 Mira Loma, CA 91752 AUTHORIZED REPRESENTATIVE aiz'YILg' ACORD 25 (2016103) ©1988 2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: ATN2335619 United Specialty Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. VEN 051 00 (02/20) PRIMARY AND NON-CONTRIBUTING INSURANCE ENDORSEMENT This endorsement modifies the Conditions provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS of the COMMERCIAL GENERAL LIABILITY COVERAGE PART, and supersedes any provision to the contrary: Primary and Non -Contributory Insurance Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless: a. (1) The Additional Insured is a Named Insured under such other insurance; and (2) A fully written contract fully executed prior to the Named Insured's commencement of work for such Additional Insured for the specificproject that is the subject of the claim, "suit," or "occurrence" expressly requires that this insurance: (i) apply on a primary and non-contributory basis; and (ii) would not seek contribution from any other insurance available to the additional insured. or b. Prior to a loss, you request in writing and we agree in writing that this insurance shall apply on a primary and non-contributory basis. Name Of Persons Or Organization(s) As Required By Written Contract, Fully Executed Prior To The Named Insured's All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. VEN 051 00 (02/20) Page 1 of 1 POLICY NUMBER: ATN2335619 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations As Required By Written Contract, Fully Executed Prior To The Named Insured's Work As Required By Written Contract, Fully Executed Prior To The Named Insured's Work Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. 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: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. 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 for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If 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 Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: ATN2335619 COMMERCIAL GENERAL LIABILITY CG20100413 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 Or anization s Locations Of Covered Operations As Required By Written Contract, Fully As Required By Written Contract, Fully Executed Prior To The Named Insured's Work Executed Prior To The Named Insured's Work Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — 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", "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 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; and 2. 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 for such additional insured. B. 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 fumished 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 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. CG 2010 0413 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If 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 Insurance shown in the Declarations; whichever is less. This endorsement applicable Limits of Declarations. shall not increase the Insurance shown in the Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 2010 0413 DATE (MM/DDIYYYY) AC ® CERTIFICATE OF LIABILITY INSURANCE 01 R /0312023 IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS THIS CERTIFICATE ALTER THE VERAGE BY BHE ELOW GATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR CT BETVyEENOTHE ISSUING NSUE ER(S)TAUTHORIZIED NCE DOES ES REPRESENTATIVE OR PRODUCER,CERTIFICATE I AND RTHE CERT F CATOCONSTITUTE A CONTRACT OLDER . sions or i fSUB IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) mushave ADDmaONAL INSURED eSan endorsement A be on If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certainpolicies this certificate does not confer rights to the certificate holder In lieu of such ends rs Carol Knox, Monica Avelar or Kory Butler PRODUCER NAME: 714 744-6537 PHONE , (714) 744-3300 FAX No : ( ) KGIB, INC. E-MAIL Carol k ibinc.com, Monica@kgibinc-com, Kory@kgibinc.com KNOX GENERAL INSURANCE BROKERS ADDRESS: @ g INSURERS AFFORDING COVERAGE NAIC # 226 SOUTH GLASSELL STREET EMPLOYERS MUTUAL CASUALTY COMPANY 21415 ORANGE CA 92866 INSURER A : 26433 INSURER B - HARCO NATIONAL INSURANCE COMPANY INSURED CERTAIN UNDERWRITERS AT LLOYD'S C SMITH CORPORATION INSURER C : 27847 PACIFIC STATES TRANSPORTATION INSURER D : INSURANCE COMPANY OF THE WEST P.O. BOX 1098 INSURER E : LLOYDS OF LONDON MURRIETA CA 92564-1098 1 INSURER F REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: MED ABOVE FOR THE CY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE ANY CONTRACTEEN ISSUED O OR OTHER DOTHE INSURED CUMENT WITH RESPECT TOLIWHICH THI INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF CER TIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES EN REDUCED BY PAID CLAIMS.DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVEPOLICY EFF� POLICY EXP LIMITS ..