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INSURANCE 710 ACORV CERTIFICATE OF LIABILITY INSURANCE DATE(M12/23/2022 Y) /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 Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc. 21820 Burbank Blvd 175 NAME Vanessa Aldershof PHONE 81g-449-0216 a Noll: 818-316-0980 ADDRESS: Vanessa aldershof@ajg.com Woodland Hills CA 91367 INSURERS AFFORDING COVERAGE NAIC p INSURER A: Com West Insurance Company 12177 7 s 3 INSURED CBELOWI-01 INSURER B : C BELOW, INC. 14280 Euclid Avenue INSURER C INSURER D : Chino, CA 91710 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:204307913 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. [NSA LTR TYPE OF INSURANCE ADDLSU POLICY NUMBER MOLIDNYY POLICY IY YY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISE Eaoccurrence) $ MED EXP _(Any oneperson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO-JECT LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY OMBI aE0 SINGLE LIMIT (Ea accent) $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNEFVEXECUTIVE YIN CWWCPI00086909 12/18/2022 12/18/2023 X PER OTH- STATUTE I ER E.L. EACH ACCIDENT $1.000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $1.000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more specs is required) Waiver of Subrogation applies in favor of the Certificate holder per the attached form. For Professional Liability, the aggregate limit is the total insurance for all covered claims reported within the policy period. 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 12363 Limonite Ave, Ste. 910 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE , Q Eastvale CA 91752 USA 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Arthur J. Gallagher Risk Management Services, LLC 21820 Burbank Boulevard, Suite 175 Woodland Hills CA 91367 MDG2023 00007452 01 City of Eastvale 12363 Limonite Ave, Ste. 910 Eastvale, CA 91752 We are providing you with a Certificate of Insurance confirming our client's coverage. Want to get certificates of insurance faster? "Go Green with Gallagher" by receiving digital copies of certificates via e-mail in the future. Or, do you no longer require a certificate of insurance for our client? Please contact us at COI.UpdateMyEmail@AJG.com and provide the following information for processing: 1. Confirmation that a certificate of insurance is no longer required; or 2. E-mail address to send future certificates of insurance in lieu of U.S. Mail delivery 3. Insured Code: CBELOWI-01 4. This Certificate Number: 204307913 To learn more about the Insurance and Risk Management Services offered by Gallagher, please visit us at www.ajg.com/us/about-us/how-we-work/core-360. Gallagher does not share your e-mail as detailed in our privacy policy found at https:// www.ajg.com/us/privacy-policy/. a v 0 N n S 8aQ0 O AI_REAWF.01 SGONZALFZ ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDONYYY) 1/2712023 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 endorsements). PRODUCER License # 0757776 Co AcT Kristie Koehrer HUB International Insurance Services Inc. t" = PO Box 5345 Irk Riverside, CA 92517 PHONE 951 779-8558 AX No ; 951 231-2572 AIC, o, D . cal.cpu@hubinternational.com INSURERS AFFORDING COVERAGE NAIC d INSURER A: Travelers Property Casualty Company of America 25674 INSURED INSURER B : Lexington Insurance Company 19437 INSURER C : Albert A. Webb Associates INSURER D : 3788 McCray Street Riverside, CA 92506 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 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR $0 Deductible X P-630-5456P929 TIL-23 2/1/2023 9/1/2023 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED 300,000 X MEO EXP An one arson 5,000 $ PERSONAL & ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑X ippa LOC OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG S 2'000,000 A AUTOMOBILE LIABILITY X ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS Ep X AUTOS ONLY X AUTOS ONLY X BA-3L23491A-23-43-G 2/1/2023 9/1/2023 COMBINED SINGLE LIMIT (Ea accidentl S 1,000,000 BODILY INJURY Per erson S BODILY INJURY Per accident S PPeOr a c cat AMAGE $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP-91-1486836-23-43 2/1/2023 9/1/2023 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED X RETENTION $ 0 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECU I IVE Y / N OFFICER/MgM EXCLUDED? �Y (MandatoryPin �j if es, describe under DSCRIPTION OF OPERATIONS below N / A X UB-4J648178-22-43-G 9/112022 9/112023 PER OTH- X I STATUTE ER E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYE 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 B Professional Liab. 031711122 9/1/2022 9/112023 Ded $150k/EaClaim 1M 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required City of Eastvale and its respective elected and appointed officers, officials, and employees and volunteers are Additional Insureds with regard to the General Liability policy per the attached endorsement fonn CGD414 04/08, Primary & Non -Contributory included. Per Project Aggregate applies with regard to General Liability per the attached endorsement form CGD321 01/04. Additional Insured applies with regard to the Auto Liability policy per the attached endorsement form CAT353 02115. Primary A Non -Contributory wording applies with regard to the Auto Liability policy per the attached endorsement form CAT474 02116. Waiver of Subrogation applies with regard to the Workers' Compensation policy per the attached endorsement form WC990376(A). Excess Liabillity follows form of the underlying General, Auto and Employers Liability coverages. City of Eastvale 12363 Limonite Ave, Suite 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 ACORD 25 (2016/03) 01988 2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Albert A. Webb Associates Policy Number: P-630-5456P929-TIL-23 Policy Period: 02/01 /2022 to 09/01 /2023 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED -WRITTEN CONTRACTS (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II — WHO IS plies only to such "bodily injury" or "property AN INSURED: damage" that occurs before the end of the pe- Any person or organization that you agree in a riod of time for which the "written contract re- written contract requiring insurance" to include as quiring insurance" requires you to provide an additional insured on this Coverage Part, but: such coverage or the end of the policy period, whichever is earlier. a. Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b. If, and only to the extent that, the injury or damage Is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is limited as follows: c. In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement shall not increase the limits of insurance described in Section III — Limits Of Insurance. d. This insurance does not apply to the render- ing of or failure to render any "professional services" or construction management errors or omissions. e. This insurance does not apply to "bodily in- jury" or "property damage" caused by "your work" and included in the "products - completed operations hazard" unless the "written contract requiring insurance" specifi- cally requires you to provide such coverage for that additional insured, and then the insur- ance provided to the additional insured ap- 2. The following is added to Paragraph 4.a. of SEC- TION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the ad- ditional insured under this Coverage Part must apply on a primary basis or a primary and non- contributory basis, this insurance is primary to "other insurance" available to the additional in- sured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But this insur- ance provided to the additional insured still is ex- cess over any valid and collectible "other insur- ance", whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any "other insurance". 3. The following is added to SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDITIONS: Duties Of An Additional Insured As a condition of coverage provided to the addi- tional insured: a. The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG D414 04 08 0 2008 The Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY 1. How, when and where the "occurrence" or offense took place; U. The names and addresses of any injured persons and witnesses; and Ill. The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against the additional insured, the additional insured must: 1. Immediately record the specifics of the claim or "suit" and the date received; and II. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. The additional insured must immediately send us copies of all legal papers received in con- nection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and oth- erwise comply with all policy conditions. d. The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of other insurance which would cover the additional insured for a loss we cover. However, this condition does not affect whether this insurance provided to the addi- tional insured is primary to that other insur- ance available to the additional insured which covers that person or organization as a named insured. 4. The following is added to the DEFINITIONS Sec- tion: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or or- ganization as an additional insured on this Cover- age Part, provided that the "bodily injury" and "property damage" occurs and the "personal in- jury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect~ and c. Before the end of the policy period. Page 2 of 2 0 2008 The Travelers Companies, Inc. CG D414 04 08 Albert A. Webb Associates Policy Term: 02/01/2023 to 09/01/2023 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: P-630-5456P929-TIL-23 ISSUE DATE: 02-01-2023 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY TOTAL GENERAL AGGREGATE LIMIT DESIGNATED PROJECT(S) -GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Total General Aggregate Limit: $ 10,000,000 Designated Project(s): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, IN A WRITTEN CONTRACT WHICH IS IN EFFECT DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. The Total General Aggregate Limit stated in the Schedule above is the most we will pay for the sum of all: 1. Medical Expenses under COVERAGE C (SECTION 1); 2. Damages under COVERAGE A (SECTION 1), except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard"; and 3. Damages under COVERAGE B (SECTION 1) regardless of the number of: a. Insureds; b. Claims made or "suits" brought; c. Persons or organizations making claims or bringing "suits"; or d. Designated "projects" listed in the SCHED- ULE above. B. For all sums which the insured becomes legally obligated to pay as damages caused by `occur- rences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION 1), which can be at- tributed only to operations at a single designated "project" shown in the Schedule above: 1. A separate Designated Project General Ag- gregate Limit applies to each designated "pro- ject", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. Subject to the Total General Aggregate Limit stated in the Schedule above, the Designated Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations haz- ard", and for medical expenses under COV- ERAGE C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". CG D3 21 01 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 COMMERCIAL GENERAL LIABILITY 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce both the Total General Aggregate Limit stated in the Schedule above, and the Designated Project General Aggregate Limit for that designated "project". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Project General Aggregate Limit for any other designated "project" shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Decla- rations, such limits will be subject to both the Total General Aggregate Limit stated in the Schedule above, and the applicable Desig- nated Project General Aggregate Limit. C. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION 1), which cannot be attributed only to operations at a single desig- nated "project" shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the Total General Aggregate Limit stated in the Schedule above and the General Aggregate Limit, or the Products -Completed Operations Aggregate Limit, whichever is ap- plicable; and 2. Such payments shall not reduce any Desig- nated Project General Aggregate Limit. As respects this Provision C., the limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Ex- pense continue to apply. D. Part 2. of SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B; and b. Damages from "occurrences" under COVERAGE A (SECTION 1) and for all medical expenses caused by accidents under COVERAGE C (SECTION 1) which cannot be attributed only to operations at a single designated "project" shown in the SCHEDULE above. E. When coverage for liability arising out of the "products -completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Ag- gregate Limit, and not reduce the Total General Aggregate Limit stated in the Schedule above, the General Aggregate Limit, or the Designated Pro- ject General Aggregate Limit. F. For the purposes of this endorsement the Defini- tions Section is amended by the addition of the following definition: "Project" means an area away from premises owned by or rented to you at which you are per- forming operations pursuant to a contract or agreement. For the purposes of determining the applicable aggregate limit of insurance, each "project" that includes premises involving the same or connecting lots, or premises whose con- nection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "project". G. The provisions of LIMITS OF INSURANCE (SECTION III) not otherwise modified by this en- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D3 21 01 04 Albert A. Webb Associates Policy Number: BA-3L23491A 23-43-G Policy Term: 02/01/2023 to 09/01/2023 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph A.1.c., Who Is An Insured, of SECTION 11 — COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph B.S., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part S. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is the first named insured when the written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non-contributory. CA T4 74 0216 u 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Albert A. Webb Associates Policy Number: BA-3L23491A-23-43-G Policy Term: 02/01/2023 to 09/01/2023 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION 11 — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow, and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 0215 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II —COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION 11—COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II —COVERED AUTOS LIABIL- ITY COVERAGE: (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (1) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "Insured" will make any settlement without our consent. (111) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (Iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION 11 — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 m 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 0215 Includes copyrighted material of Insurance Services Office, Inc. with its permission. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV —BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph AA., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION Ili — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex - We will a u to $400 for "loss" to wearing a - tent required of you by a written contract pay p 9 p signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 0215 m 2015 The Travelers indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 © 2015 The Travelers Indemnity company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Aft k TRAVELERS J ' ONE TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) - 003 POLICY NUMBER: UB-4J648178-22-43-G 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. Person or Organization ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. Schedule Job Description ARCHITECTURAL SERVICES 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 /2022-09/01 /2023 Insured Albert A. Webb Associates Insurance Company Policy No. UB-4j648178-22-43-G Endorsement No. Premium Countersigned by DATE OF ISSUE: 09-1-22 ST ASSIGN: Page 1 of 1 ALBEAWE-01 SGONZALEZ CERTIFICATE OF LIABILITY INSURANCE DATE{M YI� 1127/202Y2023 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 License # 0757776 Co CT Kristie Koehrer HUB International Insurance Services Inc. PO Box 5345 01 Riverside, CA 92517 PHONE FAX �C, No, Ext : 951) 779-8558 A/C, No): 951 231-2572 JbmpIbss: cal.cpu@hubinternational.com ENSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Property Casualty Company of America 25674 INSURED INSURER B : INSURER C : Albert A. Webb Associates INSURER D : 3788 McCray Street Riverside, CA 92506 INSURER E INSURER F : COVERAGES CERTIFICATE NLIMRFR- RFVICI[1N NI IMRFR- 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 OMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR P-630-5456P929 TIL-23 2/1/2023 9/1/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) 300,000 $ MED EXP (Anv one erson 5,000 PERSONAL & ADV INJURY 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY joCT LOC OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS - COMPIOP AGG 2,000,000 A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS p X AURTOS ONLY X AU OS O�E�Y BA-3L23491A-23-43-G 2/1/2023 9/1/2023 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY Perperson) BODILY BODILY INJURY Per accident S Per aceiRde^t AMAGE $ $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE DED I I RETENTION $ S A WO EMPLYCOMPENSATIONLIABILOY ANY PROPRIETORIPARTNERIEXECUTNE YIN WFICERIM' JMaVF EXCLUDED? �Y (Mandatory n �n1I If yes, describe under DESCRIPTION OF OPERATIONS below N I A UB-4J648178-22-43-G 9/1/2022 9/1/2023 X PER OTH- STATUTE ER 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, maybe attached If more space Is required) For Information Purposes only. City of Eastvale Attn: Kenia Lopez 12363 Limonite Ave, Suite 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 OMAaa4— ACORD 25 (2016103) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 0003545 5P 0035 -COI-P03546.1 City of Eastvale 12363 Limonite #910 Eastvale, CA 91752 LNW=& 0035-01-00-=3545.0001-0024172 -10 ACORV CERTIFICATE OF LIABILITY INSURANCE DATE (MM1DDnnnM 01/27023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CrERTIFICATE 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 "Marsh USA, Inc. Two Alliance Center 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 CONTACT NAME' N FAX (AIC. AIC No E-MAIL INSURE S AFFORDING COVERAGE NAIC # INSURER A: Liberty Mitual Fire Insurance Company 23035 CN102986923-upl-GAWU-23-24 INSUREDVCI Construction, LLC 1921 W 11th Street INSURER B : LM Insurance Corporation 33600 INSURER C : Liberty Surplus Insurance Corp 10725 INSURER D : Liberly inst mnce ConmOon 42404 Upland, CA 91786 INSURER E INSURER F r_nVFRAr.FS CFRTIFICATIF NUMRFR- ATL-004594688-23 REVISION NUMBER: 2 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. ILTR TYPE OF INSURANCE A BR POLICY NUMBER EFF MAD �MIDD EXP M LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR TB2-631-510825-233 01/31/2023 01/31/2024 EACH OCCURRENCE $ 5,000,000 DAMAGE TO RENTED PREMISES Ea occurrence) $ 1,000,0W MED EXP (Any oneperson) $ PERSONAL S ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYIfl jR O- LOC OTHER: GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMPIOP AGG $ 10,000,000 $ A AUTOMOBILE LIABILITY(Ea X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY AS2-631-004260-023 01/31/2023 01131/2024 COMBINED SINGLE LIMIT accident) $ 5,0,OW BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE RFE-631-510733-143 0113irA23 01/31/2024 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,0W DED I I RETENTION $ $ B B D WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y / N ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? a (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WA5.63D-004260-033 (AOS) WC5-631-004260-043 ( MN,WI) WA7-63D-510689-513 ( MA) 0113112023 01/31/2023 01/31/2023 YMNX 01131/2024 0113112024 IPER 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 regulred) Re: For work performed by VCI Construction,LLC. in the City of Eastvale. City of Eastvale is included as an Additional Insured as respects to General Liability as required by written contract. r%Fl?TIFIr_ATF 41f11 11111=0 CANCFLLATIAN City of Eastvale SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 12363 Limonite #/910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Eastvale, CA 91752 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE W.�IP4 %)1983-2015 AGORD GORPORATION. All rlgntis reservea. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AS2-631-004260-023 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does 'not alter coverage provided in the Coverage Form. SCHEDULE Name Of Person(s) Or Organization(s): Any Person(s) or Organization(s) as required by written contract prior to loss on file with the broker Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I -- Covered Autos Coverages of the Auto Dealers Coverage Form. CA20481013 0035-01-00-0003545-0002-0024173 U Insurance Services Office, Inc., 2011 Page 'I of 1 MGM Policy Number AS2-631-M260-023 Issued by Liberty Mutual Fire bmrance Company THIS ENDOitSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance: provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY — UMBRELLA COVERAGE FORM scneuule Name of Other Person(s) ! Oruanhation(s): Emil Address or nailing address: Number Days NoSoe: Per Schedule on File With The Company Per Schedule on File With The Company 75 or as required by writ - ten contract, whichever is less, per the schedule on file with the company A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown In the Schedule above. We will send notice to the emal or mailing address listed above at least 10 days, or the number of days listed above, If any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named Insured. B. This advance notification of a pending cancellation of coverage Is Intended as a courtesy only. Our fsllur+e to provide such advance notification will not extend the policy illation date nor negate cancellation of the Policy. All other terms and conditions of this policy remain unthanged- LIM " 010511 0 2011 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted materld of Insurance Services Ofltcs, Inc., with Its permission. POLICY NUMBER: AS2-631-004260-023 COMMERCIAL AUTO CA 04 4410 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the «accident" or the "loss" under a contract with that person or organization. CA04441013 0035-01-00.0003545.0003-0024174 Q Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: TB2-631-510825-233 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 provident 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 All persons or organizations for whom you have agreed in a written contract or agree- ment, prior to an "occurrence" or offense, to provide additional insured status 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 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: TB2-631-510825-233 COMMERCIAL. GENERAL LIABILITY CO20100413 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 A. Section II — Who Is An Insured Is amended to Include as an additional Insured the person(s) or organizstion(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 