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Insurance - Tunnelworks Services, Inc. 2018-06-18TUNNE-1 OP ID- RRC . is O CERTIFICATE OF LIABILITY INSURANCE �� 006/181201AM YY) 06/78/2018 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 909-941-9080 CONTACT Philip E Hakopian Cornerstone Commercial 8. Personal Insurance Services PHONE 009-941-9080 FAX 909-941-9050 RED Etl :INC, No): E-MAIL , p II cornerstoneinsurance.org 9340 Baseline Road, Ste 103 Rancho Cucamonga, CA 91701 Philip E Hakopian INSURERS) AFFORDING COVERAGE NAIC # INSURERA: Colony Insurance Company / INSURED Tunnelworks Services, Inc INSURER B: State Compensation Ins Fund Willie I Jeff MED EXP (Any onePerson) 5.000 12213 Philadelphia Street INSURER C: D Whittier, CA 90601 -L INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER' 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. INSR I TR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A XCOMMERCIAL GENERAL LIABILITY 1-71 CLAIMS -MADE OCCUR 103GL0006910-03 10/24/201710/24/2018 EACH OCCURRENCE 1'000,000 DAMAGETORENTED 100,000 MED EXP (Any onePerson) 5.000 PERSONAL B ADV INJURY S 1,000,000 QEN'LAGGREQAT LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/ PAGG 2,000,000 POLICY L X PRO - LOC OTHER: AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT BODILY INJURY Per erson ANY AUTO BODILY INJURY Per scadent OWNED SCHEDULED AUTOS ONLY AUTOS DAMAGE P�Oa ERdYnt AUTOS ONLY AUOTOS ONLB UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAB CLAIMS -MADE DEC RETENTION$ B WORKERS COMPENSATION AND EMPLOYERS'UABIUTY YIN ANY PROPRIETORIPARTNEWEXECUTIVE COFFICER/MEMBER EXCLUDED4 Hyl (Mantlato'yIn NH) NIA 9099073-18 05/09/2018 05/09/2019 X PER OTH. E.L. EACHA IDENT 1,000,000 E.L. DISEASE - FA EMPLOYEE 1,000,000 If yes, descnbe uneer DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1,000,000 A Pollution CSP307294 0712112017 07/21/2018 Pollution 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached R mare space is required) RE:#314 Grade 5 Repairs Phase 10 Costa Mesa Sanitary District, its agents, representatives, employees, or subcontractors shall be covered as additional Insureds with respect to the work or operations performed by or on behalf of the CONTRACTOR, including materials, parts, or equipment CFRTIFICATF HOLDFR CANCFI I ATION COSTAME SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Costa Mesa Sanitary District 290 Paularino Avenue Costa Mesa, CA 92626 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD HOLDER CODE COSTAME TUNNE-1 PAGE NOTEPAD. INSURED'S NAME Tunnelworks Services, Inc OP ID: RRC pate 0611812018 furnished in connection with such work; and (2) the insurance coverage shall be primary insurance as respects DISTRICT, its directors, officials, officers, employees, agents, and volunteers, or if excess, shall stand in an unbroken chain of coverage excess of the CONTRACTOR'S scheduled underlying coverage. Any insurance or self-insurance maintained by DISTRICT, its directors, officials, officers, employees, agents, and volunteers shall be excess of the CONTRACTOR's insurance and shall not be called upon to contribute with it in any way.Said policy shall not terminate, nor shall it be canceled nor the coverage reduced, until thirty (30) days after written notice is given to the District. Any other insurance maintained by the Costa Mesa Sanitary District shall be excess and non-contributing with the insurance provided by this policy. TUNNSER-01 TLYLES A`Ro CERTIFICATE OF LIABILITY INSURANCE DATE 05/2412 Y1'Y) 05/2412018 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 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 License # OG19762 Momentous Insurance Brokerage Inc 5990 Sepulveda Blvd., #550 Van Nuys, CA 91411 COMEACT Janice Ray PHONE FAX (MC, No, Ext): (818) 574-0888 (A/C, Nn):(818) 933.2287 AEbmDARIEss.janice.ray@mmibi.com INSURERS AFFORDING COVERAGE NAIC N INSURER A: California Automobile Insurance Company 38342 EACH OCCURRENCE $ INSURED INSURER B INSURER C : TunnelWOrks Services Inc. INSURER D 13502-H Whittier Blvd, Ste 165 Whittier, CA 90605 PRODUCTS - COMP/OP AGG $ NSURER E INSURER F: LIABILITY ANVAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COVERAGES CERTIFICATE NUMBER: RFVISIQN NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED EBEMISES Ea .nr n MED EXP (Any oneperson)$ PERSONAL B ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ A AUTOMOBILE I LIABILITY ANVAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BA040000019527 12/12/2017 12/12)2018 EOMBINEDSINGLE LIMIT $ p'seidum 1,000,000 BODILY INJURY Per arson $ BODILY INJURY Per accident $ ROPERTV DAMAGE Per accident $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOMPARTNEWEXECUTIVE FFICER/MEMBER EXCLUDED? Mandatory In NH) Ryes, describe under DESCRIPTION OF OPERATIONS below NIA I PER OTH- E ER E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) Evidence of Insurance Costa Mesa Sanitary District 290 Paularino Ave Costa Mesa, CA 92626 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 AGORD 25 (2016/03) ©1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD