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Insurance Certificates 2022/23 Granite Const - Emergency Work - Washington St, N. of Ave 47�0 CERTIFICATE OF LIABILITY INSURANCE 08/15/2023"' 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 endorsement(s). PRODUCER LIC #OC36861 1-415-403-1491 CONTACT Kimberly Leikam Alliant Insurance Services, Inc. p1epHE FAX .415-403-1491 .415-874-4818 560 Mission Street, 6th Floor San Francisco, CA 94105 INSURED Granite Construction Company 585 West Beach Street Watsonville, CA 95076 IArq,.No n E-MAIL kleikam®alliant.com _ADDRESS: INSURER(SI AFFORDING COVERAGE NAIC N INSURERA:TRANSPORTATION INS CO 20494 INSURER B: VALLEY FORGE INS CO 20508 INSURER CSTEADFAST INS CO 26387 INSURERD: INSURER E : 1 INSURERF: COVERAGES CERTIFICATE NUMBER- 69445742 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. IR TYPE OF INSURANCE thga WVD I POLICY NUMBER POLICY EFF POLICY EXP OY LT nLIMITS LTR A X COMMERCIAL GENERAL LIABILITY X X GL2074978689 10/01/20 10/01/23 EACHOCCURRENCE $ 2,000,000 CLAIMS -MADE Ili OCCUR DDAMAGE :S1 RENT rr n $ 2,000,000 X MED EXP (Any one person $ Nil Contractual Liability X XCU Hazards PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 PRO - POLICY ]�LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER B AUTOMOBILE LIABILITY X X BUA2074978692 10/01/20 10/01/23 Come INEOSiNGLELI IT Ea acdcftmi $ 2,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE P a dank $ HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY X $ Contractu8 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ H AGGREGATE $ EXCESS LIAB.J CLAIMS -MADE DED RETENTION S $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A X IWC274978630 (CA) 10/01/22 X WC274978644 (AOS/Stop Gap10/01/22 10/01/23 10/01/23 X PiATUTI ER E.L,EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 C Professional Liability EOCS08792218 10/01/22 10/01/23 Each Claim/ Agg. 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Job #TBD / EMERGENCY WORK - WASHINGTON ST. - AVENUE 47 The City of La Quinta is included as Additional Insured where required by written and executed contract and per the attached endorsements. Coverage is primary & non-contributory and waivers of subrogation apply. Thirty (30) days notic of cancellation or material change in coverage provided. GL PER ISO FORM CG0001 10/01; AL PER ISO FORM CA0001 03/10 CFRTIFICATF HOI nFR CANCELLATION 2250 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of La Quinta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Ubaldo Ayon ACCORDANCE WITH THE POLICY PROVISIONS. 78495 Calls Tampico AUTHORIZED REPRESENTATIVE La Quints, CA 92253 I USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD schultzv 69445742 SUPPLEMENT TO CERTIFICATE OF INSURANCE 08/DATE 15/2023 NAME OF INSURED: Granite Construction Company The named insured reserves its rights to provide any additional coverages under the policies above to only those expressly negotiated for by contract. CNA G-140331-D (Ed. 01/13) BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS — WITH PRODUCTS -COMPLETED OPERATIONS COVERAGE It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows: SCHEDULE (OPTIONAL) Name of Additional Insured Persons Or Organizations (As required by "written contract" per Paragraph A. below.) Locations of Covered Operations (As per the "written contract," provided the location is within the "coverage territory" of this Coverage Part.) A. Section II - Who Is An Insured is amended to include as an additional insured: 1. Any person or organization whom you are required by "written contract" to add as an additional insured on this Coverage Part; and 2. The particular person or organization, if any, scheduled above. B. The insurance provided to the additional insured is limited as follows: 1. The person or organization is an additional insured only with respect to liability for "bodily injury," "property damage," or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the "written contract"; or b. "Your work" that is specified in the "written contract" but only for "bodily injury" or "property damage" included in the "products-cor@pleted operations hazard," and only if: (1) The "written contract" requires you to provide the additional insured such coverage; and (2) This Coverage Part provides such coverage. 2. If the "written contract" specifically requires you to provide additional insurance coverage via the 10/01 edition of CG2010 (aka CG 20 10 10 01), or via the 10/01 edition of CG2037 (aka CG 20 37 10 01), or via the 11 /85 edition of CG2010 (aka CG 20 10 11 85), then in paragraph B.1. above, the words 'caused in whole or in part by' are replaced by the words 'arising out of. 3. We will not provide the additional insured any broader coverage or any higher limit of insurance than: a. The maximum permitted by law; b. That required by the "written contract'; c. That described in B.1. above; or d. That afforded to you under this policy, whichever is less. 4. Notwithstanding anything to the contrary in Condition 4. Other Insurance (Section IV), this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or G-140331-D (Ed. 01/13) POLICY #: GL2074978689 Page 1 of 2 EFFECTIVE: 10/01/2020 Copyright, CNA All Rights Reserved. G-140331-D (Ed. 01/13) any other basis. But if required by the "written contract' to be primary and non-contributory, this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured. 5. The insurance provided to the additional insured does not apply to "bodily injury," "property damage," or "personal and advertising injury" arising out of: a. The rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: (1) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities; or b. Any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this Coverage Part. C. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: (1) Give us written notice of an 'occurrence" or an offense which may result in a claim or "suit' under this insurance, and of any claim or "suit' that does result; (2) Except as provided in Paragraph B.4. of this endorsement, agree to make available any other insurance the additional insured has for a loss we cover under this Coverage Part; (3) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or "suit'; and (4) Tender the defense and indemnity of any claim or "suit' to any other insurer or self insurer whose policy or program applies to a loss we cover under this Coverage Part. But if the "written contract' requires this insurance to be primary and non-contributory, this provision (4) does not apply to insurance on which the additional insured is a Named Insured. We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a claim or "suit." D. Only for the purpose of the insurance provided by this endorsement, SECTION V —DEFINITIONS is amended to add the following definition: "Written contract" means a written contract or written agreement that requires you to make a person or organization an additional insured on this Coverage Part, provided the contract or agreement: 1. Is currently in effect or becomes effective during the term of this policy; and 2. Was executed prior to: a. The "bodily injury" or "property damage'; or b. The offense that caused the "personal and advertising injury," for which the additional insured seeks coverage under this Coverage Part. All other terms and conditions of the Policy remain unchanged. G-140331-D (Ed.01/13) Page 2 of 2 Material used with permission of ISO Properties, Inc. POLICY #: GL2074978689 EFFECTIVE: 10/01 /2020 Copyright, CNA All Rights Reserved. POLICY NUMBER: GL2074978689 EFFECTIVE: 10/01 /2020 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Any construction project as required by a written contract or agreement that was executed prior to the date of loss. I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. J A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction 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 hazard," and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits." 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction 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 Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. CG 25 03 05 09 Copyright, Insurance Services Office, Inc., 2008 Page 1 of 2 B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which cannot be attributed only to ongoing operations at a single designated construction 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 General Aggregate Limit or the Products -completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III — Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, Insurance Services Office, Inc., 2008 CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Waiver of Transfer of Rights of Recovery Against Others to Us This endorsement modifies insurance provided under the following: Commercial General Liability Coverage Form Under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, The Transfer Of Rights Of Recovery Against Others To Us Condition is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: 1. Your ongoing operations; or 2. "Your work" included in the "products completed operations hazard." However, this waiver applies only when you have agreed in writing to waive such rights of recovery in a contract or agreement, and only if the contract or agreement: 1. Is in effect or becomes effective during the term of this policy; and 2. Was executed prior to loss. This endorsement is part of your policy and takes effect on the effective date of your policy, unless another effective date is shown below. Must Be Completed ENDT. NO. POLICY NO. 26 GL 2074978689 Complete Only When This Endorsement Is Not Prepared with the Policy Or Is Not to be Effective with the Policy ISSUED TO: EFFECTIVE DATE OF THIS ENDORSEMENT: Granite Construction Incorporated 10/01/20 G-15115-A (Ed. 10/89) POLICY NUMBER: GL2074978689 EFFECTIVE: 10/01 /2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CHANGES - NOTICE OF CANCELLATION OR MATERIAL COVERAGE CHANGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART In the event of cancellation or material change that reduces or restricts the insurance afforded by this Coverage Part (other than the reduction of aggregate limits through payment of claims), we agree to mail prior written notice of can- cellation or material change to: SCHEDULE 1. Name: Any person or organization you are required by written contractor agreement to mail prior written notice of cancellation or material change. 2. Address: Per Certificates of Insurance on file with the broker. 