ads or omissions; or 2 The acts or omissions of those acting on your behalf; In the performance of your ongoing operations for the additional insuned(s) at the location(s) designated above. However: 1. The Insurance afforded to such additional Insured only applies to the extent permitted by IW 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 then 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 furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional Insured(s) at the kwation 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 fior a principal as a part of the same project. C. With respect to the Insurance afforded to these additional Insureds, the falllowln g Is added to Section III — Llrnifa 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. CG20100413 0035.01-00.0003545-0004-=4175 ® ISO Properties, Inc., 2012 rim sCHEDULE Name Of MdltlonW Insured Person(s) ar Or+aanknUontsl I Lomftnts) Of Covered DoerMons All persons or organizations for whom you have agreed in a written contract or agree- ment, prior to an "occurrence' or offense, to provide additional insured status. All locations as required by a written con- tract or agreement entered into prior to an "occurrence" or offense. I Infonnatlon required to comphAe this Schedule, if not shown above, wM be shown In the Dedaratfons. I CO 2010 0413 0 Insurance Services Ofka, Inc., 2012 Page 2 of 2 Policy Number TB2-631-510825-233 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REND fT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART UQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY — UMBRELLA COVERAGE FORM Name of O#hsr Person(s) I Ormnization(s): Emall Addren or mailing address: Nwnber Days Notice: Per Schedule on File With The Company Per Schedule on File With The Company 75 or as required by writ - ten contract, whichever is less, per the schedule on tile with the company A. If we cancel this poky for any reason other than nonpayment of premium, we will notify the persons or organizations shown In the Schedule above. We wrll send notice to the email or malting address fisted above at least 10 days, or the number of days listed above, If any, before the cancelfation becomes effective. In no event does the notice to the third party exceed the notice to the fist named Insured. B. This advance notification of a pending cancellation of coverage is Intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other berms and conditions of this policy remain unchanged. LIM 99 010511 0 2011 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. 0035-01-004)003545-0005-0024176 Policy Number TB2-631-510825-233 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEIIIENT CHANGES THE PRICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY — OTHER INSURANCE CONINTION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following Is added to Section IV — Conditions 4.Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance Is primary to and will not seek conhftfion from any other Insurance avatieble to an additional Insured under your policy provided that: (1) The additional insured Is a Named Insured under such other Insurance; and (2) You have agreed prior to a loss, that this Insurance would be primary and would not seek contribution from any other insurance available to the additional insured. (3) This Insurance Is excess over any other Iranancs available to the additional insured for which it is also covered as an additional Insured by attachment of an endorsement to another policy providing coverage for the same 'occimron ce", claim or "suit". LD 24133 0816 ® 2010 Liberty MuWW Insurance Page 1 of 1 Includes copyrighted mebuief of Insurance Services Office, Inc., with its permission. POLICY NUMBER: T132-631-510825-233 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: As required by agreement entered into prior to loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above 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 shown in the Schedule above. CG24040509 0035-01 •oo-oo03545-000 s-ON4 m © Insurance Services Office, Inc., 2008 .. Page 1 of " ` NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we wig no* the persons or organizations shown in the Schedule below. We will send notice to the email or malling address meted below at least 10 days, or the number of days listed below, 9 any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the fret named Insured. B. This advance notification of a pending cancellation of coverage Is Intended as a courtesy only. Our (allure to provide such advance notiftcation will not extend the policy cancellation date nor negate cancellation of the policy. SCHEDULE Name of Other Person(s)1 Emali Address or mailing address: Number Days Notice: Organb mtlon(s): List on Fie 30 whh the broker All other hum and condl#ions of this policy remain unchanged. Issued by LM Insurance Corporation For attachment to Policy WA5-63D-004260-033 Eflbdv9e Date 1 /31 /2023 to 1 /31 /2024 Issued Wycom Industire% Inc. WC 99 20 75 0 2016 Liberty Mutual Insurance Page 1 of 1 Ed. 12/01/2016 NOTICE OF CANCELLATION TO THIRD PARTIES A. If was cancel this policy for any reason other than nonpayment of premium, we will rw* the persons or organizations shown In the Schedule below. We will send notice to the email or mailing address Cued below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named Insured. B. This advance notification of a pending cancellation of coverage Is Intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. SCHEDULE Nuns of Other Persons) ! Email Address or mailong addrw o: Number Days Notice: Organizadon(s): List an Fie s0 with the broker All other terms and conditions of this policy remain unchanged. Issued by LM Insurance Corpomflon For attachment to Pd!W WC5-631-004260-043 Eftecive Date 1 /31 /2023 Premium $ Issued Wycom lndustbe% Inc. WC 88 20 75 0 2016 Liberty Mutual Insurance Page 1 of Ed. 12/01/2016 e 0035-01-00-0003545-0007-0024178 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone IlaWe for an Injury cowered by this poky. We will not enforce our right against the person or orgm radon named In the Schedule. (This agr eemert appOes only 10 the extent that you perfform work under a written contract that requires you to obtain this agree nent f m us.) This agreement shall not operate fteCtly or Indlre * to benefit anyone not named In the Schedule. schedule Where Required By Contract Or Written Agreement Prior To Loss And Allowed By Law. Alabama, Arizona, Arkansas, Colorado, Delaware, Dist. Of Col, Georgia, Idaho, Illinois, Indiana, Kansas, Maine, Michigan, Mississippi, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia The premium charge is 2% of the total manual premium, subject to a minimum premium of $100 per policy. Connecticut, Florida, Iowa, Maryland, Nebraska, Oregon The premium charge is 1 % of the total manual premium, subject to a minimum premium of $250 per policy. Hawaii The premium charge is $250 and determined as follows: The premium charge for this endorsement is 1 % of the total manual premium, subject to a minimum premium of $250 per policy. Louisiana The premium charge is 2% of the total standard premium, subject to a minimum premium of $250 per policy. Massachusetts The premium charge is 1 % of the total manual premium. New York, Tennessee The premium charge is 2% of the total manual premium, subject to a minimum premium of $250 per policy. Virginia The premium charge is 5% of the total manual premium, subject to a minimum premium of $250 per policy. Issued W. LM Insurance Corporation For attachment to Ply No WA"3D-004260-033 Issued to: MGM Date 1 /31 /2023 to 1 /31 /2024 WC DO 0313 01983 Nadonal council an Compensation Insurance, Inc. Page 1 of 1 Ed. 41111084 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named In the Schedule. (This agreement applies only to the extent that you perrorm