2022/03/01 Hill Crane Service, Inc.RisK
o^le {rIloD/YYYY'
022412022
THIS CERTIFICATE IS ISSUED AS A MAI"TER OF TNFORUANON ONLY ANO CONFERS NO RIG}fTS UPON THE CERTIFICATE HOLDER, tHIS
CERTIFICATE DOES NOT AFFINMAT1VELY OR I{EGATTVELY AHEND, EXTEND OR ALTER THE COVERAGE AFFOROED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S}, AUTHORIZED
REPRESENTATIVE OR PRODUCER, ANO THE CERTIFICATE HOLOEN.
IMPORTANT: l, tho cedflcato hold.r l. nn ADOITIONAL INSURED, lho pollcy(lca) muir hrvc AODITIoNAL INSURED provlslons or lro endorsod.
lf SUBROGA?IO IS WATVED, Eublscl to tho term6 end condltlonr ofthe pollcy, cerlaln pollcles may rcqulre en endor8ement. A Elrlement on
thls certlllcote dos8 not conlsr rlght6 to th6 certlficste hold€r in lleu o, auch endoreement{s}.
?ROOUCEi
Tolm€n I Wiker InBurance Servicer, LLC
136 S, F[ Sfeet
PO Box i3ag
cA s3002-1388
(805) 58s€798 (005) 58Sr€79€
lhansen@tolmanandwlker,aoln
tIsuRER(S) ATFOQOlllG COVER G€
ht8uici A . Cl€ar Blus Sp€ciBlty ln6 Co 377 45
Hill Crane Servkre. lnc.
3333 Chorry Avonuo
LonO Beach cA 90807
i{luRERa. Clear Bluo lns Co 28960
btsur€F c - Zu.ici Am6rlc6n 16535
[!9un6Ro. lndian H6rhor ln6 Co s09.0
NAURERE
CERTIFICATE OF LIABILITY INSURANCE
CERT|F|CATENUi|BERT 2,,23GUAU/xs/wcCOVERAGES REVISION NUMBER.THIS IS TO CERTIFY TTIAT TtIE POI"ICIES OF INSURANCF LISTEO 8EI"OW HAVE BEqN |SSUED TO THE INSUEEO NAMED AAOVE FOR TNE POLICY PEFIIOI)
INOICATEO NOTWITHSTANOING ANY REOUIREMENT. TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CER1 IOATE M^Y EE ISSUEO OR MAY PERTAIN. THE IN$URANCE AFFORDED BVTHE POI-t(:I€B OESQFIBEO HEREIN IS SUBJECl TO ATLTHE TERMS,
EXCLUSIONSAND CONOITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HA!€ BEEN REDUCED BY PAID CLAIMS.
CO{TTERCIAL GENERAL LTABILITY
cL^rMs u^oE ffi o""ro
oN , hooK
OVER THE ROAD
GEN'L AGGREGATE LIMIT APPLIES PETI.
r,unt"ffi JECT
AWo3-RS-210008802 o31o1t2022 03101t2023
s 1.000.000
PnEMTSEt {E, @d..,/-.)s 250,000
MEO HxP (AnV m p.Mh)s r0,000
PERBONAL !AOV INJUBY s 1,000.000
GENERAT A6GREGATE r 2,O00,0o0
PR()Otr(i rs, coliF/oP AGo ( 2,000,000
a
^uto oBr!! LrAE[rY
OWIEO
BrR€O
SC'lEDULEO a3n1t2t)u 0310112024a
(:oMB$r€o 8rrict,t r,Mrr s 1.000.000
aOOILY I\JURY (P6r p.r*sl 3
E()oltY rN.tlrRY lPqr..ld. l t
UMEIELLA IJAB
EtCE'!LIAB
x
CLAIMS.MADE AWM2100029,02 olio1t2022 o3tol12023
s 5.0o0.0o0xr 5,O0O,000
I
c
WoE(Ent ColrP€tlSaiibir
ANO EUPLOYERG' LIABILTTY
ANY PROPFIETOIT,PAFTNEfu E\ECUTIVEO[r.rOEnIuC$ggR TiXCllJO!O')
OEgCRIPTION OF OPEFATIO']S b€ie
wc5084565-10 11t01t?Q21 11101t2022
x PCR otl'l,
E I E CI] ACCTOCNT s 1,000,000
EL DISEASE - EA EMPLOYEE i'1,000,000
EL DISE/ISE. POTICY LITIIT s 1.000.000
D
EXCESS sxs0056130"02 031o112023 $5,000,000
ss.000.000
DECCRIPIIOI| OF OPEtAtIONa / LOC tIONS / v€HlcLES IACOf,D tot, Addh|on.r R.Mrtr &hrdel.. Dy b. intxh..t il ror rpft. l' rcqdr.jl)
Rei 1,2. GLr Certlflcate Holdor ls Addltlonal lnsurod as respects to Operatlons ot tho Namod lnsured por fonn CG20101001. EndoBemont applles only as
rcquirsd by cunoflt wntten contrsct on 616. "GL: EXCLITDES ALL WFAP/OCIP PROJECTS
ACORO 25 (20r6i03)
RH LLATION
@ 1988.m15 ACORD CORPORATION, All dghts rolrw.d.