3. Number of days advance notice: For non-payment of premium, the greater of: • the number of days required by state statute or • the number of days required by written contract For any other reason, the lesser of: ■ 60 days or the number of days required in a written contract G-15115-A Page 1 of 1 (Ed. 10/89) CNA71527XX (Ed. 10/12) ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Persons Or Organizations Any person or organization whom the named insured is required by written contract to add as an additional insured on this policy. 1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II — LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy. 2. The insurance afforded to the additional insured under this policy will apply on a primary and non-contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the "accident" for which the additional insured seeks coverage under this policy. All other terms and conditions of the Policy remain unchanged. CNA71527XX (10/12) Page 1 of 1 Policy No: BUA2074978692 Endorsement No: Effective Date: 10/01 /2020 Insured Name: Granite Construction Incorporated Copyright CNA All Rights Reserved. POLICY NUMBER: BUA2074978692 COMMERCIAL AUTO CA04441013 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. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Granite Construction Incorporated Endorsement Effective Date: 10/01/2020 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization for whom or which you are required by written contract or agreement to obtain this waiver from us. 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 Copyright, Insurance Services Office, Inc., 2011 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Notice of Cancellation or Material Change — Designated Person or Organization This endorsement modifies insurance provided under the following: Business Auto Coverage Form In the event of cancellation or material change that reduces or restricts the insurance afforded by this Coverage Part, we agree to mail prior written notice of cancellation or material change to: SCHEDULE 1. Name: Any person or organization you are required by written contract or agreement to mail prior written notice of cancellation or material change. 2. Address: Per Certificates of Insurance on file with the broker 3. Number of days advance notice: For non-payment of premium, the greater of: • the number of days required by state statute or • the number of days required by written contract For any other reason, the lesser of • 60 days or • the number of days required in a written contract This endorsement is part of your policy and takes effect on the effective date of your policy, unless another effective date is shown below. Must Be Completed ENDT. NO. POLICY NO 19 BUA 2074978692 Complete Only When This Endorsement Is Not Prepared With the Policy Or Is Not to be Effective_ with the Policy ISSUED TO: EFFECTIVE DATE OF THIS Granite Construction Company ENDORSEMENT 10/01 /2020 c,Irva Countersigned by t. Authorized presents jve EA/M 19B B 18 G-39543A Endorsement # 15 Notification to Others of Cancellation — lElectronic Schedule Policy No. I Eff. Date of Pol. I Exp. Date of Pol. EOC 5087922-18 1 10/01/2022 1 10/01/2023 Named Insured and Mailing Address: GRANITE CONSTRUCTION INCORPORATED P.O. BOX 50085 WATSONVILLE, CA 95077 Eff. Date of End. I Producer 19 ZURICH Add'I Prem. I Return Prem. 10/01/2022 1 52154000--_------ Producer: ALLIANT INSURANCE SERVICES, INC. 100 PINE ST FL 11 SAN FRANCISCO, CA 94111-5113 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: Contractor's Protective Professional Indemnity and Liability Insurance Policy In consideration of the premium already charged, we agree with you, subject to all terms, exclusions, and conditions of the policy that: A. If we cancel this policy by written notice to the first "Named Insured" for any reason other than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation: 1. To the name and address corresponding to each person or organization shown in the Schedule provided to us by the first "Named Insured". Such Schedule: a. Must be initially provided to us within 15 days: (1) After the beginning of the policy period shown in the Declarations; or (2) After this endorsement has been added to the policy; b. Must contain the names and addresses of only the persons or organizations requiring notification that this Policy has been cancelled; c. Must be in an electronic format that is acceptable to us; and d. Must be accurate. Such Schedule must be updated and provided to us, by the first "Named Insured", during the policy period. Such updated Schedule must comply with paragraphs b., c., and d, above. 2. At least thirty (30) days prior to the effective date of the cancellation, as advised in our notice to the first Named Insured, or the longer number of days notice if indicated in the Schedule provided to us. B. If we cancel this Policy by written notice to the first "Named Insured" for non-payment of premium, we will mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or organization shown in the Schedule provided to us by the first "Named Insured" at least 10 days prior to the effective date of such cancellation. Such schedule shall meet the requirements outlined in item A. 1. C. Our notification, as described in Paragraph A. or B. of this endorsement, will be based on the most recent Schedule provided to us by the first "Named Insured" as of the date the notice of cancellation is mailed. D. Proof of mailing will be sufficient proof that we have complied with Paragraph A. or B. of this endorsement. E. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the Schedule provide to us as described in Paragraph A. of this endorsement. All other terms and conditions of this policy remain unchanged. STF-CPP-171-B CW (07/11) Page 1 of 1 CNA Workers Compensation And Employers Liability Insurance Policy Endorsement BLANKET WAIVER OF OUR RIGHT This endorsement changes the policy to which it is attached. It is agreed that Part One - Workers' Compensation Insurance G. Recovery From Others and Part Two - Employers' Liability Insurance H. Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE - Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure. The amount is 2%. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: G-19160-B (11-1997) Endorsement Effective Date: Endorsement Expiration Date: Endorsement No: 6; Page: 1 of 1 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Policy No: WC 2 74978630 Policy Effective Date: 10/01/2022 Policy Page: 53 of 83 191 Copyright CNA All Rights Reserved. CNA Workers Compensation And Employers Liability Insurance Policy 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 perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. Schedule Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover from under a written contract or agreement. The premium charge for the endorsement is reflected in the Schedule of Operations. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: WC 00 03 13 (04-1984) Endorsement Effective Date: Endorsement Expiration Date: Endorsement No: 32; Page: 1 of 1 Underwriting Company: Transportation Insurance Company, 151 N Franklin St, Chicago, IL 60606 Policy No: WC 2 74978644 Policy Effective Date: 10/01/2022 Policy Page: 296 of 442 Copyright 1983 National Council on Compensation Insurance. CNA G-20472-A (Ed. 10/93) WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY NOTICE OF CANCELLATION OR MATERIAL CHANGE ENDORSEMENT In the event of cancellation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of days advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule 1. Number of days advance notice: For non-payment of premium, the greater of: • the number of days required by state statute or • the number of days required by written contract For any other reason, the lesser of: • 60 days or • the number of days required in a written contract 2. Notice will be mailed to: Any person or organization you are required by written contract or agreement to mail prior written notice of cancellation or material change. Address: Per Certificates of Insurance on file with the broker This endorsement changes the policy to which It Is attached and is effective on the dale Issued unless otherwise stated. (The information below Is required only when this endorsement Is issued subsequent to preparation of the policy,) Endorsement Effective 10-1-22 Policy No. WC274978630 Valley Forge Insurance Company WC274978644 Transportation insurance Company WC 99 06 06 G-20472-A Page 1 of 1 (Ed. 10/93) AC a0 CERTIFICATE OF LIABILITY INSURANCE 08/15/2023"' 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 andorsement s . PRODUCER LTC #OC36861 1-415-403-1491 CONT. T Kimberly Leikam AMF Alliant Insurance Services, Inc. PHONE 415-403-1491 q/� :415-874-4818 EMAIL kleikam®alliant.com 560 Mission Street, 6th Floor ADDS = INSURER(S) AFFOROINOCOVERAGE NAIL A San Francisco, CA 94105 _ INSURER A:COLUMBIA CAS CO T 31127 INSURED INSURER B : Granite Construction Company INSURER C 585 West Beach Street INSURERD: INSURER E : Watsonville, CA 95076 INSURER F: CAVFROGFS CFRTIFICOTF Nl1MRFR- 69445754 RFVISInN NI1RARFR- 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. I TR TYPE OF INSURANCE /10UL BR 1611" lea POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE EAOCCURPREMS ff— S =f $ MED EXP An one erson $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY1:1 .IEET` 11 LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SIN LE LWI _Ln accid $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTYOAMAGE _(P_er ag-Otall $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ 1 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N PER oTH- E ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPFRATIONS h_e_In_w E.L. DISEASE - POLICY LIMIT S A Cyber Liability 596744793 09/30/22 09/30/23 Limit of Liability 1,000,000 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Job #TBD / EMERGENCY WORK - WASHINGTON ST. - AVENUE 47 Evidence of Cyber Liability insurance as required by written and executed contract. CFRTIFICOTF NnI nFR CONCFI I OTIC]N 2250 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of La Quinta THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Ubaldo Ayon ACCORDANCE WITH THE POLICY PROVISIONS. 78495 Calls Tampico AUTHORIZED REPRESENTATIVE La Quints, CA 92253 ���yyy���JJJ �;% USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD schultzv 69445754 SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE 08/15/2023 NAME OF INSURED: Granite Construction Company The named insured reserves its rights to provide any additional coverages under the policies above to only those expressly negotiated for by contract.