■.nnnivwt SR ......� ..__.. TYPE OF INSURANCE POLICY NUMBEK mtr�,uv..... .... __ EACH OCCURRENCE $ 1,QOO,OO X COMMERCIAL GENERAL LIABILITY DAMA R TED PREMISES Ea occurrence $ 500,000 CLAtMS-MADE FX OCCUR MED EXP Any and person) $ 10,000 2D9 41 07 04/01 /2022 0410112023 PERSONAL & ADV INJURY $ 1,000,000 A X GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s 2,000,000 POLICY X J C LOC $ COMBINED SINGLE LIMIT $ 1,000,000 OTHER: Ea accident AUTOMOBILE LIABILITY BODILY INJURY (Per person) $ ANY AUTO SCHEDULED RFL0000550-00 04/01 /2022 04/01 /2023 BODILY INJURY (Per accident) $ B OWNED AUTOS ONLY X AUTOS PROPERTY DAMAGE Per accident $ NON-0OWNED X HIRED AUTOS ONLY X AUTOS ONLY $ EACH OCCURRENCE $ 2,000,00I UMBRELLA LIAB X OCCUR SCT1234122 04/01/2022 04/01/2023 AGGREGATE $ 2,000,00( C X EXCESS LIAB CLAIMS -MADE WORKERS COMPENSATION I AND EMPLOYERS' LIABILITY Y� 101/01/2023 01101 /2024 E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNERIEXECUTIVE D OFFICER/MEMBER EXCLUDED? Y NIA WSD5069221-00 E.L. DISEASE - EA EMPLOYE $ 1,000,000 (Mandatory in NH) E.L. DISEASE - POLICY LIMIT $ 1,000,000 if yes, describe under DESCRIPTION OF OPERATIONS below $100,000 Limit Motor Truck Cargo -Primary tNA22EDOU & NA22EDOW 04/01/2022 04/01/2023 $1,900,000 Limit Min $1000 E Motor Truck Cargo- Excess Ded- Mint% of load I of DESCRIPTION OF OPERATIONS !LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space Is required) THER19 NSURED DFORM CG75 8 02URING RE: ROAD PERMIT / ALL OPERATIONS BY THE NAME UIRED PER WITH RESPECTOTO GENERAL LIABILITY INS AS REQUIRED BY CITY OF EASTVALE IS INCLUDED AS ADDITIONAL -10 FOR NON PAYMENT OF PREMIUM.' WRITTEN CONTRACT. *30 DAY NOTICE OF CANCELLATION CITY OF EASTVALE 12363 LIMONITE AVENUE SUITE 910 EASTVALE ACORD 26 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CA 91752 --- -- @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORV CERTIFICATE OF LIABILITY INSURANCE �r DATE(MM/DDIYYYY) 12/29/2022 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). PRODUCER Emery & Karrigan, Inc. 9880 SW Beaverton -Hillsdale Hwy Suite 202 Mo[I McCarthyFAX PHONE c A/c No): ADDRESS: certs@emerykarrigan.com Beaverton OR 97005 INSURERS AFFORDING COVERAGE NAIC 0 INSURERA : Clear Blue Specialty Ins Co 37745 INSURED MRCRANE-01 Mr. N Harinc Crane Inc. Mr. ton INSURER B : National Interstate Insurance 32620 INSURER C : Vanliner Insurance Company 21172 INSURER D : Orange CA 92868-1311 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:1987708584 REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL BR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X� OCCUR Hook Liablltiy Y AW03-RS-2200067-02 2/15/2022 2/15/2023 EACH OCCURRENCE $1,000,000 MA TO RENTED PREMISES Ea occurrence $100,000 X MED EXP (Any one person) $10,000 X Over The Road ME PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 Employee Benefits $ B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY SCR 0000499-08 1/1/2023 1/1/2024 COMBINED SINGLE LIMIT Ea accident $1.000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y AW042200027-02 2/15/2022 2/15/2023 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 DED RETENTION $ $ C -IFyes, WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) descr�iinder"� DESCRIPTION OF OPERATIONS below N I A - - SCW 0000499-08 _- - - - - 1/1/2023 — 1/1/2024 - XPER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1.000,000 E.L. DISEASE - POLICY LIMIT $1,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Eastvale is named as additional insured when required by written contract per the attached endorsement. Excess policies are follow form over the General, Auto, and Employer Liability policies, including Hook Liability.; CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Eastvale ACCORDANCE WITH THE POLICY PROVISIONS. 12363 Limonite Ave. Ste. 910 AUTHORIZED REPRESENTATIVE Eastvale CA 91752 USA :2 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD