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HomeMy WebLinkAboutLD24-1464Permit Number: LD24-1464 LD - Utilities/ Access to Utility Agency Facilities Issued: 06/17/2024 Expired: 12/14/2024 Job Address: 32240 Temecula Pky Legal Description: City of Temecula - Land Development Division 41000 Main Street - Temecula, CA 92590 Mailing Address: P.O. Box 9033 Temecula, CA 92589-9033 Phone: (951) 308-6395 Fax: (951) 694-6475 Sung Baik 7391 Lincoln Dr Garden Grove, CA 92841 (714) 909-3912 Applicant: Frances Heredia 1373 Old Temescal Rd. Corona, CA 92881 (951) 277-0800 ext 235 Contractor: Utility Work Order Number: 5257994 Description: Charter Spectrum PID 5257994 WORK HOURS SHALL BE MONDAY – FRIDAY, NO HOLIDAYS, 9:00am - 2:00pm Location: Campanula Way Proposed work: Install new coax as shown on Charter "EXCAVATION PLAN 32240 TEMECULA PKWY, LD24-1464" All facilities shall be installed in accordance with City Standard Drawing 117. Traffic Control shall be in accordance with approved Traffic Control Plan LD24-1464 Permittee shall comply with all applicable Traffic Control General Notes. Safe pedestrian/bicycle traffic and driveway access shall be maintained at all times. Concrete repair shall be in accordance with City Standards and the Greenbook. Trench repair shall be in accordance with City Standard Drawing 407. Final compaction test results shall be provided by a soils engineer. Concrete curbs, walks, gutters, cross gutters and driveway approaches damaged during construction shall be removed from joint to joint and reconstructed in accordance with City Standards and the Greenbook. All disturbed landscaping and other improvements shall be removed/repaired and replaced to the satisfaction of Public Works Inspector. Permittee shall contact LDInspections@temeculaca.gov a minimum of two (2) business days prior to any work. Permittee must also request a final inspection, via LDInspections@temeculaca.gov, to verify completion of Page 1 of 3 Permit Number: LD24-1464 LD - Utilities/ Access to Utility Agency Facilities project. Permittee Responsibilities This Permittee agrees to indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Trench repair shall be pursuant to City of Temecula Standard Drawing No. 407. 3.Traffic control devices shall be utilized to protect and control pedestrian and vehicular traffic in the construction area in accordance with the latest revision of the “Manual of Uniform Traffic Control Devices for Streets and Highways” (MUTCD). The contractor shall submit a specific traffic control plan for review and approval by the City in accordance with City “Traffic Control Plan Guidelines” for all work within Major Circulation Element streets. 2.BEFORE YOU DIG - CALL (TOLL FREE) 800-422-4133 A pre-construction meeting is required two (2) business days prior to any scheduled work. Permittee shall contact LDInspections@TemeculaCA.gov to schedule a meeting. 