08-0304_ALL AMERICAN ASPHALT_Insurance111,118/120111 ]V20 FAII 71,11374185 HIIIC
a118ai100191
' ACORD. OR IaIABILIITYI IN SURANCB
AM REQUIREMENT, TERNS OR CONDITION OF ANY CONTRACTOR OIFIEA DOCUMENT WITH RESPECT TO WHICH THIS 4 ERTIFICATE MY BE ISSUED OR
CER"MRICA"NS
POLICIES. AGGREGATE LIMITS SHOWN MAY HA11E E ISN RE]UO EO M I RP Io a LA MS.
071311�°"""Y'
PRODUCER
TYPE OF INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ed% ealood Pa rtners Ins. (I a rtes
PCATELICY
ON l Y AN I CONFERS NO RIGHTS UPON THE CERTIFICATE
I is #OB211371 (714) 937-11824
IOE DER. THU CERTIFICATEIIIF IG OR
(ALTERR B
GPPOO2265WO
0810'1/07
THE COVERAGE AllRORDEID THEAMEND£POLICIIEES BELOW.
Cine Cit) I EIIvd West #100
ClRange, Cpl 978118.2947
This AOI rdf cite
1NSI RE RS An FORDING CCIVERA G9 I (AIC A
I10 UREfl
DAMAGES I �� b100 000
INSURER A: Arch Specialty Insurance Co.
All Am aria an A! p halt
MA OCC( R
ILAIMI DE nX
INSURER EI: Ina. Co. of the State of PA
P.C1. Bax 2229
INSURER 4: Seabright Insurance Co
Corona, Cpl 12878-2729
INSUREIIII1: Hartford Fre Insurance Co.
supercedes
II SI RE] 1:
COVERAGES
THEF Pal ICIE3 ON INSURANCE LISTED E ELOW HAVE SEEN 1551 ED TO THE INSURED NAMED ABO) IE ROR 'IH■ POU CY PERIOD INDICATED. NOTWITHSTANDING
AM REQUIREMENT, TERNS OR CONDITION OF ANY CONTRACTOR OIFIEA DOCUMENT WITH RESPECT TO WHICH THIS 4 ERTIFICATE MY BE ISSUED OR
W Y PERTAIN, THE INSURANCE AFFORDED I Y T1111 R OLICIE S DESO F HED HERIHII I R I LIBJMC71 IO A LL THEI TEMAS, EXCLI ISM NS AND CONDITIONS OF SI ICH
POLICIES. AGGREGATE LIMITS SHOWN MAY HA11E E ISN RE]UO EO M I RP Io a LA MS.
TR
R
TYPE OF INSURANCE
Pl UC`IINUMBER
D NDDIM F
PCATELICY
L011ITS
AI
GOMRALLMASILITY
GPPOO2265WO
0810'1/07
08101/09
EACH OCCURRENCE $1000000
X COMMERCIAL GENERAL LL4SILITY
This AOI rdf cite
DAMAGES I �� b100 000
MA OCC( R
ILAIMI DE nX
voids ar d
ne
MED EXP (My operson) S
PERSONAL SADV INJURY $1.000.000
supercedes
GENERAL AGGREGATE s2.000.000
prey a us
GEN'L AGGREGATE Uhl IT APPLIES PEE:
PRODUCTS - COMP/OP AGG 42 000 000
certN Cat1
POLIcY 7XI PRO Loc
Issued 07/24/08
D
AUTOMOSLEUIEULnI
X
AM ► ul O
72UENGK5491K2
This cartel cak
08101/08
08/01/09
(EEM e1 mW SING LE w IIT s'I ,001,011
BODII Y IN.II RrI I
(per P—)
ALL OWI E[ A UTO11
SCHOI LU 0AUTOS
reflects ull c atecl
Auto Lil t ilii I &
X
X
FIRIID Alda
nION-OWI EDA UTOS
Workers Ca mp
COVeralge a my
BOCq Y III II IF `I I
(Per @wide I)
PRC A ERTI DAMAOI I $
(Pd ecCMden }
GARAWLMA RM
AUTO ONLY -EAACCI[)Wr $
0 TNHR TFW EA ACC 8
AII'll AUTO
A093 ONL1t AW S
EXCESSIUMBRELLAU461UfY
X OCCUF F] CLAIMS MADE
5686440
18111/07
0810'1109
EACH OCCURRENCE $10,000,000
AGGREGATE 410 OLIO 000
b
$
1EDUC1119u
$
X RETENTION $10000
C
wORKERscome ENIATmAmo
BBI 080243
080,1108
0810'11119
°TM
X wcsTRY Lurr 1.
EMPLOYERS` LIATO 1 It ITY
AFI' I PRG PRIETORIAARTII ERIE7CEal ITIVE
OF 114 ERIMMEMB11 EX[ LUDED?
nder
S I describePRa VISIONS below
E.L. EACH ACCIDENT $1,000,000
E.L DISE AkSE . EA EMPLOYEE $1,00,000
E.L. DISEASE- POLICY LIMIT I 41 000,000
OTH111
I EsaRIPTgM GI OPIRATIOMI I U ICA TIONS I VEF III I EXCU SMOFII ADI ED Ell ENDO114 I EMT I SPECJAL PROVISIONS
RE: AHRP Ciel ahilite tion of Dei OI ispl Streel S Junill e ro Sera Rand - STPL
5377 (009) (CIP Na. 408) & STPI I -372 (110) (CIR No. 415)
12aAl a
Q N1101 S an Juan Q apistrl nc
32400 A a sea Adeia nto
San Juan C4pistrano, CAI 92175
ACORD 2.1 (2001101)1 a f 2 #N 32729
SMULD Al IY OF Tell ABOVE I EiSGREE] POI ICES ON CANIELLEI BEFORE THI EXPIiA TM
DATE TIIER£DF,TNaLSSNwGINWRERyrLLX000800MFWL —3(L D►`IswRiTTEM
NOTICE TO 7111 CER'MPrgM HDI IDM KAMED TO THE LP1T,
SCCIi 0 ACORD CORPORATION '1988
1,/
C9/11ACC8 JUIC FAX 71 4 931-11 8 9 EPIU (oOoo ms
AL;UtW 2b�-* tzoviros) 2 of 2 8432729
09,1'1 8 11 3 011 8 39°21 Hp% 1149371189 HHIC [?Iaai4/11009
I TH I:I EN DORSHMEIr 1110H1AINGSI-EcI 11111 E FIOLICIY. RLEASS READ 1111 CARIFL LLN.
SLA NKEI AC DITIONAL INSU RED EN DC R:IEUHNT
This en dors emenl modillies in s urc n cc piovided under the lollawing:
CIOMMEIIRCIALI GENERAL LIABILITY C:CNERACIE FORM
CIOMMEIRCIAIL GEINBRAL LIA>IILiTY SELF -HIL RED RETElN110P CO% EIRACI8 FORM
SEKI1111CIN II - 1A IH O IS IN EIIJ RBD is ani o n dec to include as an additional insulted those persons on
organizat is n s who aro required Linder a written con tnact v ith you to be named as an a c ditlonal ins tined,
but only wth nespe c la liabilit} fon "bodill injury", °peoperty damage", of "personal and ad) isrl'sing injury"
caused, in whole on in pari, by yawn acts or omissia ns or It a acts on omissions oil your subcon rac ors:
Al. In the N rformance of your ongoing ope rations or °youn worV, inclUding "youn wank° that has
been con pleled; or
S. In connectior with premises owned b) a nenied to yau.
As us ed in 'I his endorsement, the yr ords "you' ar d "1 our nelen 10 the F arr ad In s ured.
Alll ottle n ierms and caaclilions olihis Policy remain unci angoc1.