work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or Indirectly to beneft anyone not named in the Schedule. This waiver does not apply to any right to recover payments which the Minnesota Workers Compensation Reinsurance Association may have or pursue under M.S. 79.36. Schedule Where Required By Contract Or Written Agreement Prior To Loss And Allowed By Law. Minnesota The premium charge is 2% of the total manual premium, subject to a minimum premium of $100 per policy. Wisconsin The premium charge Is 2% of the total manual premium, subject to a minimum premium of $60 per policy. rssued by: L.M Ina mce wpm aw For.aftdu eentto Po[Icy NoWC5-631-004260-043Efteative Date 1 /31 /2023 to 1 /31 /2024 Prentum s Issued to: Dycom Ir dusdre% Inc. WC 00 0313 01983 National Council on Compensation Insurance, Inc. Page 1 of 1 Ed. 411119" 0035-01-00-0003545-0008-0024179 0001120 SP 0035-001-P01120-1 City of Eastvale 12363 Limonite Ave ste 910 Eastvale, CA 91752 0035-01-00-0001120-0001-0004684 , ® ACOR.0 CERTIFICATE OF LIABILITY INSURANCE `�. DATE (MM/DD/YYYY) 01/27/2023 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 endorsements . PRODUCER "'Marsh USA, Inc. Two Allianca Center 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 CONTACT NAME: PRONE FAX A/C o E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Fire Insurance Company 23035 CN102986923-upl-GAWU-23-24 INSURED auley Construction, LLC 2021 West Melinda Lane INSURER B : LM Insurance Corporation 33600 INSURER C : Liberty Suriplus Insurance Corp10725 INSURER D : Libeity Insurance Cnoration 42404 Phoenix, AZ 85027 INSURER E : INSURER F : CnVFRAGFS CERTIFICATE NUMBER: ATL-004594691-17 REVISION NUMBER: 0 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. ILTR TYPE OF INSURANCE ADDL AMAM UBR POLICY NUMBER MM/DDmYY MM1DD1 EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR TB2-631-510825-233 01/3112023 01/31/2024 EACH OCCURRENCE $ 5,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 5,W0,000 GEWL AGGREGATE LIMIT APPLIES PER: POLICY a JECT ❑ LOC OTHER: GENERAL AGGREGATE $ 1000,000 PRODUCTS -COMP/OP AGG $ 10,000,000 $ A AUTOMOBILEUABILnY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY AS2.631-004260-023 01/3112023 01/31/2024 CEO�MBIN�ED SINGLE LIMIT $ 5,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE RFE-631-510733-143 01/31/2023 0113112024 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I I RETENTION $ $ B B D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUIIVE OFFICER/MEMBEREXCLUDED? a (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WA5-63D-004260-033 (AOS) WCM31-0042M-043 (MN,WI) WA7-63D-510689-513(MA) 3TfffMffr__ 01/31/2023 01/31/2023 0113112024 0113112024 0113112024 X STATUTE ER E.L. EACH ACCIDENT $ 1000 000 E.L. DISEASE - EA EMPLOYEE $ 1.000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Eastvale is included as an Additional Insured as respects to General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION City of Eastvale SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 12363 limonite Ave ste 910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Eastvale, CA 91752 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AS2-631-004260-023 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds` for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. SCHEDULE Name Of Person(s) Or Organization(s): Any Person(s) or Organization(s) as required by written contract prior to loss on file with the broker Information, required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I -- Covered Autos Coverages of the Auto Dealers Coverage Form. CA20481013 0035-01-00-Ml 120-0002-0004685 © Insurance Services Office, Inc., 2011 Page 1 of 1 R Policy Number AS2.S31-M260-023 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement rnoditfes insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF4NSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY — UMBRELLA COVERAGE FORM Schedule Name of Other Pemoras) ! Oruankationts): Emall Address or malling address: Number Days Notice: Per Schedule on File With The Company Per Schedule on File With The Company 75 or as required by writ - ten contract, whichever is less, per the schedule on tile with a company A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown In the Schedule above. We will send notice to the email or nalling address listed above at least 10 days, or the number of days listed above, If any, before the cancebtton becomes elfiecthre. In no event does the notice to the third party exceed the notice to the first named Insured. B. This advance notification of a pending cancellation of coverage Is Intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate canceladon of the policy. All other terms and conditions of this policy remain unchanged. LUN " 010511 0 2011 Liberty Mutual Group of Companies. AD rights wed. Page 1 of I Includes copyrighted material of Insurance Services Ofllc:e, Inc., with Its permission. POLICY NUMBER: AS2-631-004260.023 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Names) Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. information required to complete this Schedule, if not shown above will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 O Insurance Services Office, Inc., 2011 Page 1 of 1 -- "• 0035-01-00-0001120-0003-0004686 POLICY NUMBER: TB2-631-510825-233 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 All persons or organizations for whom you have agreed in a written contract or agree- ment, prior to an "occurrence" or offense, to provide additional insured status 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" 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 0 Insurance Services Office, Inc., 2012 Page 1.of 1 POLICY NUMBER: TB2-631-510825-233 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 A. Secdon 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 Injuri', "property damage" or "personal and advertising lnJuW caused, in whole or in part, by. 1. Your acts or omissions; or L The arts or omissions of those acting on your behalf, In the perforrnence of your ongoing operations for the additional Insureds) 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 time additional Insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after. 1. All work, including materials, parts or equipment furnished In connection with such work, on the project (other than service, maintenance or repairs) to be performed by cr 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 opemtIoons for a principal as a part of the same project. C. With respect to the Insurance afforded to, these additional insureds, the following Is added to Section III — Urnits 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 cr agreement; or L Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Umits of Insurance shown in the Decl aumtions. CG20100413 0035-01-00-Ml 120-0004-0004687 0ISO Properties, Inc., 2012 Page 1 of SCHEDULE Nate Of Addltlonal Insured Pemon(s) Or O anh tlon s Locatlon s Of Cavemd Opmflons All persons or organizations for whom you All locations as required by a written con - have agreed in a written contract or agree- tract or agreement entered into prior to an ment, prior to an "occurrence" or offense, to "occurrence" or offense. provide additional insured status. Information reguftd to complete this Schedule If not shown above wM be shown In the DedaraUons. CG 2010 0413 0 Insurance Servim Office, I=, 2012 Pup 2 of 2 Policy Number TB2.831-510825.233 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSMOMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY — UMBRELLA COVERAGE FORM Schedule Name of Other Personas) I OrvanbaMonts): Email Address or making address: Number Days Nodew Per Schedule on File With The Company -Per Schedule on File With The Company 75 or as required by writ - ten contract, whichever is less, per the schedule on -tile with the company A. If we cancel this poky for any