1. 4. Water Quality: Contractor shall remain in compliance with the City Water Pollution Control Ordinance. Contractor is required to provide protection of the City storm drain system. 5. Work hours shall be limited between 7:30 AM and 4:30 PM, Monday through Friday, unless otherwise noted. No work shall be allowed during City-recognized holidays." 6. THIS PERMIT IS ISSUED AND ACCEPTED SUBJECT TO THE FOLLOWING CONDITIONS AND ANY ATTACHED PROVISIONS: All U.S.A. mark outs shall be removed prior to completion of project.7. 8.All contractors and subcontractors shall have a valid City of Temecula business license and valid Certificate of Liability prior to start of work. 9.Should there be any claim against the City and the property owner with the encroachment being the proximate cause, the property owner shall be notified in writing to remove the encroachment within 30 days or the City will remove and bill the owner. 10.Permission is hereby requested to encroach into public right of way to perform work as set forth above. It is understood that this permit is limited to the work described herein and that all work is to be done in compliance with the provisions attached to this permit and with all other applicable rules. Permittee shall be responsible for said compliance, for acceptability of the work, for repair or replacement thereof if defective, and for repair or replacement of any existing improvement damaged by the doing of the work I hereby certify and agree on behalf of the Permittee that all laws, regulations and ordinances of the City of Temecula and the State of California and the terms and conditions of the Permit shall be complied with whether herein stated or not. 11. 12.I hereby warrant and represent to the City that I am authorized to execute this Permit Application on behalf of the Permittee and bind the Permittee to the agreements contained herein and any conditions of the Permit. ******Contractor and all subcontractors shall be present at the pre-construction meeting; otherwise, the meeting will be rescheduled to a later date****** Any work commencing within the City right-of-way before permit issuance or a pre-construction meeting shall be subject to a 72-Hour suspension of said work and an assessment of double permit fees.13. Permitee Date Page 2 of 3 Permit Number: LD24-1464 LD - Utilities/ Access to Utility Agency Facilities City Engineer or Authorized Representative Date 06/17/2024 Page 3 of 3 TOTAL NEW CONDUIT BORE ASPHALT TRENCH CONCRETE TRENCH DIRT TRENCH (PARKWAY) REMOVE AND REPLACE CSW RESURFACING LF LF LF LF SQ. FT. SQ. FT. QUANTITY OF VAULT(s) & PED(s) 4 4 0 0 0 0 0 0 EXCAVATION PLANWORK ZONE VICINITY MAP N.T.S. N REV#DATE DESCRIPTION INT TOTAL EXCAVATION 4 Charter LF SIDEWALKRAILROAD T TREE R/R S/W FOC R/W EDGE OF PAVEMENT