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CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDDIYY'M <br />�.. <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder m an ADDITIONAL INSURED, the pa9icy(ies) must have ALPDfiIONAL INSURED provisions or be endorsed. <br />if SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endcorsement(s). <br />PRODucERP.dgeyvpOd paftnBrS lnsutanCe Center NAMe: Certificates De ariment <br />6 PHONE 925-24d-770D ta/c.sm: F. 925-901-0871 <br />San Ramon, CA 94583 E-MNL EPICcens@eaicbrokemoarn -- <br />ADDREss:_ <br />CA LICENSE #OB29370 <br />INSURED <br />All American Asphalt <br />P.O. Box 2229 <br />Corona CA 92878 <br />,rL�, unuRCD• <br />COVERAGES CERTIFICATE NUMBtR: 5305`,122--- <br />BEEN ISSUED TO 7HE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />PERIOD <br />I5 TO CERTIFY THAT THE POLICIES 6F INSURANCE LISTED BELOW HAVE <br />CONTRACT OR OTHER <br />Tr11SIC, <br />DOCUMENT WITH RESPECT 70 <br />INDICATED. NOTMNTHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY <br />THE POLICIES DESCRIBED <br />HEREIN IS SUBJECT TO ALL THE TERMS, <br />CERTIFICATE MAY SE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY <br />POLICIES. LINIDS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH —_P0OLICYEFF Pocky EXP <br />: Lir1r5 <br />AD UBRj <br />Lr POUCYNUbISER MFVDD i 1.8VDDNYYN <br />TYPEOF DVSURANGE <br />IDPC1005858-03 StIt2019 '8J112020EACH <br />occuRRENce i 51 DDD 006 <br />A '. MMERCMLGENEtALUAER.RY <br />NT@ I51D0.000 <br />CL. M$-MADE ✓ OCCUR <br />PREiASES iEaoauna�I <br />: <br />MED EXR (ARy meperson) S <br />-- <br />PERSDNY' B ADV INJURY $1.000,000 <br />-- <br />GEN=RAt AGGR,c^uATE $2,000,000 <br />GWL AGGREGATE LIMIT A UES PER <br />PRODUCTS-WNLMOPAGG SZ.QOD ODD <br />PODGY j .—_'LCC <br />S <br />OTHER <br />'BAP5571088A7 j BI1/2019 8f712(120 <br />COMSINE65INQE LIWT <br />I;_ zKj- errtL $2,000.L1D0 <br />AUTOMoeaEUM LAY <br />BODILYNU (Pe[O M) s <br />✓", ANYAUTO <br />BODILY INJURY(Peramtlenv} $ <br />OWNED BGkEDULED <br />AUTOSONLY AUTOS <br />PROPERTYDAMAG I $ <br />�L r--I, NED <br />HIRED <br />✓ AUTOS ONLY ✓ AUTOS ONLY <br />IAe� <br />'�.SXSD19797003 �I� 81V20i9 8I1i2020 <br />-� EAcNo=URRENC=_ S5.000.000 <br />C ,J uMeaeLuuAe J _ occOR <br />AGGREGArc s5,000.000 <br />✓ EXCESS UAE G(AIMSMADE' <br />IFOilovnng-Form $ <br />I DED ✓' RE7EN'RONS10,000 <br />WC593205708 8/1/2019 9il112i126 <br />V STATVi'E ER <br />B WORXERscoMPEtLSATION <br />".AND 9dP3AYLR51.M811IFY YIN <br />EL.EACHACCIDEW S1,000,coo <br />AM'PROPRF.TORIPARTINERE(ECURYE EN -�ICERlMEMBESYEXCIUDEDi � •- i'.. : <br />E.L DISEASE -EAEMPLOYEE S <br />,(Mudrtory In NH) <br />jx yes, a esT10N ' <br />! E.L. DISEASE -PoucY uzn 151.000.004 <br />,DcSCRIPT10N OF OP= -.RATIONS ➢elaw <br />90 <br />DESOW ON OF OPERATIONS! LOCATIONS I VEHICLES(ACM 1e1. Mr ..M Rmm)aB We, U morvspaoab mgwu ) <br />Project #19-5SQ 1 RE: BnstOI St. Rehabilitation: MacArthur Blvd. to Railroad (N. of Afton Ave.) i <br />and representatives are Additional insureds with respect to General Liability and Auto Liability <br />City of Santa Ana, its officers, employees, agents <br />or as required by written contract. Insurance is Primary and Non-contributory. <br />per the attached endorsements <br />Certificate Holder is Additional Insured if Required by Written Ocrzbact ExciUdding Workers Compensation <br />City of Santa Ana <br />Risk )vtanagement Division, 4th <br />20 Civic Center Plaza <br />Sana Ana CA 92703 <br />In <br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />tlYlgLyr. '-- AUr,,oR E REPRESENTATNE <br />202D Certificates Department <br />O 1988-2015 ACORD CORPORATION- All rights <br />ACORD 25 (2018103) I 1 Ti MO.j(j$'reglstered marks of ACORD <br />:s sca=n. k- $5. z I = �a sc,:bes i :21_stzo_s <br />