reason other than nonpayment of premium, we will notify the persons or organizations shown In the Schedule above. We will send notice to the email or maMng address listed above at least 16 days, or the number of days listed above, N any, before the canceHiation becomes effective. In no event does the notice to the third party exceed the notice to the first named Irw red. B. This advance notification of a pending cancellation of coverage Is Intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancslleflon date nor negate cancellation of the policy. All other Now and conditions of this policy remain unchanged. UM"010511 0 2011 Liberty Mutual Group of Companies. Alt rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 0035-01-00-0001120-0005-0004688 Policy Number TB2-$31-510825-233 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY — OTHER INSURANCE CONDITION This endorsement modifies Insumnce provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART The following Is added to Section IV — Conditions 4. Other Insurance and supersedes any provision to the contrary: Primary And Nor=ntrlbutory Insurance This insurance is primary to and will not seek contribution from any other insurarx* available to an additional Insured under your policy provided that: (1) The additional insured Is a Named Insured under such other Insurance; and (2) You have agreed prior to a loss, that this Insurance would be primary and would not seek contribution from any other insurance available to the additional Insured. (3) This Insurance Is excess over any other Insurance available to the additional Insured 1br which it Is also covered as* an additional Insured by attachment of an endomenrent to another policy providing coverage for the same "occurrence", claim or "suit!'. IM 24133 0816 0 2016 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material & Insu ma Services Woe, Inc,, with its permission. POLICY NUMBER: TB2-631-51 U825-233 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: As required by agreement entered into prior to loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above 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 shown in the Schedule above. CG24040509 0035-01 •oo-000> > aa000s-000asa9 U Insurance Services Office, Inc., 2008 Page 1 of NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of mum, we win rw* the persons or organizdons shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the thins party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage Is Intended as a courtesy only. Our failure to provide such advance notiflcaton will not extend the policy cancellation date nor negate cancellation of the policy. SCHEDULE Name of Other Pemon(s) ! Email Address or maitng address: Number Days Notice: Or+ganizatlon(s): List an Flo 30 with the broker All other teens and conditions of this policy remain unchanged. Issued by LM Insurance Corporation For anachmerrt to Policy WA"3D-004260-033 Effeam Date 1 /31 /2023 to 1 /31 /2024 Issued t 0ycom Industire% Inc. WC 99 20 75 ® 2016 Liberty Mutual Insurance Page 1 of 1 Ed. 12/0IM s NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown In the Schedule below. We will send notice to the email cr mailing address listed below at least 10 days, or the number of days listed below, If any. before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. E. This advance notification of a pending cancellation of coverage is Intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. Name of Other Peraon(s) I Organs Won(s): List an Flo with the broker SCHEDULE Email Address or mailing address: Number Days Natiice: All other terms and conditions of this policy remain unchanged. Issued by LM Insu mnoe Corporation 90 For attachment to Policy WC5-631-W4260-043 Effbd +e Date 1 /31 /2023 Premiums Issued tol) o=m Industhe, Inc. WC 09 20 75 Ed. 12/0112016 0035-01-00-0001120-0007-0004690 0 2016 Liberty Mutual Insurance Page 1 of WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone Ilable for an Injury c ovemd by this policy. We wtll not enforce our right against the person or organization named In the Schedule. (This agreement applles only to dw extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or Indirectly to benerd anyone not named In the Schedulle. Schedule Where Required By Contract Or Written Agreement Prior To Loss And Allowed By Law. Alabama, Arizona, Arkansas, Colorado, Delaware, Dist. Of Col, Georgia, Idaho, Illinois, Indiana, Kansas, Maine, Michigan, Mississippi, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia The premium charge is 2% of the total manual premium, subject to a minimum premium of $100 per policy. Connecticut, Florida, Iowa, Maryland, Nebraska, Oregon The premium charge is 1 % of the total manual premium, subject to a minimum premium of $250 per policy. Hawaii The premium charge is $250 and determined as follows: The premium charge for this endorsement is 1 % of the total manual premium, subject to a minimum premium of $250 per policy. Louisiana The premium charge is 2% of the total standard premium, subject to a minimum premium of $250 per policy. Massachusetts The premium charge is 1 % of the total manual premium. New York, Tennessee The premium charge is 2% of the total manual premium, subject to a minimum premium of $250 per policy. Virginia The premium charge is 5% of the total manual premium, subject to a minimum premium of $250 per policy. 188aed tv. LM insurance Corporation For attohmmt to Pallor/ No WA5-63D-004260-033 leaww to: EffUMN Deis 1 /31 /2023 to 1 /31 /2024 WC 00 0313 01 M Nadonal Council on Comperxsallon Insurance, Inc. Page 1 of 1 Ed. 411/IS" WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this poky. We will not enforce our right against the person or organization named In the Schedule. (This agreement appiles only to the extent that you perform work under a written contract that requires you to Main this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named In the Schedule. This waiver does not apply to any right to recover payments which the Minnesota Workers Compensation Reinsurance Association may have or pursue under M.S. 78.36. Schedule Where Required By Contract Or Writb n Agreement Prior To Loss And Allowed By Law. Minnesota The premium charge Is 2% of the total manual premium, subject to a minimum premium of $100 per policy. Wisconsin The premium charge Is 2% of the total manual premium, subject to a minimum premium of $60 per policy. Issued by: LM Insumas Corporation For attachment m Policy NoWC5-631-004260-043Etradve cte 1 /31 /2023 to 1 /31 /2024 Pr+amium $ Issued to: Dycom Induadres, bm WC 60 0313 01983 National Council on Compensation Insurance, Inc. Page 1 of 1 Ed. 401119N taicat 0035-01-oo-0001120-0008-000469 1 in 0004773 SP 0034-001-P04775-1 City of Eastvale 12363 Limonite Ave. Suite 910 Eastvale, CA 91752 0034-01-00-0004773-0001-0012546 ® ACCML I CERTIFICATE OF LIABILITY INSURANCE k�. DATE (MMIDDNYYY) 01/27/2023 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 endorsement(s). PRODUCER "Marsh USA, Inc. Two Alllance Center 3560 Lenox Road, Suite 24M Atlanta, GA 30326 CONTAW NAME: NAME: PHONE FAX ac No E-MAILD: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Fire Insurance Company 23035 CN102986923--GAWU-23-24 INSURED CableCom LLC 19910 North Creek Parkway North, Suite 100 INSURER B : LM Insurance Corporation 33600 INSURER C : Liberty Surplus Insurance Corp 10725 INSURER D : Liberty Insurance Corporation 42404 Bothell, WA 96011 INSURER E : INSURER F r f%%1=DArrr-c l'_FRTII;I['_ATF Nl1MRFR- ATL-OW69819-16 REVISION NUMBER: 9 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. ILTR TYPE OF INSURANCE ADDL S BR POLICY NUMBER MMIDDY EFF M/DD LICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR TB2-631-510825-233 01/31/2023 01/31/2024 EACH OCCURRENCE S,O�,000 $DAMAGE TO RENTED PREMISES Ea occurrence) $ 1,000,000 MED EXP (Any one $ PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: � PR ❑LOC OTHER: GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMPOP AGG 10,000,000 $POLICY $ A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY AS2-631-004260.023 OW112023 0113112024 COMBINED SINGLE LIMIT Ea accident $ 5.000,000 BODILY :NJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X UMBRELLA UAS EXCESS UAB X OCCUR CLAIMS -MADE RFE-631-510733-143 01/31/2023 01131/2024 EACH OCCURRENCE $ 1,000-000 AGGREGATE $ 1,000,0W DED I I RETENTION $ $ B B D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N ANYPROPRIETOR/PARTNEr?IEXECUTIVE N OFFICERIMEMBEREXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N f A WA5.63D-0IY.260.033 (AOS) WC5-631-004260-043 (MN,WI) ( WA7-63D-510689-513 (MA) 01131120 3 01/3112023 01/31/2023 TWIM 01/31/2024 01/31/2024 X STATUTE OT ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,0NAW E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addlt[onal Remarks Schedule, may be attached If more space Is required) Re: For work performed by CableCom in the City of Eastvale, CA. The City of Eastvale is/are included as additional insured where required by written contract with respell to general liability. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured subject to policy terns and conditions with respect to general liability. Ia:Le]Re];q;i City of Eastvale 12363 Limonite Ave. Suite 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 iwSPi 4%c. 01583-2015 AGORD GORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Policy Number AS2-831-004260-023 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF4NSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY — UMBRELLA OVERAGE FORM Schedule Name of Other Person(*)1 izagon s En all Address or rustling address: Nronber Days Nadco: Per Schedule on File -With The Company Per Schedule on File With The Company 75 or as -required by writ - ten contract, whichever is less, per the schedule on ti e w� a company A. If we cancel this poky for any reason other than nonpayment of premium, we will notify the persons or organizations shown In the Schedule above. We vAl send notice to the email or maifing address fisted above at least 10 days, or the number of days listed above, If any, before the cancellation becomes efliecdve. In no event does the notice l o the third party exceed the notice to the first named Insured. B. This advance notification of a pending cancellation of coverage Is Intended as a courtesy only. Our fallur a to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 010511 0 2011 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. 0034-01-0"004773-0002.0012547 POLICY NUMBER: TB2-531-51 0825µ233 COMMERCIAL GENERAL LIABILITY CO 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Ail property owners, cell tower owners, or utility pole owners on whose property, cell tower, or utility pole you must enter to perform your operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Information required to complete this Schedule, if not shown above, will be shown In the Declarations. I A. Section it 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 26 04 13 O Insurance Services Office, Inc., 2012 Paige 1 of 1 Policy Number TB2.831-510WS-233 Issued by Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART COMMERCIAL LIABILITY — UMBRELLA COVERAGE FORM 8cneaula Name of Other Person(s) i Ization s : Emall Address or rnallln g address: Number Days Notice: Per Schedule on File With The Company Per Schedule on File With The Company 75 or as required by writ - ten contract, whichever is less, per the schedule on file with the company A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown In the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, If any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the fast named insured. S. This advance notification of a pending cancellation of coverage N intended as a courtesy only. Our failure to provide such advance notification will not extend the policy c ancelation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM " 0105 11 0 2011 Liberty Muhl Group of Companies. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Page 1 of 1 003" t-00-OW4773-0003-0012saa NOTICE OF CANCELLATION TO THIRD PARTES A. If we cancel this policy for any reason odw than nonpayment of premium, we wit notify the persons or organizations shown M the Schedule below. We will send notice to the email or mailing address tided below at least 10 days, or the number of days listed below,11 any, before +canoellation becomes eflecilve. In no event does the notice to the third party exceed the notice to the first named insi+ed. B. This advance notification of a pending cancellation of coverage Is Intended as a courlesy only. Our failure to provide such advance ra f'tcatul w6n, w M not extend the policy cancellation date nor new cancellation cif the Policy. SCHEDULE Name of tither Person(s) ! Emall Address or mama tddraw: Number Days Notice: Organ ization(s): List on File 30 with the broker All other berms and conditions of this policy remain unchanged. Issued by LM Insuwce Corporation For attachment to Policy WA"3D-004260-033 Effacm Date 1 /31 /2023 to 1 /31 /2024 Issued k0ycom Industir % Inc. WC 99 20 75 ® 2016 Liberty Mutual Insurance pop 1 of 1 Ed. 12101/2016 0034-01-00-0004773-0004-0012649 ACoRo® CERTIFICATE OF LIABILITY INSURANCE DA E(MM/ID201 3Y) 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 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 The Empire Company 9050 Archibald Avenue P.O. BOX 5400 Rancho Cucamonga CA 91729 CONTACT NAME Marie Ramos ACNE Extl:(909) 476-0600 FAX No): (909)476-0601 E-MAIL mramos@empire-co.com - ADDRESS: INSURE S AFFORDING COVERAGE NAIC # INSURER A: Continental Casualty Co. 20443 INSURED Delgados Concrete Services, LLC 1012 Fortuna St. Perris CA 92571 INSURER B : Benchmark Insurance CompanyCompny 41394 INSURER C : INSURER0: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:23/24GLWC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDIYYYY POLICY EFF MMIDDIYOLICY EWX Y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX1 OCCUR C6983861630 2/1/2023 2/1/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY PRO D LOC JECT OTHER: GENERAL AGGREGATE $ 2,000,000 X PRODUCTS-COMPIOPAGG S 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ S UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? Y❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A I CST5024990 I 2/3/2023 I 2/3/2024 X PERLITE ORH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 5 11000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addltlonal Remarks Schedule, may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Eastvale THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 12363 Limonite Ave . , Suite 910 ACCORDANCE WITH THE POLICY PROVISIONS. Eastvale, CA 91752 AUTHORIZED REPRESENTATIVE Marie Ramos/MARIE n 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401) �1 BALBO-3 DATE (MM/DDNYYI) 02/03/2023 AICORO- 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(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 endorsements . PRODUCER RPS Bollinger Sports & Leisure PO Box 1322 W. cT PHONE FAX Ac No Ext : I JAIC, No): Morristown, NJ 07960 Carolyn D. Budelman INSURERS AFFORDING COVERAGE NAIC p INSURER A : *Markel Insurance Company ` 38970 INSURED Balboa aas� ement r LLLLC 1 0101es l La INSURER B • INSURER C INSURER D 101"901"'X a San Juan Capistrano, CA 92693 INSURER E INSURER F : COVERAGES CERTIFICATE NUMRFR- RFVtsInN NIIMRFR- 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 SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE DX OCCUR Inct-Part-Leg Lta— X 8502AH009795 f— 02/02/2023 - 02102/2024 -- - -- EACH OCCURRENCE S 1,000,000 X DAMAGETO RENTED MED EXP An one arson S 100+000 S 5,000 X Inc) Spectat Lia PERSONAL A ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY l__I JECT F—ILOC