CURB FACE UNDERGROUND CENTER LINE CONCRETE RIGHT OF WAY FRONT OF CURB EXISTING FROM CURB FACE CL EOP CF U/G CONC EX FCFEOP C/L R/W FOC SYMBOL/LINETYPE DESCRIPTIONABBRV. TRAFFIC SIGNAL HAND HOLE FIRE HYDRANT STREET LIGHT MANHOLE VALVE PEDESTAL UTILITY POLE SYMBOL/LINETYPE DESCRIPTIONABBRV. HH F/H MH VLV PED SL TS W G SS SLC SD E T ELECTRIC TELEPHONE GAS STORM DRAIN SANITARY SEWER WATER OIL / PETROLEUMOIL STREET LIGHT CONDUIT SYMBOL/LINETYPE DESCRIPTION DESCRIPTIONABBRV. C&G CURB & GUTTERC&G VENT METERM DRIVEWAYD/W CURB FACE GUTTER LIP POLE MTR SIDEWALK DRAIN POLE ANCHOR FIBER OPTICFO CATVTV EXISTING STRUCTURES MISC. LE G E N D ADA RAMP BACKFLOW CONC.SIDEWALKCSW P PARKING METER STREET SIGN BEHIND CURB FACEBCF VERTICAL GROUND RODVGR OVERHEADO/H OF SHEET E-MAIL: DATE: SCALE: PROJECT: WORK LOCATION: SERVICE ADDRESS:THOMAS GUIDE: CITY OF TEMECULA5257994 CAMPANULA WAY / MEADOWS PKWY / TEMECULA PKWY(HWY 79) 32240 TEMECULA PKWY TEMECULA, CA 92592 1 3 03/26/2024 N.T.S. steven.gamilong@vvdcomm.net 979-F2 REVISION: CLIENT: TICKET# UNDERGROUND SERVICE ALERT OF SOUTHERN CALIFORNIA AT LEAST TWO DAYS BEFORE YOU DIG CONTACT 811 ENGINEER: VIDEO VOICE DATA 7391 Lincoln Way Garden Grove, CA 92841 714-897-6300 PROPOSED WORK LEGEND NO. OF CONDUIT LENGTH OF CONDUIT SIZE OF CONDUIT POTHOLE DIRT / ASPHALT BORE PIT DIRT / ASPHALT PROPOSED VAULT / PEDESTAL PROPOSED TRENCH BP PHPH BP SYMBOL/LINETYPE DESCRIPTIONABBRV. PROPOSED BORE CONCRETE REPLACEMENT / PROPOSED ANCHOR PROPOSED POLE / PROPOSED VGR ' " X X X KEY NOTE# LD24 - 1464 CONSTRUCTION NOTES: 1.BORE UNDER ALL CURBS AND GUTTERS. 2.PLACE VAULT OR PEDESTAL PARALLEL TO CURB. 3.USE SLURRY BACKFILL. 4.ALL CONDUITS SHALL BE SCH-40 UNLESS OTHERWISE SPECIFIED. ALL SWEEPS TO POLES SHALL BE SCH-80. 5.ALL CHANGES IN SKETCHES AND PERMIT LIMITS MUST HAVE PRIOR DEPT APPROVAL BY THE CITY'S PUBLIC WORKS DEPARTMENT/ENGINEERING DIVISION. 6.WHEN CROSSING EXISTING UTILITY LINES THAT ARE ALSO SAME DEPTH, PLACE NEW CONDUIT UNDERNEATH EXISTING UTILITIES TO PROVIDE ONE (1) FOOT MIN. VERTICAL CLEARANCE. 7.RESTORE DISTURBED LANDSCAPING & IRRIGATION. 8. ALL EXISTING STRUCTURES TO BE PROTECTED IN PLACE. 9. ANY SIDEWALK DISTURBANCE SHALL BE REPLACE FROM SCORE LINE TO SCORE LINE TO MEET CITY STANDARD. 10. TRAFFIC CONTROL NOTE: CONTRACTOR SHALL SET UP TEMPORARY TRAFFIC CONTROL PER APPROVED TRAFFIC CONTROL PLAN. 11. ALL PROPOSED FACILITIES SHALL BE PLACED BEHIND CONCRETE SIDEWALK OR IN GRASS/ DIRT AREA. 1. ASSUME SOLE AND COMPLETE RESPONSIBILITY OF THE JOB SITE CONDITIONS DURING THE COURSE OF CONSTRUCTION OF THIS PROJECT, INCLUDING THE SAFETY OF ALL PERSONS AND PROPERTIES THAT THESE REQUIREMENTS SHALL APPLY CONTINUOUSLY AND NOT BE LIMITED TO NORMAL WORKING HOURS AND CONDITION. THE CONTRACTOR FURTHER AGREES TO DEFEND , INDEMNIFY AND HOLD CITY OF TEMECULA, REPRESENTATIVES, AND ENGINEERS HARMLESS FROM ANY AND ALL LIABILITY, REAL OR ALLEGED IN CONNECTION WITH THE PERFORMANCE OF THE WORK ON THIS PROJECT. 