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Insurance Certificates 2025/26 Performance Concrete Services IncMelody Espinoza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 11/10/2025 KYC Insurance Services LLC 17777 Center Court Dr Ste 710 Cerritos CA 90703 Alan Redekosky 562-473-4080 (562) 473-4074 certs@kycinsurance.com PERFORMANCE CONCRETE SERVICES INC 2674 E Main St Ste 193 Ventura CA 93003 Houston Casualty Company 42374 Infinity Select Insurance Company 20260 U.S. Specialty Insurance Company 29599 Clear Spring Property and Casualty Company 15563 C 6 6 6 BI/PD Ded $1,000 6 Y Y U25AC155428-02 06/30/2025 06/30/2026 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 B 6 Y 50006097601 09/30/2025 03/30/2026 1,000,000 A 6 6 Y Y H25XP51684-00 11/05/2025 06/30/2026 2,000,000 2,000,000 D Y Y CWC01833802 03/31/2025 03/31/2026 6 1,000,000 1,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of La Quinta is listed as additional insured for both ongoing and completed operations as per CG 20 10 07 04 and CG 20 37 07 04 with a waiver of subrogation and primary/non-contributory wording as per HCS 040 06 10 13 with respect to general liability when required by written contract. Additional insured as per 50461AIS01 with a primary/non-contributory wording as per 500PNCV01 with respect to Commercial Auto Liability when required by written contract. Waiver of subrogation as per WC 04 03 06 (Ed. 04-84) with respect to Workers Compensation when required by written contract. Excess Liability follows form for General Liability and Commercial Auto Liability. 30 days notice of cancellation. Public Works / Engineering Department 78495 Calle Tampico La Quinta, CA 92253 City of La Quinta POLICY NUMBER: U25AC155428-02 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1  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):Location(s) Of Covered Operations Any person or organization for whom you are performing operations during the policy period when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. 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. 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. POLICY NUMBER: U25AC155428-02 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1  ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Any person or organization, when you and such parties have agreed in writing in a contract or agreement pertaining to “your work” performed during the policy period. This additional insured coverage does not apply to “excluded residential construction". "Excluded residential construction" means: a) the ground-up construction of any building whose units will be individually owned and titled; and, b) “your work” performed on the conversion of any building into a condominium or townhome. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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". POLICY NUMBER: U25AC155428-02 COMMERCIAL GENERAL LIABILITY HCS 040 06 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HCS 040 06 10 13 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PRIMARY AND NONCONTRIBUTORY AND BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. PRIMARY AND NON-CONTRIBUTORY TO OTHER INSURANCE With respect to any person or organization that is an additional insured under this Coverage Part, the following is added to paragraph 4. of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: If you have agreed in writing in a contract or agreement that this insurance is primary and non- contributory relative to an additional insured’s own insurance, then this insurance is primary and we will not seek contribution from that other insurance. For the purpose of this endorsement, the additional insured’s own insurance means insurance on which the additional insured is a Named Insured. When this endorsement is attached to the policy it supersedes all other insurance conditions within. B. WAIVER OF SUBROGATION – BLANKET 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: a.Your ongoing operations; or b.“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: a.Is in effect or becomes effective during the term of this policy; and b.Was executed prior to loss. ST-White ADDL INSURED COPY AMEND DATE : 11/06/2025 50461AIS01 ENDORSEMENT : 6-2 Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Customer Service: (800) 722-3391 Claims Service: (800) 353-6737 ADDITIONAL NAMED INSURED ENDORSEMENT Copy To Policy ID Number Expiration Date 50006097601 03/30/2026 12:01 a.m. Named Insured PERFORMANCE CONCRETE SERVICES INC La Quinta Public Works/Engineering Department 78495 Calle Tampico La Quinta, CA 92253 This endorsement is attached to and forms a part of the listed policy. No changes will be effective prior to the time changes are requested. Additional Insured La Quinta Public Works/Engineering Department Part A - Liability Coverage, is changed as follows: The definition of insured is changed to include the additional insured named above. Adding an insured will not increase the limit of our liability. The insurance provided by this endorsement will be excess over any other valid and collectible insurance. All other parts of this Policy remain unchanged. ST-White ADDL INSURED COPY AMEND DATE : 11/06/2025 500PNCV01 ENDORSEMENT : 6-2 Kemper Auto Commercial 11700 Great Oaks Way, Suite 450 Alpharetta, GA 30022 Underwritten by: Infinity Select Insurance Company Customer Service: (800) 722-3391 Claims Service: (800) 353-6737 PRIMARY AND NONCONTRIBUTORY ENDORSEMENT Copy To Policy ID Number Expiration Date 50006097601 03/30/2026 12:01 a.m. Named Insured PERFORMANCE CONCRETE SERVICES INC La Quinta Public Works/Engineering Department 78495 Calle Tampico La Quinta, CA 92253 This endorsement is attached to and forms a part of the listed policy. The following endorsement applies only if Form Number 500PNCV01 appears on your Declarations Page. This endorsement modifies the insurance provided under your COMMERCIAL AUTO POLICY. PART A – LIABILITY COVERAGE OTHER INSURANCE – PART A ONLY The following is added to this section: The coverage afforded under your Commercial Auto Policy is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: a.You have agreed in writing in a contract or agreement that the coverage afforded under your Commercial Auto Policy would be primary and would not seek contribution from any other insurance available to such additional insured; and b.Such additional insured is a named insured under such other insurance. ALL OTHER TERMS, LIMITS, CONDITIONS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENTCALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 5% of the California workers’ compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description CITY OF LA QUINTA PUBLIC WORKS/ENGINEERING DEPARTMENT 78495 CALLE TAMPICO,LA QUINTA,CA, 92253 CITY SIDE WALKS GET REDUCED TO AVOID TRIP HAZARDS- THERE IS NO BLOCKING OF THE STREET OR ANY DUST PRODUCED. - THROUGHOUT CALIFORNIA 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 03/31/2025 Policy No.CWC01833802 Endorsement No.4 Insured PERFORMANCE CONCRETE SERVICES INC Premium $4,040 Insurance Company:Clear Spring Property and Casualty Company Countersigned by: