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Insurance - Tunnelworks Services Inc. 2016-10-26TUNNE-1 OP ID: SW `a`vRo DATE YYI CERTIFICATE OF LIABILITY INSURANCE 612 01 10126/2016 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 pollcy(ies) must 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 (leu of such endorsement(s). PRODUCER Cornerstone Commercial & Personal Insurance Services 7365 Carnellan St. Rancho Cucamonga, CA 91730 Philip E Hakopian CONTACT NAME: _ PHONE - — xt, - FNQ No: wo ---- - ADw1Ess: _ INSURER(SI AFFORDING COVERAGE NNCO INSURER A:.tat8Colo LIMITS INSURED Tunnelworks Valdez Services, Inc Nicole Valdez ylCompensation IN8URERB:COiOn Insurance Company - _ INSURERC: 13235 Helmer Drive INSURER 0 Whittier, CA 90602 INSURER E: _ $ 1,000,00 INSURER F: X COMMERCIAL GENERAL LIABILITY L:VVCHAGts CERTIFICATF NIIMRFR• RcvlelnM NUMRRR. 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. INTSRR TYPE OF INSURANCE A -- - POLICY NUMBER POUCY EFF TPOLICY MMIDDIYYYY EXP MWD LIMITS Costa Mesa, CA 92627 GENERAL LMBIUTY EACH OCCURRENCE $ 1,000,00 B X COMMERCIAL GENERAL LIABILITY X X �103GL0006910-02 10/2412016 1012412017 ENTED— PREMISES Ea ocwrrence $ 100,00 j MED � EXP (Any om Person) $ 5,00 CLAIMS4AADE n OCCUR r PERSONAL B ADV INJURY_ $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 PROOUCTS-COMPIOPAGG GEN'L AGGREGATE LIMIT APPLIES PER: $ 2,000,00 POLICY PIFCT RO ' LOC $ AUTOMOBILE LIABIL$TY BINEDi SINGLE LIMIT Ea $ i BODILY INJURY (Per parson) S ANY AUTO AOSCHEDULED AUU TOSS AUTOSNON-OM 'BODILY INJURY (Per accitlent), $ EO ACCIDRTY ENM GE $ HIRED AUTOS AUTOS PER � $ II (UMBRELLA LMB OCCUR EACH OCCURRENCE $ AGGREGATE _ _ $ EXCESS LAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- X AND EMPLOYERS' LIABILITY YIN L 5ER A ANY PRCPRIETORIPARTNERIEXECUTIVE X 19099073-16 05/0912016 0610912017 E. L. EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCWDED9 NIA -- E.L. DISEASECAEMPLOYEE $ 1,000,00 (MarMete,I.NMI nySCRIPTI N OF O DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1.000,00 DESCRIPnON OF OPERATIONS I LOCATIONS I VEHICLES (ANaeh ACORD 101, MdINonSI RemaHR Sehetl01e, H mol. apace Is requln ) JobN314 Grade 5 Phase 4 Repairs Certificate Holder, its directors, officers, employees, agents and volunteers are all named as Additional Insureds. General Liability Endorsement attached with WC Waiver of Subrogation to follow CERTIFICATE HOLDER CANCELLATION ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The Costa Mesa Sanitary District AUTHORIZED REPRESENTATIVE 628 W 19th Street Costa Mesa, CA 92627 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD ACORO "' CERTIFICATE OF LIABILITY INSURANCE TUNNSER-01 FSTEPANIAN DATE (MM/OD/YVYY) 10/7/2016 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(les) must 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 License # OG19762 Momentous Insurance Brokerage Inc 5990 Sepulveda Blvd., #550 Van Nuys, CA 91411 INSURED Tunnelworks Services Inc. 13502-H Whittier Blvd, Ste 165 Whittier, CA 90605 NAMEM41 Chris FerrarisPHO_ (NC, 14%Ext):(816) 574-0424 FAX No): (818) 574-0466 ADDRESS: chris.ferraris@mmibi.com _ INSURER(S) AFFORDING COVERAGE NAIC p INSURERA: California Automobile Insurance Company �38342 INSURER D: INSURER E: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTH E POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSR LTR TYPE OF INSURANCE ADDLISUBR'I INSD MD POLICY NUMBER POLICY EFF POLICY EXP MMIDDA'YYV MMIDDIYYYY I LIMITS COMMERCIAL GENERAL LIABILITY 1 ! EACH OCCURRENCE $ _ III rDAMAGE TO RENTED CLAIMS -MADE J OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) l'i $ _ PERSONAL B ADV INJURY $ GENU AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D PES __. LOC PRODUCTS - COMP/OP AGO $ OTHER' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) _ A X 12/12/2015112/12/2016 BODILY INJURY (Per _ $ ANY AUTO iBA040000019527 person) ALL OWNED SCHEDULED BODILY INJURY (Per accident)I $ AUTOS (AUTOS L- _ 'NON -OWNED PROPERTY DAMAGE 'I, $ HIRED AUTOS _1 AUTOS (Per accident) $ UMBRELLA LIAB I'i OCCUR EACH OCCURRENCE $ EXCESS LIAB 1 CLAIMS -MADE AGGREGATE $ 7 DED I I RETENTION$ $ WORKERS COMPENSATION j PER OTH- OR AND EMPLOYERS' LIABILITY :____STATUTE _. VIN ANY PROPRIETORI E.L. EACH ACCIDENTOFFICERIMEM$ EXCLUDED? 'NIA EXCLUDED? (Mandatory H) .(Mandatory in NH) E.L. DISEASE- EA EMPLOYEE $If yedescribe under E.L. DISEASE- POLICY LIMIT 1 $s, DESCRIPTION OF OPERATIONS below II ' DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: #314 Grade 5 Phase 5 Repairs Costa Mesa Sanitary District, its directors, officials, officers, employees, agents, and volunteers are named as an additional insured on the Auto Liability Policy per the attached form. Costa Mesa Sanitary District 628 W 19th Street Costa Mesa, CA 92627 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 103 GL 0006910-02 POLICY NUMBER: 103 GL 0006910-02 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 The Costa Mesa Sanitary District, its directors, officers, All persons or organizations as required by written employees, agents and volunteers contract with the Named Insured 234 E 17th Street #205 Costa Mesa, CA 92627 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 B. 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 ads 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. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to the insurance afforded to these additional insureds, the following additional exdusicns 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. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 103 GL 0006910-02 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 Colony Insurance Company - Company Profile - Best's Credit Rating Center A.M. Best Rating Services Colony Insurance Company u A.M. Best#:003283 NAIC M 39993 FEIN M 541423096 Mailing Address View Additional Address Information P.O. Box 469012 San Antonio, TX 78246 United States Web: www.colonvspecialtv.com Phone: 804-560-2000 Fax: 804-560-0820 Page I of 3 Financial strength Rating t BEST Assigned to insurance companies that have, in our opinion, an excellent ability to meet their ongoing insurance obligations. Based on A.M.Best's analysis, 058448 - Argo Group International Holdings. Ltd is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure. View a list of operating insurance entities in this structure. Best's Credit Ratings Financial Strength Rating View Definition Rating: A (Excellent) Affiliation Code: g (Group) Financial Size Category: XII ($1 Billion to $1.25 Billion) Outlook: Stable Action: Affirmed Effective Date: October 22, 2015 Initial Rating Date: June 28, 1993 Long -Term Issuer Credit Rating View Definition Long -Term: a Outlook: Stable Action: Affirmed Effective Date: October 22, 2015'�I Initial Rating Date: June 29, 2005 u Denotes Under Review Best's Rating '.. Best's Credit Rating Analyst '.. Rating Issued by: A.M. Best Rating Services, Inc. '.. Senior Financial Analyst: Susan Molineux Director: Jennifer Marshall, CPCU, ARM Disclosure Information View A.M. Best's Rating Disclosure Form A M Best AffiirmsA M Best Affirms Ratinf Argo Group International Holdings Ltd and Subsidiaries? Assigns Ratings to ARIS Title Ins Corp.Corpof Argo Group International Holdings Ltd and Subsidiaries Assigns Ratings to ARIS Title Ins Corp October 22, 2015 Rating History A.M. Best has provided ratings & analysis on this company since 1993. Financial Strength http://www3.ambest.com/ratings/entities/SearchResults.aspx?AltSrc=9 10/27/2016 List of Approved Surplus Line Insurers (LASLI) California Department; of Insurance Insurance Protection for All Californians Page 1 of 7 List of Approved Surplus Line Insurers (LASLI) Please use the "Find" option in the "Edit' menu of your browser to search for a particular company. List is current as of: September 7, 2016 AIB=DIE-GIH=LLCM-PDQ=Z 9 Insurer Date Approved Acceptance Casualty Insurance Company (Nebraska) 10/23/2007 ACE European Group Limited (U.K.) 06/20/2007 Admiral Insurance Company (Delaware) 06/30/1995 Adriatic Insurance Company (North Dakota) 06/30/1995 AIG Specialty Insurance Company (Illinois) (Name changed from Chartis Specialty Insurance Company effective 10/01/2013) 06/30/1995 AIX Specialty Insurance Company (Delaware) 06/05/2009 Allianz Global Corporate & Specialty SE (Germany) (Name Changed from Allianz Global Corporate Specialty AG effective 11/13/2013) 06/16/2004 Allied World National Assurance Company (New Hampshire) (Name changed from Newmarket Underwriters Insurance Company effective 10/03/2007) 12/18/1997 Allied World Surplus Lines Insurance Company (Arkansas) (Name changed from Darwin Select Insurance Company effective 06/03/2014) (Name changed from ULICO Indemnity Company Effective 05/13/2010) 12/22/1995 American Empire Surplus Lines Insurance Company (Delaware) 09/01/1995 American Western Home Insurance Company (Oklahoma) 09/01/1995 Arch Insurance Company (Europe) Limited (U.K.) 10/19/2009 Arch Specialty Insurance Company (Missouri) (Name changed from Rock River Insurance Company effective 08/01/2002) (Domicile changed from Nebraska to Missouri effective 09/30/2014) 09/01/1995 Aspen Insurance UK Limited (U.K.) 12/29/2004 Aspen Specialty Insurance Company (North Dakota) (Name changed from Dakota Specialty Insurance Company, effective 10/22/2003) 03/03/1998 Associated Industries Insurance Company, Inc. (Florida) 01/11/2012 http://www.insurance.ca.gov/01-consumers/120-company/07-lasli/lasli.cf n 10/27/2016 Company Profile Company Profile Company Search Company Search Results Company Information Old Company Names Agent for Service Reference Information NAIC Group List Lines of Business Workers' Compensation Complaint and Request for Action/Appeals Contact Information Financial Statements PDF's Annual Statements Quarterly Statements Company Complaint Company Performance & Comparison Data Company Enforcement Action Composite Complaints Studies Additional Info Find A Company Representative In Your Area View Financial Disclaimer COMPANY PROFILE Company Information STATE COMPENSATION INSURANCE FUND 333 BUSH STREET SAN FRANCISCO, CA 94104 877-405-4545 Old Company Names Agent For Service CORPORATE LEGAL STATE COMPENSATION INSURANCE FUND 5880 OWENS DRIVE, 3RD FLOOR PLEASANTON CA 94588 Reference Information Effective Date NAIC #: 71 35076 California Company ID #: 0449-9 Date Authorized in California: 01/01/1914 License Status: UNLIMITED -NORMAL Company Type: Property & Casualty State of Domicile: CALIFORNIA back to top NAIC Group List NAIC Group #: 0000 Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. WORKERS' COMPENSATION back to top © 2008 California Department of Insurance Page 1 of 1 https://interactive.web.insurance.ca.gov/companyprofile/companyprofile?event=company... 10/27/2016