2. PRIOR TO THE BEGINNING OF ANY CONSTRUCTION AND THROUGHOUT THE COURSE OF CONSTRUCTION WORK, THE CONTRACTOR SHALL FULLY COMPLY WITH THE "CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH" ACT OF 1973 INCLUDING ALL REVISIONS AND AMENDMENTS THERETO. 3. ALL WORK SHALL CONFORM TO THE LATEST EDITION OF GO 95, 128, AND THE STANDARD "SPECIFICATIONS FOR PUBLIC WORKS CONSTRUCTION", AS ADOPTED BY THE CITY, COUNTY OR STATE AS MODIFIED BY STANDARD PLANS AND ADDENDUMS. 4. THE EXISTENCE AND LOCATION OF UTILITIES AND OTHER AGENCY FACILITIES AS SHOWN HEREON ARE OBTAINED BY A SEARCH OF AVAILABLE RECORDS. OTHER FACILITIES MAY EXIST, THE CONTRACTOR SHALL VERIFY PRIOR TO THE START OF CONSTRUCTION AND SHALL USE EXTREME CARE AND PROTECTIVE MEASURES TO PREVENT DAMAGE TO THESE FACILITIES. THE CONTRACTOR IS RESPONSIBLE FOR THE PROTECTION OF ALL UTILITY OR AGENCY FACILITIES WITHIN THE LIMITS OR WORK, WHETHER THEY ARE SHOWN ON THIS PLAN OR NOT. 5. THE CONTRACTOR SHALL NOTIFY UNDERGROUND SERVICE ALERT AT 811, AT LEAST TWO WORKING DAYS PRIOR TO THE START OF ANY EXCAVATION. 6. THE CONTRACTOR SHALL NOTIFY THE INSPECTION DEPARTMENT AT LDInspections@temeculaca.gov A MINIMUM OF TWO DAYS BEFORE START OF ANY WORK REQUIRING THEIR INVOLVEMENT. 7. ALL WORK AREA AND STREET TRAFFIC CONTROL SHALL BE IN ACCORDANCE WITH THE SPECIFICATIONS OF THE MUTCD AND SPECIFICATIONS FROM THE CITY, COUNTY AND STATE. 8. THE CITY, COUNTY OR STATE SHALL SPECIFY THE EXPIRATION PERIOD OF THE PERMIT FOR THIS CONSTRUCTION PROJECT. 9. THE MINIMUM COVER FOR ALL CONDUITS PLACED UNDERGROUND SHALL BE 36 INCHES BELOW GUTTER. 10. THE CONTRACTOR SHALL PUNCH THROUGH & BORE ALL CURB AND GUTTERS AND BORE ALL CONCRETE DRIVEWAYS AND WALKWAYS AT THE DIRECTION OF THE CITY, COUNTY OR STATE INSPECTION. 11. ALL ASPHALT CONCRETE AND/OR CONCRETE PAVEMENT SHALL BE REPLACED AT THE DIRECTION OF THE CITY, COUNTY OR STATE ENGINEERS. 12. ALL SHRUBS, PLANTS OR TREES THAT HAVE BEEN DAMAGED OR DISTURBED DURING THE COURSE OF THE WORK, SHALL BE REPLANTED AND OR REPLACED SO AS TO RESTORE THE WORK SITE TO ITS ORIGINAL CONDITION. 13. IF DAMAGE OCCURS TO THE CITY OR COUNTY FACILITIES, THE CONTRACTOR SHALL IMMEDIATELY NOTIFY: CITY OF TEMECULA, PUBLIC WORKS DEPARTMENT AT TEL. NO. (951) 694-6411 STREET LIGHTING IS ALSO REPORTED TO THE CITY. 14. AT LEAST TWO DAYS PRIOR TO THE COMMENCEMENT OF ANY WORK, THE CONTRACTOR SHALL NOTIFY THE POLICE DEPARTMENT AND THE FIRE DEPARTMENT. 15. THE CONTRACTOR WILL BE RESPONSIBLE FOR THE PROCESSING OF ALL APPLICATION PERMIT FORMS ALONG WITH THE REQUIRED LIABILITY INSURANCE FORMS, CLEARLY DEMONSTRATING THAT THE CITY OF TEMECULA AS ALSO INSURED WITH THE REQUIRED LIABILITY INSURANCE FOR THIS CONSTRUCTION PROJECT. 