City of San Juan Ca,pistrwo, its elected and appointed off vials
Hroi4a .
AHRP Rehabilitation oil Dal C bispo Street & Juniper o Serra Road SIML-537211009; (CIIP No. 408' &
STPI-9372 (tl 10) ((IIA No. 419)
Endorserneni Number:
Tr is endorsement is effective on the in ce ption date of this pq licll un less otherwise stated herein
(TI a irrlorma tion below is required only 0 en # is endorsemeni is issued sc bs equen'l to the p reparation
alIhe policy)
F a licy IS urn be r. GIPP0023 9 9800
Named Insuned: Alll Almeuican Asphalt
Endorsement Elfilecthie dale: 84, X107
00 CGL0006 00 05 07 Rage 1 al 1
C9/.11,13(C8 J1'II FAX 114 931,1111 EPHI 2oov,100(5
TH IS EINDC REIEIMEINI CH AN CHIS TF E I R01110. PLEASE READ Il CAIREFIJ LL -1.
Ol 1 EIR IN 91.1 RAN CEI — BROAD FORK, CIGII PCIUCIY EINDCIREIEMBNT
1 his endorsement modifies it f urar cA p roAded L nder tl a Hollowing:
CCIL N BRCIIAL C113N 13RAL LIABILITY CIOVERAGE FC1RM
CCIN h BRCIIAL GE P BRAL LIABILITY SELF -Ir EURE[l ROTEP 111On CIO% ERACIE FORM
Under SEICTION 1% — OOMMERCIAL CIEIN URAL LIAEII11rn CON DITION9, the followingl pal agraph is added
-lo Condition 4.Othler Insuiian ce:
Whene ti a Named Insured i9 required by a written col' ti act to pi ori( a insul ance -I hal is p1 imary an (l
nor-contr'hutory, and the written coni ract s o nequiring is executed b)l the Named Insured belone amt
"o=irrence' on oflense, t1 is in$ L ranae w'11 bE primary, but only it and Ilo the extent required by tl at
written contract.
All other terms and conditions of this Policy I emain unchanged.
Endorsement � urn km n:
Tt is endorsement is efilectirie on the inception dale of -This poliay unless otherwise stated herein
(The ii formatlon belomi is nequilied only wt en this endomiment is issued s L t sequenl to 9 e p reparation of the
policy.)
Policy Numbers: GPP001165804
Named Insulied: A Il American A:Iphalt
Endorsement Effect've Date: &47
0 0 CIGL0130 00 09 06 Rage 1 of 1
09/118/21108 15°211 HILI 11 4 9 3 14389 EPIC
�11erilcar Cooled
Hdgewa& Partr. ers Xniurance Cer ]tea
Licenu 9CEIM70
f1horr.le :11714) 9371-4366 • Fadi: 1�7: 4) 634-113:18
710:
Khoon Tan
Dale:
9il180008
flax:
149493 -125'1
1 ages:
5
Ca:
❑arrr en Ocboa
I aa-:
951-739.401
RAI: Cie rdfieatel s ) of hJurat ae
009(1/0(149
Please find attached cert'ficau (51' as aegw sl ed. Please also note that the General Lial ility
policy fon All Arrlericar Asphalt was written ilorn a tWo year term from 8111 x107 to 841(109;
tl a ilenewa certific, le received by your offlce reef eated only update d Wo111'lers
Compensad for and Automobile Biabili t31 cove age; Ni previa u513 -rel ceived cartiFcate and
endorse mx r 1 foil General vi abi liq is still in effect. Hope fully this will be-sufiia i e n-1 I o lift
d a insuranne Hold placed on1 owl client+ if yot should have any questions, do not be5itate
to canta,ci me at 4714: 9371366.
1111 nki
0 m Citi lied West, 7 uile 700
Of on", CA 94866
EUCEWOW PARn ERS 4h: () 1,1)131-1624
Ira uranoe C40ter Fmr (1 14) 634-13: 4
Lie. No. 01121770