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2022/05/01 Claerwater Pipeline, Inc.--,.ACORD CLEAPIP-01 CERTIFICATE OF LIABILITY INSURANCE 612312022 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 BYTHEPOLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLOER. IMPORTANT: lI the certificate holder is an ADDITIONAL INSURED, tho policy(ios) must have ADOITIONAL INSUREO provislons or bo ondo.sed. It SUBROGATION lS WAIVED, subject to the lerms and conditions ol the policy, certain pollcies may requiro an endorsemont. A statemenl on this certitlcate dogs not confer rights to the certificatg hold€r in lieu of such ondorsement(s). RDING COVERAGE INSURER B : BENChMATK lnsurance Company -Trax INSURER O (951) 742.4679 pRoDUcER Lic€nse 7776 chad.hill hubinternational.com Middlesex lnsurance company 23434 41394 r Chad Hill PHONE (951) 779-8549No, E Clea.watsr Pipolino, lnc P.O. Box 357 P9.rls, CA 92572 HUB lntornatlonal lnsumnce Services lnc. PO Box 5345 Riv6rside, CA 925t7 ION N MBER: L THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REOUIREI\4ENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUI\.,IENT WTH RESPECT TO \M]ICH THIS CERTIFICATE MAY BE ISSUED OR [4AY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES, LIMITS SHO\AN MAY HAVE BEEN REDUCED BY PAID CLAIMS EACH OCCURRENCE DAMAGE IO RENTEO MED EXP rAnv one @rsonr PRODUCTS -COMP/OPAGG POLLUTION '1,000,000 PERSONAL A AOV NJURY 1,000,000 500.000 1s,000 2,000,000 't,000,000 3,000,000 A x 77373004 6129t2022 6t2912023x x x COMIUERCIAL GEI,IERAL LIABILIry OCCUR GEN'L AGGREGATE LIMIT APPL ES PER: LOC lc.erus-ueoe PD Oed: $2,000 "or""fxl359; fl OWNEDAUTOSONLY HIREDAUTOS ONLY 1,000,000 A0177373001 xt x x $ COMBINE O S]NGL E LIMIT SCHEOULEDAUTOS NONOVINEDAI-ITOS ONLY AUIOMOBILE LIABIUTY tl TEXCESS LIAB RETENTION $DEO C'cCUR 5t112023 OTH IT x 1,000,000 1,000,000 1,000,000 B WORKERS COIIIPENSATIONANO EMPTOYERS' LIABILITY ANY PROPR FTORTPARTNER]EXECUTIVE OFF CER/IVEMSER EXCLUOEDT OESCR PI ON OF OPERATIONS b6|ow csT5023528 5t112022 oESCRTPnON OF OPERAnONS / LOCAnOiIS / VEHICLES {ACORO i 0l, Addhlon.r R. rtr Sch.dulo, my b6 .t cn.d r m6 .p.c. l. EqulDd) RE: Encroachmenl PermiL The City of Meni{ee is Additional lnsured with regard to Goneral Liability when requi.ed by written contract per tha attached endorsement fotm CG20l0 04/13 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION OATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WTH THE POLICY PROVISIONS,City of Msnifge, Engineering Department 29714 Haun Road Monitee, CA 92586 AUTHORIZED REPRESENTATIVE @ 1988-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks ot ACORO ACORO 25 {2016/03) INSURER E: BOOILY INJURY (Per.@denu t PROPERTY DAMAGE{PdeeldBn0 S 612912022 612912023 Bop Ly TNJURy (perp6on) g Nr4.ru^-- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED . OWNERS, LESSEES OR CONTRACTORS . SCHEDULED PERSON OR ORGANIZATION This endorsement modjfies insurance provided under the following COMMERCIAL GENERAL LIABILIry COVERAGE PART SCHEDULE POLICY NUMBER: A0177373004 A. Section ll - Who ls An lnsured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but onlywith respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissionsi or 2. The acts or omissions of those acting on your behalf. in the performance of your ongoing operations forthe 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 lawi and 2. lf 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. COMMERCIAL GENERAL LIABILITY cG 20't0 04 13 B. Wth 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 organizalaonother than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. O lnsurance Services Office, lnc.,2012 Name Of Additional lnsured Person(s) Or Organization(s)Location(s) Of Covered Operations Any person or organization you are required to add as an additional insured under a written contract or agreement in effect prior to any acoident, injury, loss or damage All locations per written contract, agreement or permit. Description: All jobs performed that have a written contract, agreement, or permit. lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations cG 20 10 04 13 40177373 Middlesex lnsurance Company 00001 0000m0000 22173 0 N b3278ad6-7b2b 4dtl4€860-8d3c62r065c Page 1 of 2 06t22t2022 C. VMth respect to the insurance afforded lo these additional insureds, the following is added to Section lll - Limits Of lnsurance: lf 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 2. Available under the applicable Limits of lnsurance shown in the Declarations; whichever is less. This endorsement shall not lncrease the applicable Limits of lnsurance shown in the Declarations. cG 20 10 04 13 06t2z2a22 Page 2 oi 2 ao'177373 [,4iddlesex lnsurance