16. VAULTS, PEDESTALS, CONDUITS AND ALL OTHER TYPES OF SUBSTRUCTURE ARE EITHER SPECIFIED ON THIS PLAN OR WILL BE SPECIFIED BY THE CONSTRUCTION ENGINEER. ANY AND ALL DEVIATIONS FROM THE SPECIFIED TYPES OF MATERIAL MUST BE APPROVED BY THE SYSTEM ENGINEER OR CONSTRUCTION ENGINEER, IN WRITING BEFORE INSTALLATION THEREOF. GENERAL NOTES INDEMNIFICATION CLAUSE: THE CONTRACTOR AGREES AND SHALL; TOTAL PULL THRU EX. CONDUIT (Rod & Rope)COAX 1,325 LF LF SITE PLAN FOR: TIE-IN TO EXIST. CHARTER HANDHOLE 1 IN DIRT, 1,325' ROD & ROPE NEW COAX THRU EXISTING CHARTER CONDUIT TO EXIST. CHARTER HANDHOLE 5, 4' BORE AND STUB TO R/W THEN PLACE BORE PIT. 1 5/3/24 CITY REDLINES SG INLAND ENGINEERING SERVICES, INC. CONTRACTOR: 1373 OLD TEMESCAL RD. CORONA, CA 92881 2 5/22/24 CITY REDLINES FB CLEARED BY CITY OF TEMECULA PUBLIC WORKS Tricia.ortega 06/17/2024 06/17/2024 06/17/2024 06/17/20 C L CL CL CL C L C L C L C L C L C L C L C L C L CL CL CL CL CLCL CL C L C L R/W R/W R/W R/W R/W R/W R/W R / W R / W R / W R / W R/W R / W R / W R / W R / W 100' 50' 50'16' 8' HH TV TV TV H H H H TV TV TV T V T V T V T V 1 3 3 2 2 1 0 0 ' 5 0 ' 5 0 ' 3 2 ' 1 8 ' 4 4 ' 6 ' 39 ' 82 ' 43 ' 31 ' 12 ' 27 ' 12 ' 6+00 5+00 4+00 3+00 2+00 1+00 1 + 0 0 2 + 0 0 3 + 0 0 1+0 0 1 + 0 0 0+0 0 0 + 0 0 365' 445' EX. HH1 EX. HH3 EX. HH2 32081 3220 595' 247' 2 9 8 ' 7' 7 ' 6' R/W R/W R/W R/W R/W R/W D/W D/W SEE DETAIL "A" 34' 42' C&G C&G C&G C&G C & G C & G R A I S E D M E D I A N R A I S E D M E D I A N C & G C & G 100' 50' 50' 38' 38' 12' 12' 100' 50' 50' 38' 38' 12' 12' C & G C & G RAISED M E D I A N 6' S/W 6' DIRT S/W R/WR / W R / W R / W R / W HH EXCAVATION PLAN REV#DATE DESCRIPTION INT 0 SCALE: 1"=40' 40'80' Charter SIDEWALKRAILROAD T TREE R/R S/W FOC R/W EDGE OF PAVEMENT CURB FACE UNDERGROUND CENTER LINE CONCRETE RIGHT OF WAY FRONT OF CURB EXISTING FROM CURB FACE CL EOP CF U/G CONC EX FCFEOP C/L R/W FOC SYMBOL/LINETYPE DESCRIPTIONABBRV. TRAFFIC SIGNAL HAND HOLE FIRE HYDRANT STREET LIGHT MANHOLE VALVE PEDESTAL UTILITY POLE SYMBOL/LINETYPE DESCRIPTIONABBRV. HH F/H MH VLV PED SL TS W G SS SLC SD E T ELECTRIC TELEPHONE GAS STORM DRAIN SANITARY SEWER WATER OIL / PETROLEUMOIL STREET LIGHT CONDUIT SYMBOL/LINETYPE DESCRIPTION DESCRIPTIONABBRV. C&G CURB & GUTTERC&G VENT METERM DRIVEWAYD/W CURB FACE GUTTER LIP POLE MTR SIDEWALK DRAIN POLE ANCHOR FIBER OPTICFO CATVTV EXISTING STRUCTURES MISC. LE G E N D ADA RAMP BACKFLOW CONC.SIDEWALKCSW P PARKING METER STREET SIGN BEHIND CURB FACEBCF VERTICAL GROUND RODVGR OVERHEADO/H OF SHEET E-MAIL: DATE: SCALE: PROJECT: WORK LOCATION: SERVICE ADDRESS:THOMAS GUIDE: CITY OF TEMECULA5257994 CAMPANULA WAY / MEADOWS PKWY / TEMECULA PKWY(HWY 79) 32240 TEMECULA PKWY TEMECULA, CA 92592 2 3 03/26/2024 1' = 40' steven.gamilong@vvdcomm.net 979-F2 REVISION: CLIENT: 1 5/3/24 CITY REDLINES SG TICKET# UNDERGROUND SERVICE ALERT OF SOUTHERN CALIFORNIA AT LEAST TWO DAYS BEFORE YOU DIG CONTACT 811 ENGINEER: VIDEO VOICE DATA 7391 Lincoln Way Garden Grove, CA 92841 714-897-6300 PROPOSED WORK LEGEND NO. OF CONDUIT LENGTH OF CONDUIT SIZE OF CONDUIT POTHOLE DIRT / ASPHALT BORE PIT DIRT / ASPHALT PROPOSED VAULT / PEDESTAL PROPOSED TRENCH BP PHPH BP SYMBOL/LINETYPE DESCRIPTIONABBRV. PROPOSED BORE CONCRETE REPLACEMENT / PROPOSED ANCHOR PROPOSED POLE / PROPOSED VGR ' " X X X KEY NOTE# CONSTRUCTION NOTES: 1.BORE UNDER ALL CURBS AND GUTTERS. 2.PLACE VAULT OR PEDESTAL PARALLEL TO CURB. 3.USE SLURRY BACKFILL. 4.ALL CONDUITS SHALL BE SCH-40 UNLESS OTHERWISE SPECIFIED. ALL SWEEPS TO POLES SHALL BE SCH-80. 5.ALL CHANGES IN SKETCHES AND PERMIT LIMITS MUST HAVE PRIOR DEPT APPROVAL BY THE CITY'S PUBLIC WORKS DEPARTMENT/ENGINEERING DIVISION. 6.WHEN CROSSING EXISTING UTILITY LINES THAT ARE ALSO SAME DEPTH, PLACE NEW CONDUIT UNDERNEATH EXISTING UTILITIES TO PROVIDE ONE (1) FOOT MIN. VERTICAL CLEARANCE. 7.RESTORE DISTURBED LANDSCAPING & IRRIGATION. 8. ALL EXISTING STRUCTURES TO BE PROTECTED IN PLACE. 9. ANY SIDEWALK DISTURBANCE SHALL BE REPLACE FROM SCORE LINE TO SCORE LINE TO MEET CITY STANDARD. 10. TRAFFIC CONTROL NOTE: CONTRACTOR SHALL SET UP TEMPORARY TRAFFIC CONTROL PER APPROVED TRAFFIC CONTROL PLAN. 11. ALL PROPOSED FACILITIES SHALL BE PLACED BEHIND CONCRETE SIDEWALK OR IN GRASS/ DIRT AREA. MATC H L I N E @ S T A 4 + 0 0 SEE S H E E T 3 KEY NOTES: 1 TIE - IN TO EX. CHARTER HANDHOLE IN DIRT STA. 5+95 - 7' BCF. 2 3 ROD & ROPE NEW COAX THRU EXISTING CHARTER CONDUIT EX. CHARTER HANDHOLE IN DIRT STA. 2+47 - 7' BCF. (EX. HH2) IN DIRT STA. 2+98 - 6' BCF. (EX. HH3) DETAIL "A" EXIST. CHARTER HANDHOLE 1 R/W 6' DIRT 6' S/W C&G TV LD24 - 1464 INLAND ENGINEERING SERVICES, INC. CONTRACTOR: 1373 OLD TEMESCAL RD. CORONA, CA 92881 2 5/22/24 CITY REDLINES FB CL CL CL CL CL CL R / W R / W R/W R/W R/W R/W R/W R/W R / W R / W CL CL CL CL CL CL SS SS SS CL HH HH TV TV T V T V T V 1 4 7 ' 7 1 ' 7 6 ' 5 4 ' 1 7 ' 5 6 ' 2 0 ' 7 6 ' 5 6 ' 2 0 ' 1 7 ' 1 4 7 ' 3 3 5 + 0 0 6 + 0 0 3+00 2+00 1+00 0+00 0 + 0 0 7 1 ' 5 4 ' " ' 1 4 2 EX. HH5 - R/W BORE STUB @ R/W STA. 3+00 2200' 2315' 300' 96' 3 EX. HH3 EX. HH4 EX. HH5 32240 32225 1 1 ' 1 1 ' BP 4 ' D/W SEE DETAIL "B" HH E E E TC TC TC W W W 6 ' 6 4 ' 4 8 ' 5 5 ' C&G C&G C&G C&G RAISED M E D I A N R A I S E D M E D I A N C & G C & G 6' S/W 14' GR A S S 6' S/W GRASS 6' S/W 14' GR A S S 7' S/W10' GRA S S 100' 50' 50' 38' 38' 12' 12' 100' 50' 50' 38' 38' 12' 12' C & G C & G R / W R / W HH EXCAVATION PLAN REV#DATE DESCRIPTION INT 0 SCALE: 1"=40' 40'80' Charter SIDEWALKRAILROAD T TREE R/R S/W FOC R/W EDGE OF PAVEMENT CURB FACE UNDERGROUND CENTER LINE CONCRETE RIGHT OF WAY FRONT OF CURB EXISTING FROM CURB FACE CL EOP CF U/G CONC EX FCFEOP C/L R/W FOC SYMBOL/LINETYPE DESCRIPTIONABBRV. TRAFFIC SIGNAL HAND HOLE FIRE HYDRANT STREET LIGHT MANHOLE VALVE PEDESTAL UTILITY POLE SYMBOL/LINETYPE DESCRIPTIONABBRV. HH F/H MH