2021/03/01 Hill Crane Service, Inc.OR
COVERAGES
CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NUUBERI 21122 OL/AU,(S''/VC REVISION NUMBER:
10t2212021
THIS CERTIFICATE IS ISSUED AA A
"ATTER
OF IIIFORUATION ONLYANO CONTERS NO RIGHTS UPON IHE CERTIFIGATE HOLDER, THI$
CERNFICATE DOES T'IOT AFFIRMATIVELY OR I{EGATIVELY AMEIID, EXTEND ORALTER THE COVERAGE AFFORDED BY IHE POLICIES
BELOW, THI$ CERTIFICATE OF I SURANCE POES NOT CONSTMJTE A CONTRACT BET|IVEE THE ISSUING INSURER(S}, AUTHORIZEO
REPRESENTATVE OR PROOUCER,AT{D THE CERTIFICATE HOLOER.
IftIPORTANT: il Itre centlcite iroidei'ia sriI66moNAL INaURED, tho pollcy{les} musl hevo AODITIONAL INSUREb provistonr or bo oniiorsiid.
lf BUBROGATION 13 WAIVED, Erblect to the lerrn! and condltlonE of the pollcy, cert.ln pollcler may rcqulre rn endoftement. A stat€ment on
thl8 cortlllcote doer hot conlsr rlghte to lhe c.dficrte holdEr in lleo ot auch ondorsem6ot(s).
PRODUCIi
Tolm€n 8 Wiker InBurEnce Servlceo, LLC
196 S, Flr Street
Po 8ox 1 368
cA 93002-1398
iftlcr JennlLr Hansen
P,5" co'. (80s156557qu (80s1 5896798
lhansen@lolmanandwlker,com
ltsuaER(s) alroeD]NG covgFloE
rilunEi ^
| Gl6tr glut sp€ciElty lni co ?7745
Hillclsne S€rvk€ lnc
3333 Cherry Ayonue
Loig B€ech cA 00807
tisuRERB. Clear Bluo hrs Co 28660
u{suRER c Zudch Amsrlcsn 16535
,{guFER D. lndian Harbor lns Co 36e40
IIISURER E .
THIS IS TO CERTIFYTHATTTiE POLICIES OF INSURANCE IISTED BELOW hAVE BEEN ISSUEO TO THE INSUFIEO NAMEOABOVE FOR TI"IE POLICYPERIOD
INDICATEO. NOTWITHSTANDING ANY REOUIREMENI TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMEI{T WITH RESPECT TO WHICH THIS
CERTIFICATE MAY EE lsSUEO OR MAY PERTAIN, THE INSTJRANCE AFFORDED BVTHE POIICIES OESCRIBEO HEEEIN IS SUBJECT TO AtL THE IERMS.
EXCLUSIONSANO COTiDTTIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED 8Y PAIO CLAIMS,
UUITS
COI!I'EIClAL GENERAL LIAS]LITY
cLArMs.M^oE E o""ro
ON - HOOK
OVER TIiE ROAD
GEML AGGREGATE LIMIT AOPLIES PET
or,-n t ffi ,'GCT
AWo3- RS-2 1 00069-01 03t0112021 a3ta1l2a2a
s 1.000.000
PnETiSES iEsodur&{.)s 250,000
MCD ExPlAny ffi p.Mn)$ 10,000
PENSONAL (AOV IIIJUNY s 1.000.m0
GE'.IEN I A66REGATE r 2,0o0,m0
r'R()ou(:rs. c(rMP/r)P A(ilt ! 2.000,000
s
B
auTotaoErlE U Blrfi
OIINED SCTiEDUTEO AWo2,RS-21 0005&01 031o112021 o3,al/2022
oo.aiNf,r, sur(it E | lllrr s 1,000.000
AOOLY INJURY(Pe,t*rt$)s
BODTLY hTJURY {lts rf,i.,.r'l}Ji
n
3
EICEAELIAg
x
AW042100029-0.1 03ta1/2o21 o3to1t2022
3 5.00o,00oxs 5,000.000
!
c
rcaxERa coxPEtiE^llota I{O EIIPLOYEFA' UABILfTY
ANY PAOFRIETO'{P F'NER/E.iECUTIVE
OFFICEIVMEMEER EXCLlJ6EO?
DESCRIPTION OF OPERATIONS O€I(*t
wc5084565.10 11nln021 11t01m22
x PER orH.
E L. EACh ACCIDCNI ,1,000,000
F I.. DISFASF . FA FMPI,OYFI:e 1,000,000
E L, DISEASE. POLICY LIVIT s 1,00o.0o0
o EXCFSS
03101t2022 96,000,000
$s,000.000
OEECRIFTD{ OF OFERAtlOllG / LOCAnOIS MB|GLAA hCOiD l0l. Adrlion.l i.nub G.n dcL. nty b. io.h.d lt ruE .p-. L Dqtrr.d)
REr1,2 GLrCerlitiBte Holdcr bAddltlonal lnsuod ag respec!9 to Oporollons of lho Named lnsured por fo{m CO20100413. EndoBetnont nppllcs ooly n9
rEquirBd by cunBnt wntlen contrBd on file- "'GL: EXCLUDESALL WRAP/OCIP PROJECTS
R
AHOULDAT{Y OT TXE AAOVS DSACRISIO PALICIEE BS CANCSLLEO BETORI
THE EXPIRATION DATE THEREOF. iIOTICE WILL BE DELIVERED IiI
ACCORDANCE IYIIH THE POLICY PROVISIOTIS.
cA 92586 2*,-,e
4UTHORTtEO kEpREggr.rIArrvE
ACORD 25 (2016/03)
@ 1988.20tE ACORD CORPORATIOiI, All rlght3 rcre.vcd
The ACORD nente and logo are r0,gialered merk. ot ACORD
]N9UREO
03to1t2vz1sxs0056130"01 Each occurlencc:
A0C16{ato
Ctty ol Monifso
20714 Haun Rosd
R CERTIFICATE OF LIAB]LITY INSURANCE
CERflFEATENUMBER. 21/22CllAur(s^,vcCOVERAGES REV'SION NUMBER:
10t2212021
THIS CERTIFI6ATE IS ISSUED AA A MATTER OF I}IFORMATION ONLYANO CONFERS NO RIGHTS UPON THE CERTIFrcATE TIOLDER, T'IIS
CERIFICATE DOES l{OT AFFIRi,IAIIVELY OR NEGATIVELY AUEND, EXTEND OR ALTER I}lE COVERAGE AFFORDED BY ll.lE POLICIES
BELOW. THIS CERnflCATE OF TNSURANCE pOES NOT CONSTmJTE A CONTRACT BSTWEEN THE |SSUtr{G TNSURER(S), AUTHORTZED
REPRESENTATIVE OR PRODUCER,AND TH€ CERTIFICATE HOLOER,
IMPORTANT: lf tho conlflc.te hotdoiie inADI
lf SUBRoGAflON lS WAIVED, rublect to the lerms rnd condlllonr ot the pollcy, cerlrln pollcler m.y rcgulre .n endorlgment. A lta(emenl on
lhl8 col.llllcate do€B not coniar rlghts to ths certificate hold€r in lleu ot auch endorsemeot(a).
PROOUCER
Toh€n E Wiker lneurEnce SeMc€B. LLC
1 96 S, Fh Street
Po Box 1 388
cA 93002-1388
(805) 585S798 (8O5) 585-6798
lhansen@lolmanandwlker,corn
lxsuRER(a) AFroRDrxc covgR oP
ftluREia, ClqBr Bluo spocislty lns Co 37745
INSUREO
Hill Cr.ne Servlcq, lnc
3333 Chon'y Avonug
Loig Beach cA 90807
!,rsuRER B. Clear Bluo hrg Co 28080
ltsuncR c. Zutich Aherlcsn 16535
fisrrnER o. lndian H€rbor lns Co 3€e40
IIISURER E
LtMlfs
CO'IIERCIAL GENERAI LIABIUIY
OVER THE ROAD
GEML AGGREGATE LIMIT APPLIES PE'Txlicr
aw03-Rs-21 m089,0 1 0310112021 03i01t2a22
s 1.000.000
DnEMiSES i€3 wur'|.).n)s 250 000
MED EXP (Anv om n mn)r 10,000
PERSONAL ( 'trIV INJUFT s 1.000.000
GENEqATAGGREGAIE , 2,0o0,m0
PHOOI'C rS, COr,lPt)P ACO s 2,000,000
s
B
AUTOIIOgILE LI^BILfi
OWNED
AL]TOS ONIY
SCHEDULEOAUIOS AW02 -R S-2't 00058 01 a3lo1t202',l o3l01/2022
s 1,000.000
EODTIY lNJtlRY iPg,*e$))
BODITY INJURY lPs ffii.rso s
t
s
Ul.ARELTA UAE
EXCEA6LIAB
x
CLAIM!.MAOE AW04210002$01 o3to1t2o21
3 5.m0.000xs 5,000.000
c
v{o&xEFa coIPEraE rloir
ANO EUPLOYEIS' UAALTY
ANY PROFRIEIO'.1/P^RTN€FITEXECUTIVE
OEFICERr1NEMgER EXCTUOEO'
DE9CRTFT|ON OF O!2€RATTONS bo{}r/
wc50M565.10 11tolt2021 11t01r2o22
x PER oi8
EL E CR ACCIOENI r 1,000.000
F,I.. DISEASF -FAEMP'-OYEF $ 1,000,000
E L DISEASE . POLICY Li'JIT ,1,000.000
0 EXCESS 5XS0056130"01 43to1t2021 03101D022 €ach Ocrurrenca
A09160at6:
$6,000,000
ss.000.000
OEGCRIFTION OF OtEt lloNg/IOCAIIONE/VEIiICLEA (ACORD to't, Arldrt,oo.l t.|rxrir 8.h.dul.. dt h. rru.h.n Imr rp*. t nqlrrd|
REr 1,2 GLr Cerlirioa(e Holder is Addltlonal lnsurod a9 respectg lo Oporoiloos ol lho Nomed lnsured Dor form CG20100413. Endorsemont dpplles only ier.qu'Ed by currBnt writ6h coritred on file. "GL: ExcLUDES ALL WRAP/OCIP PROJECTS
CERT
SIIOULOANY OF THE AAOVS DEACRIATD POLIC|SA BE CANCELLED BEFORE
THE EXPIRATION DATETHEREOF, T{OTICE II'ILL BE DELIVERED IN
ACCOROANCE ffTH TXE POLICY PROVISIOIIS,
cA 92586
Clty ol Moniloo
29714 Hsun RoHd
/,-e ,-,a
AUTfl OFIZEO FEFFEIgI{'AIIVE
ACORD 25 (20r6/03)
THIS IS TO CERIIFYTHAT TXE POI.ICIES OF INSURANCE LISTED BETOW }IAVE SEEN ISSUEO TO THE INSUREO NAMEO ASOVE FORTHE POLICY PERIOP
INDICATEO, NOTWITHSTANDING ANY REOUIREMENI TERM OR CONDITION OF ANY CONTRACT OR OIXER OOCUMENT WITH RESPECT TO WHICH THIS
CERIIFICAtE MAY EE ISSUEO Oft MAY PEffAIN,IHT INSI,,RANCE AFFOROEb EY lHE POIICIES OESCFIBED HEREIN IS SUBJECTTO AIt THE TERMS,
EXCLUSIONSANO COIIOITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAIE SEEI] REDUCED gY PAIO CLAIMS.
] ".n,*.rnoo fi o""ro
oN " HOOI(
s
03t0112022
t
T ETTITEFT ]
| 1,G,.r.,,,r,u r
I
@ 1988.ml5ACORO CORPORATION. All rlghta.osorvcd.
The ACORD nante and logo are reoirtcrcd m.rks ol ACORD
AC'fu CERTIFICATE OF LIABILITY INSURANCE
CERTIFTCATE NUiIBER: 21l22 GL/AU/xS&vcCOVERAGES REVISIOTI NUMBER:
10t2^2t2021
TTIIS CERTIFICATE IS ISSUEO AS A ilIAITER OF INFORUATIoN ONLYATiD CONFERS NO RIGTTTS UPON T}IE CERTFICATE HOLDER, THIS
CERTIFICATE DOES I.IOY AFFIRIIATIVELY OE NEGATIVELY AMEND, EXIEND OR ALTER IIIE COVERAG€ AFFONDED BY THE POLICIES
BELOW. THrS CERnFTATE OF INSURANCE pOES NOT CONSTTTUTE A CONTRACT AETWeEN rHE TSSUTNG
'XSURER(S),
AUTHORTZED
REPRESENTATIVE OR PRODUGER, AND THE CERNFICATE HOLDER.
IMPORTANT l, tho certlflcrto hoid.ili an ADbIiIotiIftn-SURED. t@UEEEprovHons or bG endoBod
lf SUBROGATION 19 WAlvED, subioct to lho terms and condltlons of the pollcy, cert.tn policles may requho an endorsemont. A statomeot ofilhlr ce(ltlcate doea not cohrer rlgh(r to lhe cenltlcate holder ln lleu o, auch endoGe ment(r).
PROOUCER
Tolman A Wker lneuraflc€ S€rvic€s, LLC
196 S Fir Str€ot
FO Bor 1 3ag
cA 03002-1348
ixllfur JonnllerHansan
fX8l,[ E,tl {8os) 585-67s8 (805) 585-6798
ihansonC0tolmanandvrikor com
NS!RER(S) A6FORDTNO COV!tAGE
,{!uREi A . Cl6Fr Blu€ Spaci€lly In6 Co 37745
Hill Crane Servlce. lnc.
3333 Cherry Avenue
Lo6g Boach cA 90807
itsurEn E. Clear Bluo |ls Co 28860
btsuREi c. Zudch Amorlcen 16535
[r9uR€io, lndien Harhor ln6 Co 309d0
THIS I$ TO CERTIFY THAT TTIE POLICIES OF INSURANCE I.ISTED BELOW I{AVE BEEN ISSUED'TO ThE INSUR€O NAMEO AAOVE EOR THE POLICY PERIOD
IND'CATEO, NOTWTHSTANDINGANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTI{ER OOCUMEMT W|TH RESPECT TO WHICH THIS
CeRTITIC^'E MAY b( ISSUT.O OR M^Y PT.EIAIN, IHE INSURANCE AFTOAOED BY IHE POLICIES OI.SCRIBEO HTR[IN IS 5I'8J[CT TOALL ITIE IEIIMS,
EXCLUSIONSANO CONDITIONS OF SUCH POLICIES. LIMI.rS SHOWN MAY HAVE BEEN REOUCED BY PAIO CLAIMS,
s 1,000.000
nafrr,.,a: t ! ,rr ,-, rnr s 250,000
MED EIP (A.y os D.M^r ,'to,0o0
rIERSONAL ( AOV ]NJURY s 1.000.000
! 2,O00,o00
PHOOUC tS - COMP/(JP AOC!r 2,000,000
COXT'€RC IAL GE NERA L LiAAIL[Y
GEML ^GGFECATE LIMITAOPTIES 9Eq
troN " HOO(
CLAIIIIS MADE
*u"' ffi !["g
AWo3,R$2100060-01 03/01/2A2-\c3t01t2022
s
r I,000,000
BOOILY TNJURY (Po e.66)s
EI)OILY TNJURY (pd.ac1d6r,jBo',1r1!o
AIJTOS ONLY SCHEOULEOAUTOS
AUtorroElLl fnEIltv
AW02€921 0005S-01 03to1t2021 ouo t 12022
sxs 5.000.m0xEICEGS Lt a AGGAEGATE r 5,000,000a3!o1t2021 D310112022
aXl 8ff u,,oTi,l
ER
E L EACITACCIDINT r 1,000.000
F L OISFASE . FA FMPL OYFF s 1,000,000c
lrcFxERS COrPEraCAnOr
At{D gi.PLOYEFSI LIABILIYY
ANY PROPRIETOR/PAFTNEFUO(ECUTIVE
OFFICERAIEMSER EXCI.I,IDED'
DEgCnlFTTOl{ Or OPERATION9 D€ro{
wc5084565- 1 0 11/O112021 11n11m22
5 1.0o0,0o0EL OIgEAsE. POLICY LIMII
o FXCESS sxs003613041 03101t2021 o3to1t2022 Each Oocunenc€
Aggregat6:
s5,000,000
t5.000.000
DEGCRIIIloll OF OPEFlllONS , LOCAIIONS / VEHlCtEa (ACORD l0l, A(drilon.l R.h.ri. S!i.del.. f:y b. ntet d It Eor. .p... L Equlr.dl
RE; 1,2. GLr Cerllfloate Holdor ls Addltlonal lnsured as r*peols to OperDllons ol tho Namod lnsured p€r form CG20100413. Endorsemonl applles only as
roquirod by cudsnl writterr sontrect orr fils. "GL: EXCLUDES ALL WRAPiOCtP PROJECTS
EII
HOLDER
C{ty ol Monlloo
2071,1 Hsun Rosd
cA C2586 /,-e,-e
ar-tf HonlzEb happle! frrYlvts
ACORD 25 (20,r6/03)
OVER THE ROAD
SHOULDANY 9T THE AE9VE DEECRIBED POLICIEE BE CATICELLEO SEIORE
THE EXPIRATION DATE IHEREOF, NOTICE IVILL BE DELIVERED IN
ACCORDANCE WITII TI{E POLICY PROVISIONE,
I
@ 1988.4115 ACORO CORFORA?IOI{. AII rlghts roilrvod,
The ACORD h.me and logo.re r.Cialcred markr ot ACOnD