Company O lnsurance Services Offlce, loc.,2012 ,-A,CORD'CLEAPIP-01 CERTIFICATE OF LIABILITY INSURANCE 6t23t2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND COI{FERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATTVELY AMENO, EXTEI.ID OR ALTER THE COVERAGE AFFORDEO 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 HOLOER. IMPORTANT: lf ths ce.tificate holdsr is an ADDITIONAL INSURED, tho policy(ies) must havo ADOITIONAL INSUREO provisions or bo ondorsed. lf SUBROGATION lS WAIVED, subject to the terms and conditions of tho policy, certain pollcles may requiro an endorsement. A statoment oo this certificato doqs not confer rights to tho cortillcate holdor in lieu oI such endo,sement(s). Chad Hill r) 779-8549 INS URER{S) AfFORDING COVERAGE [i6, r.r,(ssr)7424679 hmark lnsura!ce Compa ny chad.hil unen a ,Middlesex lnsurance Company URER B : BENC 4r394 23434 Clearwatsr Pipeline, lnc. P.O. Box 357 Perris, CA 92572 pRooucER Licenss # 0757776 HUB lnte.national lnsurance Sgrvices lnc PO Box 53,15Rivorside, CA 92517 COVERAGES s THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 'TO THE INSURED NAMED AAOVE FOR TH E POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENIv\,lTH RESPECTTO V"+IICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERIUS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHO1AA INAY HAVE BEEN REDUCED BY PAIO CLAIMS x 77373004 5t2912023lo, I 6129t2022 s S SMED EXP EACH OCCURRENCE ENTED POLLUTION PROOUCTS COMPACPAGG GENERAL AGGREGAIE PERSONAL & AOV]NJURY 1,000,000 Soo,ooo i5,000 X coMMqRcraL GENERAL LtaBtLtrY T- l .*,u..,l--': GEN'LAGGRECATE LIMITI "o,"" I xl 159_l oro* - x OCCUR x ADE ,000 LCrC OSNGLELMIT 1,000,000sAUTOMOBILE LNAILITY *"ro"cr""an"u l, $ AGGREGATE occirRl ]"*'r'r^* RETENTONSOE 5t1t2022 5t1t2023 v I FER I lorH- I^ STATUTE I ER E.L. EA.H AclrsENr ]! a..-. ora^sE -laEu",oral , a a.,"*aa -*r,"",,u,, L 1,000,000 1,000,000 1,000,000 sTs023528 B NEt DFsaRrFrrnN oF oPERATIoNS berd WORl<ERS COMPENSATION ANO EMPLOYERS' LIAAILITY /PARTNER/EXECUTIVE EXCLIJOEO? oESCRIPTION OF OPERATIONS / LOCATIOfl S I VEHICLES IACORD 101, Add'llon.l R.mrt3 Schodulo, ruy bo.nrch.d il moo ip...l. requiEd) City of irenilee ls Additional lnsured with regard to Geneial Liability when required by written contract per the attached endorsement form CG2010 04/13 City ol Monlfee 29714 Haun Road Monlfeo, CA 92586 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WLL BE DELIVEREO IN ACCOROANCE WITH THE POLICY PROVISIONS. AUTHORIZEO REPRESENTATIVE O'1988-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD ACORO 25 (2016i03) I l!'rsUEEE! l L tot urur , I'T3URER E : SGONz,/ Ti o"., orro A017?373001---1 owll€o - l scHEoL-EDL ] AU'OSO\LY L ] AUTOSXllf€o.o",., E]mug$ts 612912022 1 6l2gt2123 l morLy rf,,JURy {pd oronr sl_---_r-I I BoDILY riuURY lP* tudomr sI T-PRoPERTY fr IGE-TI lP6r.dd.nll 5 L ] uirBRELr-a uaB EXCESS UAA **M,^,- ATI( 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 POLICY NUMBER. A0177373004 A. Section ll - Who ls An lnsured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but onlywith respect to liability for "bodily injury", "property damage" or "personal and advertising in.lury" 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 forthe 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. lf 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. COMMERCIAL GENERAL LIABILITY cG 20 10 04 13 B. Wth 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 organizationother than another contractor or subcontractor engaged in performing operatlons for a principal as a part of the same project. O lnsurance Services Office, lnc.,2012 Page 1 ol 2 Name Of Additional lnsured Person(s) Or Organization(s)Location(s) Of Covered Operations Any person or organization you are required to add as an additional insured under a written contract or agreement in effect prior to any accident, injury, loss or damage. All locations per written contract, agreement or permit. Description: All jobs performed that have a writlen contract, agreement, or permit. lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations cG 20 10 04 13 40177373 Middlesex lnsurance Company 00001 000000mm 22173 0 N b3278ad+7b2b4!44.a86G8d3.6210665c 06122t2022 C. Wth respect to the insurance afforded to these additional insureds, the following is added to Section lll - Limits Of lnsurance: lf 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 2, Available under the applicable Limits lnsurance shown in the Declarations; whichever is less. This endorsement shall not increase applicable Limits of lnsurance shown in Declarations. of the the cG 20 10 04 13 06t22t2022 Page 2 ol 2 40177373 Midd!esex lnsurance Company O lnsurance Services Office, lnc.,2012