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Project 142 - Insurance - Atlas Underground - 1996-05-14 Th ,"'"I A PR , CERTIFICATE-OF LIABILITY INSURANLc 05 DATE MDD96 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR CALBOND SURETY INSURANCE AGENCY ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P 0 BOX 1748 COMPANIES AFFORDING COVERAGE y CORONA COMPANY L F_C4M.1'/ Ait 909 371-2027 A AIG—AMERICAN INT L —8-1:3R-P-IrtIS LINES INSURED COMPANY 'VAN "..*X ATLAS UNDERGROUND B AIG—NATIONAL UNION FIRE INS CO P 0 BOX 951 COMPANY CHINO, CA 91708-0951 C JOHN DEERE INSURANCE ( 909 ) 465-5710 COMPANY AX 909 465-5730 D COVERAGES • . . . . . 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. Ea TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE POUC EXPIRATION UMITS DATE(MM/DD/YY) DATE IMM/DD/YYI I GENERAL UABIUTY GENERAL AGGREGATE $2 , 000 000 © COMMERCIAL GENERAL LIABILITY PRODUCTS COMP/OP AGG s2 000 000 ■■ CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ 50, 000 © OWNER'S&CONTRACTOR'S PROT 91644—CA95110027 11/2995 11�29�96 EACH ENERAL OCCURRENCE E2 000, 000 El MODIFIED OCCUR FIRE DAMAGE(Any one fire) $ 50, 000 © BROAD FORM PD MED EXP(Any one person) $ 5 000 IAUTOMOBILE UAWUTY ■ COMBINED SINGLE LIMIT E1 000 000 ANY AUTO © ALL OWNED AUTOS BODILY INJURY © SCHEDULED AUTOS IPe pa nl E ■ HIRED AUTOS 91644—CA95110027 11/29/95 11/29/96 BODILY INJURY © NON-OWNED AUTOS IPe cldentl E 1111 ■ PROPERTY DAMAGE S I GARAGE UABIUTY AUTO ONLY EA ACCIDENT III IN■ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT 5 AGGREGATE E EXCESS '1, OTHER THAN UMBRELLA FORM EACH OCCURRENCE E UMBRELLA FORM AGGREGATE S E III WORKERS COMPENSATION AND ■ J EMPLOYERS'UABWTY .`�sa"•I'F'i- EL EACH ACCIDENT S THE PROPRIETOR/ ■ INCL EL DISEASE POLICY LIMIT $ PARTNERS/EXECUTIVE' OFFICERS ARE: ■ EXCL EL DISEASE EA EMPLOYEE 5 I OTHER RENTAL EQUIPMENT CIM-00444609 11/29/9 '( 11/29/16 $55, 000 DESCRIPTION OF OPBIATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS ALL OPERATIONS IN RESPECT TO THE LIABILITY COVERAGES ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED PROJECT RECONSTRUCTING FORCE MAIN FOR ADAM S PUMP STATION PROJECT #1112100-142 COSTA MESA SANITARY DISTRICT CERTIFICATE HOLDEN CANCELi.ATION .. SHOULD AN OF THE ABOVE CRIB POUC CANCELLED BEFO HE COSTA MESA SANITARY DISTRICT EXPIRATION DATE THEREOF THE ISSUING COMPANY mm.. .•./VE 234 E 17TH STREET 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. COSTA MESA, CA 92627 ATTN ROBIN B HAMERS . AUTHORIZED REPRE TAT- ADDITIONAL INSURED —�// ACORD 2$'6 11/9$j. - - o C• D CO0Pf5RAT10N '1988• * 10 DAY NOTICE FO NON t°_ , 1E - '.0 i 4, ,.. t , c ‘ ki -k '-ICalBond CalBond Surety Insurance Agency P.O.Box 1748 Corona,CA 91718 Your Surety Bond Marketplace , 1426 W 6th St.1 Suite 207 boron ,CA 91720 •1 I (09)371.8147•(714)8364345 /It 7 I t < 1 V FAX(909)371-2027 ‘ ), ''- '.. it i ,,,,, t 4 s'11'. 4 '‘ .' 114J'a turePiF ' 1 f May 17, 1996 ; , 1 .,.i 9 v I t., 4 IS j:4 ;4 s A' PA "7' A 1. ..6 441 A jr 41 L4-)5 4 I/ 4a„; "N. ,I, 4t i Ns P)15.3$‘i.3)% (4 ". Y., ti 1 ''''' A '4 i owe) 1'i 4 '1 1.4 p Jemcr 74A. ' r '' 1 •' ,, ■ t A) er 77 I , 41, Mr Robin B flamers i„ c 1 "1 "tt ) .) ' I. kt. i r , - p , ( Costa Mesa Sanitary District 4 r ,1 4 10',., r I' 234 E 17th Street 1 ,, i ;c•a i t t k $ , 11.'` CI, 1 Costa Mesa, CA 92627- , 44! \ 1 -0 I m ) Dear Mr , Haera, i , i ,..• ‘. .I.4• Per your request, enclosed please find a Certificate of Insurance 1 and Additional Insured on the account captioned above I am also well aware that you request Atlas Underground to Carry' an aggregate insurance limit of $5, 000, 000 To do so, it will require ' an umbrella policy of $3, 000, 000 above the current insurance. policy (see Certificate) 1 1 4 k 1 ? tits . e it 6 •i 65 C t,.4. As theft agent, I am prepared to adtivate the umbrella policy at any .t time However, since this job does not start until late June, will you allow my client to wait until then to activate the policy? } 4-4 Your consideration is appreciated Please advise , ,, NII„s .1 V 11 C, 4,7,t41744b,q t i 4 1 1 4 .‘'. 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