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PALP, INC.
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />JEANA
<br />Da11M112023 Yl
<br />FTE
<br />1172023
<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 Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED previsions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms 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 endorsemont s .
<br />PRODUCER
<br />The Wooditch Company Insurance Services, Inc.
<br />1 Park Plaza, Suite 400
<br />Irvine, CA 92614
<br />6RMEACT
<br />C,iio agh 949) 553.9800 No :949 553-0670
<br />DISURERfin AFFOROmO COVERAGE
<br />NAIC
<br />suRERA:Allied World Ins. Co. Inc.
<br />22730
<br />INSURE
<br />Pelp, Inc. DBA Excel Paving Company; GAP Equipment, LLC
<br />2230 Lemon Avenue
<br />Long Beach, CA 90808
<br />INsuRERB:AIIIed World Assurance Company
<br />19489
<br />iasuRER c:Staretone National Insurance Company
<br />25496
<br />INSURER D :
<br />INSURER E:
<br />NSURER F:
<br />COVERAGES CFRTIFICATF NIIMRFR! RLVISIn1d AIn MIRFR•
<br />THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICYPERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTIMTH RESPECTTO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />TYPE OF INSURANCE
<br />AOD
<br />SUBfl
<br />POLICY NUMBER
<br />PO IC EFF
<br />PO04MLL E%P
<br />LIMITS
<br />A
<br />X
<br />COMMERCIALGENERALLUIBa
<br />CLAIMS -MADE QX OCCUR
<br />X
<br />X
<br />6004-1245
<br />61112022
<br />61112023
<br />EACHOCCURRENCE
<br />$ 1,000,000
<br />RE GETORENTEOmr1
<br />100,000
<br />MEDEXP An one rson
<br />3.000
<br />PERSONAL&iADVINJURY
<br />1 1,000,000
<br />'LAGGRE��C,yTE� �LIRMpITAPPGESPER:
<br />POLICY I'•I dECT LOC
<br />GENEFALAGGRE TE
<br />2,000,000
<br />GE
<br />PRODUCTS.CO OPAGG
<br />S 2,0110,000
<br />EMPLOYEE BENEFI
<br />11000,000
<br />OTHER:
<br />B
<br />AUrOMOBUUr
<br />LIABILITY
<br />COMBINrdDSINGLELINUT
<br />1,000,000
<br />X
<br />ANYAUTO 88CC
<br />OWNAUTAHL�Ip
<br />M�OESµSOpWWUN�NEEop
<br />X
<br />X
<br />6000-1394
<br />6/1/2022
<br />61112023
<br />BoDILY1NIURv eam,
<br />BODILYIiNVJURV Pereceldw
<br />X
<br />�O�SONLY
<br />AUTOSONLY X AMVff1LV
<br />eahlm[ OE
<br />'
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACH OCCURRENCE
<br />AGGRE E
<br />EXCESSLMB
<br />CLAIMS -MADE
<br />DELI I I RETENTION$
<br />C
<br />11aXU(ERSCOMPENSAnON
<br />AND EMPLOYER LIABILITY
<br />A�NPY�PpR�Oq�P,�REIETgOEWpPARDIERIEXECUTME IJ
<br />(Mandatary In NH)FxObuoEY LJ
<br />ryyeess,, eescrlbe under
<br />DESCRIPTION OFOPEItATN)NS
<br />NIA
<br />X
<br />10221268
<br />6/112022
<br />6MI2023
<br />X PER Ono
<br />E EACH DENT
<br />1,000,000
<br />E IX8 E- EMPLOYEE
<br />1,0D0,000
<br />E.L DIS E-POLICYUNI7
<br />1,000.000
<br />DESCFUP71ON OF OPERAMONS I LOCATIONS IVEHICLES (ACORD 101, Addleanal Remarks Schedule, may be attached If mom space Is mgekedl
<br />RE: Excel Job #5901; City of Santa Ana Job 419.0951; (ATPSBIL-5063(103)); Safe Routes to School Davla Elementary Access Compliance Project.
<br />glelpwvlauaipwvrwowv
<br />The City of Santa Ana, Its officers, employees, agents, volunteers and representatives are included as Additlanal Insureds as respects General Liability and
<br />Auto Liability per attached endorsements.
<br />This Insurance shall apply as Primary and Non -Contributory per attached endorsements,
<br />Waiver of Subrogation for Gomm] Liability, Auto Liability and Workers' Compensation: Sea Attached Endorsements.
<br />CERTIFICATE HOLDER CANOFI I annN
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana
<br />Risk Management Division, 4tl1 Floor
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />,AunroORIZED REPRESENTATIVE
<br />'7 r_
<br />Banta Ana, CA 92701
<br />ACORD 25 (2016103) 491988.2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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