OTHERAbuse/Mol GENERAL AGGREGATE S 3,000,000 PRODUCTS - COMP/OP AGG S 1,000,000 I$1 MM/$2MM AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS OONLY ANNNS COMBINED StNGLE LIMIT (Ea accident) $ BODILY INJURY Per n S BODILY INJURY Per accident $ ETAMAGE Oerr accident? S S A UMBRELLA LIAR EXCESS LIAS X OCCUR CLAIMS -MADE X 4602AN009295 02/02/2023 02/02/2024 EACH OCCURRENCE 5,000,000 X AGGREGATE _S , $ 5,000,000 DED I X I RETENTIONS 0 Follow Form WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PRROR/IPRIIETBOERRIPARTNERIEXECUTIVE Y r N Weadatory to {�H) EXCLUDED? It s describe under D SG�RIP ION OF OPE IONS below NIA I PER OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S E.L.DISEASE - POLICY LIMIT S A Accident Full Excess 4102AH010152 02/02/2023 02/02/2024 Mod Max Ded 25,000 250 -DESCRHMOITOF I LOCATIONS? VEHICLES (ACORD 101; Additional Remarks Schedule, may be attached 9 mom space Is required] -- Certificate Holder Is named as an additional Insured on the liability policy. Coverage is provided for sponsored, supervised activities of the named Insured as scheduled with the carrier. CERTIFICATE IHALDFR CANCFLLATInN CITYEL3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI Eastvale City of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12363 Limonite Ave, ste 910 Eastvale, CA 91752 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) 01988-2015 ACORD CORPORATION. -All- rights reserved. The ACORD name and logo are registered marks of ACORD A`� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 2/8/2023 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 Risk Strategies Company 2040 Main Street, Suite 450 Irvine, CA 92614 CONTACT NAME: Risk Strate ies Company PHONE 949-242-9240 FAX No ADD ILRESS; s oun risk-strat ies.com INSURERS AFFORDING COVERAGE NAIC 0 INSURER A: Citizens Insurance Company of America 31534 www.risk-strategies.com CA DOI License No. OF06675 INSURED Lei hton Consulting, Inc. 26TO Michelson Drive, Suite 400 INSURER B : Allmerica Financial Benefit Insurance Co 41840 INSURERC: Travelers Property CasualtyCo of America 25674 INSURER D : Lexington Insurance Company 19437 Irvine CA 92612 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 72928251 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 ADDLSUBR POLICYNUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD LIMITS A �/ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F./I OCCUR �/ V OB3J208488 11/1/2022 11/1/2023 EACH OCCURRENCE $1000000 DAMAGE TO RENTED PREMISES Ea occurrence $1 000 000 MED EXP (Any one person) $10 000 PERSONAL 8 ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a JECT LCC GENERAL AGGREGATE s 2,000,000 PRODUCTS - COMP/OP AGG $ 2 000 000 S OTHER: B AUTOMOBILE LIABILITY ✓ ✓ AVi13J20847$ 11/1/2022 11/1/2023 COMBINED SINGLE LIMIT Ea accident $ 1 000 000 BODILY INJURY (Per person) $ ✓ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ ✓ HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY PROPERTY DAMAGE Per accident $ S A �/ UMBRELLA UAB ✓ OCCUR OB3J208488 11/1 /2022 1111 /2023 EACH OCCURRENCE $ 5 000 000 AGGREGATE s5,000,000 EXCESS UAB CLAIMS -MADE ✓ DED I I RETENTION $0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED9 N I A ✓ UB I R5099812243G 9/1/2022 9/1/2023 �/ PER STATUTE ERH- E.L. EACH ACCIDENT $1,000 000 E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1 000 000 D Professional Liability/Pollution Liab 013001524 2/14/2023 2/14/2024 Per Claim $2,000,000 Claims Made Aggregate $4,000,000 Deductible $100,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more 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 (2016103) The ACORD name and logo are registered marks of ACORD 72928251 I (LC) 22-23 GL-AUTO-UMB-WC 23-24 PL 1 Sandi Moreno 1 2/8/2023 9:09:19 AM (PST) I Page 1 of 8 Architects and Engineers The following policy language is from Businessowners General Liability Coverage Part NAMED INSURED: Leighton Consulting, Inc. POLICY NUMBER: 063J208488 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 II — 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: (i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (ii) 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. 72928251 1 (LC) 22-23 GL-AUTO-UMB-WC 23-24 PL I Sandi Moreno 1 2/8/2023 9:09:19 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: 1. "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 30 Days. AUTHORIZED REPRESENTATIVE 'From Hanover Forms. 391-1003 (08116); 391-1445 (08(16); 391-1586 (0816), 391-1003 (0816) 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. 72928251 1 (LC: 22-23 GL-AUTO-UMB-WC 23-24 PL I Sandi Moreno 1 2/8/2023 9:09:19 AM (PST) I Page 4 of 9 POLICY NO.: 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 11 — 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 72928251 1 (LC) 22-23 GL-AUTO-UMB-WC 23-24 PL I Sandi Moreno 1 2/8/2023 9:09:19 A4 (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 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, SUITOR 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) 72928251 1 (LC) 22-23 GL-AUTO-UMB-WC 23-24 PL I Sandi Moreno 1 2/8/2023 9:09:19 AM (PST) I Wage 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) 72?28251 1 (LC) 22-23 GL-AUTO-UMB-WC 23-24 PL I Sandi Moreno 1 2/8/2023 9:09:19 AM (PST) I Page 7 of 8 TRAVELERSO ONE TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UB I R5099812243G 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 Mess 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 �Fn%rinmPmPnt Nn Insured Leighton Consulting, Inc. ^��---r Insurance Company Travelers Property Casualty Co of America DATE OF ISSUE: ST ASSIGN: Countersigned by Page 1 of 1 72928251 1 (LC) 22-23 GL-AUTO-UMB-WC 23-24 PL I Sandi Moreno 1 2/8/2023 9:09:19 AM (PST) I Page 8 of 8 10 A C40RV CERTIFICATE OF LIABILITY INSURANCE DAT M4 02/3 YY) 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 CONTACT Mall McCarthyFAX PHONE A/C No): ADDRESS: certs@emerykarrigan.com Beaverton OR 97005 INSURERS AFFORDING COVERAGE NAIC 0 INSURER A: Clear Blue Specialty Ins CO 37745 INSURED MRCRANE-01 Mr. N Harinc Mr. Crane Inc. 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: 1702465863 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 SUBR POLICY NUMBER POLICY EFF MM1DDlYYYY POLICY EXP MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR Hook Liability Y AW03-RS-2300067-03 2/15/2023 2/15/2024 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrencal $100,000 X MED EXP (Any oneperson) $10,000 X Over The Road ME PERSONAL & ADV INJURY $1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY CT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ 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 LIAR EXCESS LIAR X OCCUR CLAIMS -MADE Y AW042300027-03 2/15/2023 2/15/2024 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 DED I X RETENTION $ n $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If es, describe under DESCRIPTION OF OPERATIONS below N / A SCW 0000499-08 1/1/2023 1/1/2024 TH X 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 / LOCATIONS 1 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 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AW03-RS-2300067-03 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 Organization(s) Locations Of Covered Operations ALL PERSONS OR ORGANIZATIONS AS REQUIRED AS DESIGNATED IN WRITTEN CONTRACT BY WRITTEN CONTRACT WITH THE NAMED WITH THE NAMED INSURED INSURED 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", "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 furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the 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 0 Insurance Services Office, Inc., 2012 Page 1 of 2 Policy Number: AW03.RS-2300067-03 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 shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 C Insurance Services Office, Inc., 2012 CG 2010 0413