the ACORD n.me and lo0o.re .rgistered niarls ol ACORO
EI{OUID ANY OF TIIE ABOVE DTECRIEED POLICIES BE CAI{CELLED SEFORE
TtiE EXTIRATION OA'E TIIEREOF, NO'TICE 9IILL BE DELUENED N
ACCOXOAT{CE Y{ITH T}IE POLICY PROVlalo{S,Clly of Monllo€
20714 Hsun Rosd
cA v2s86 A*
U'IHOFIZEO hgFRESEIYAIIvE
^-il-
I
I
AWo2-RS-210005842
Each Occunenc€
Agorogele:
03n1t2022
POLICY NUMBER: Awo3Rs22ooo6$'02 COMMERCIAL GHNERAL LIABILITY
cG 21 54 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
EXCLUSION - DESIGNATED OPERATIONS COVERED BY
A CONTROLLED (WRAP-UP) TNSURANCE PROGRAM
This 6ndo.somcnt modifies insurance provided under the following
COMMERCIAL GENERAL LIABILIry GOVERAGE PART
SGHEOULE
DoscrlptJon And Locatjon(E) Or Operalioo({:
Any and all consolidated insurance program wrap-up locations
lnformation required to complete lhis Schedule, if not shown above. will be shown in the Declarations
A. Tho following oxclusion is added to Paragaph 2.
Excluelone of Sectlon I - coverago A - Bodlly
Inlury And Propody Damag6 Llablllty:
This insurance does not apply to "bodily injury" or
"property damage':
1. Arising out of your ongoing operations; or
2. lncludod in the "prodrrcts-comploled oporations
hazard":
at the location(s) described in the Schedule of this
endorsemenl. bul only if you are enrolled in a
"controlled (wrap-up) insurance program" with
respecl to the "bodily injury" or 'property damage"
described in Paragraphs A.1. and A.2. above al
such location(s),
This exclusion applies whether or not the
"controlled (wrap-up) insurance program":
a, Provides covorago identical to that providod
by this Coverage Part:
b, Has limits adaquato to cov6r all claims: or
c. Remains in effect.
B. The following definition is added to the Dofinltlons
sectionl
"Controlled (wrap-up) insurance program" means
a c€ntralazed insuranco program undor which oneparty has secured eithor insuranco or solf-
lnsurance covorlng som€ or ail of th6 contractors
or subconlractors porforming work on ono ot more
spGclflc projoc(s).
cG 21 U 1219 O lnsurance Servioes Offioe, lnc., 2018 Page 1 of 1
POLICYNUMBERi AW03RS220006$-02 COHIIERCIAL GENERAL LIABILITY
cG 20,t010 0't
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifieg ingurance provided under the follo ring:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Nam€ of Percon or Organlzation: Any person or oqanization for whom you aro pertormlng op€ratlons wh6n
you and such person or organization have agreed in writing in a cont,act or agreement thst such person or
organization be added as an additional in6ured on your policy.
(lf no 6ntry app€ar6 abov€, lnformatlon roquirod to complete thls gndoG€m€nt will b€ Ehovrn in tho Doclaretions as
applicable to this endoBemenl.)
A. S€ction ll - Who lt An lnsured is amended to
includo as an lnsured the porson or organizatlon
sholvn in the Sohedule, but only wilh respoct to
liability arising out of your ongoing operations per-
formod for thal insured.
B" With respect to the insurance afforded to these
additional insureds, the following exclusion is
addod:
2. ErcluSlonS
This insurance does nol apply to "bodily in-
jury" or "propsrty damags" occurring after
(l) All work, including materials, parts or
oqulpmBnt furnlshod in connoction with
such work, on the proiect (other than
seNice, maintenance or h6peir0) to be
performed by or on behalf of the addi-
tional insured(s) at the site of the cov-
ered operations has be6n completed;
or
(2) That po(ion of "your work" out of which
the injury or damage ads€s has be€n
put to its inl€nd6d usG by any person or
organization other than another crn-
tractor or subcontractor ongagod in
performing operalions tor a principal as
a part of the same project.
cG 20 10 10 01 O ISO Propertios, lnc., 2000 Pago l ofl tr
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.