VLV PED SL TS W G SS SLC SD E T ELECTRIC TELEPHONE GAS STORM DRAIN SANITARY SEWER WATER OIL / PETROLEUMOIL STREET LIGHT CONDUIT SYMBOL/LINETYPE DESCRIPTION DESCRIPTIONABBRV. C&G CURB & GUTTERC&G VENT METERM DRIVEWAYD/W CURB FACE GUTTER LIP POLE MTR SIDEWALK DRAIN POLE ANCHOR FIBER OPTICFO CATVTV EXISTING STRUCTURES MISC. LE G E N D ADA RAMP BACKFLOW CONC.SIDEWALKCSW P PARKING METER STREET SIGN BEHIND CURB FACEBCF VERTICAL GROUND RODVGR OVERHEADO/H OF SHEET E-MAIL: DATE: SCALE: PROJECT: WORK LOCATION: SERVICE ADDRESS:THOMAS GUIDE: CITY OF TEMECULA5257994 CAMPANULA WAY / MEADOWS PKWY / TEMECULA PKWY(HWY 79) 32240 TEMECULA PKWY TEMECULA, CA 92592 3 3 03/26/2024 1' = 40' steven.gamilong@vvdcomm.net 979-F2 REVISION: CLIENT: TICKET# UNDERGROUND SERVICE ALERT OF SOUTHERN CALIFORNIA AT LEAST TWO DAYS BEFORE YOU DIG CONTACT 811 ENGINEER: VIDEO VOICE DATA 7391 Lincoln Way Garden Grove, CA 92841 714-897-6300 PROPOSED WORK LEGEND NO. OF CONDUIT LENGTH OF CONDUIT SIZE OF CONDUIT POTHOLE DIRT / ASPHALT BORE PIT DIRT / ASPHALT PROPOSED VAULT / PEDESTAL PROPOSED TRENCH BP PHPH BP SYMBOL/LINETYPE DESCRIPTIONABBRV. PROPOSED BORE CONCRETE REPLACEMENT / PROPOSED ANCHOR PROPOSED POLE / PROPOSED VGR ' " X X X KEY NOTE# CONSTRUCTION NOTES: 1.BORE UNDER ALL CURBS AND GUTTERS. 2.PLACE VAULT OR PEDESTAL PARALLEL TO CURB. 3.USE SLURRY BACKFILL. 4.ALL CONDUITS SHALL BE SCH-40 UNLESS OTHERWISE SPECIFIED. ALL SWEEPS TO POLES SHALL BE SCH-80. 5.ALL CHANGES IN SKETCHES AND PERMIT LIMITS MUST HAVE PRIOR DEPT APPROVAL BY THE CITY'S PUBLIC WORKS DEPARTMENT/ENGINEERING DIVISION. 6.WHEN CROSSING EXISTING UTILITY LINES THAT ARE ALSO SAME DEPTH, PLACE NEW CONDUIT UNDERNEATH EXISTING UTILITIES TO PROVIDE ONE (1) FOOT MIN. VERTICAL CLEARANCE. 7.RESTORE DISTURBED LANDSCAPING & IRRIGATION. 8. ALL EXISTING STRUCTURES TO BE PROTECTED IN PLACE. 9. ANY SIDEWALK DISTURBANCE SHALL BE REPLACE FROM SCORE LINE TO SCORE LINE TO MEET CITY STANDARD. 10. TRAFFIC CONTROL NOTE: CONTRACTOR SHALL SET UP TEMPORARY TRAFFIC CONTROL PER APPROVED TRAFFIC CONTROL PLAN. 11. ALL PROPOSED FACILITIES SHALL BE PLACED BEHIND CONCRETE SIDEWALK OR IN GRASS/ DIRT AREA. MATC H L I N E @ S T A 4 + 0 0 SEE S H E E T 2 DETAIL "B" EXIST. CHARTER HANDHOLE 5 TO PROTECT IN PLACE PROP. 1-2" CHARTER CONDUIT R/W BP GRASS S/W TC C&G TV KEY NOTES: 2 3 ROD & ROPE NEW COAX THRU EXISTING CHARTER CONDUIT EX. CHARTER HANDHOLE IN GRASS STA. 0+96 - 11' BCF. (EX. HH4) IN GRASS STA. 3+00 - 11' BCF. (EX. HH5) EXIST. POLE TO PROTECT IN PLACE LD24 - 1464 1 5/3/24 CITY REDLINES SG INLAND ENGINEERING SERVICES, INC. CONTRACTOR: 1373 OLD TEMESCAL RD. CORONA, CA 92881 2 5/22/24 CITY REDLINES FB TYPICAL CONSTRUCTION SIGNS END ROAD WORK SIDEWALK CLOSED SHARE THE ROAD PUBLIC WORKS - TRAFFIC ENGINEERING DIVISION CITY OF TEMECULAENGINEER'S INFORMATIONENGINEER'S SEAL FOR TRAFFIC CONTROL PLANS 32240 TEMECULA PKWY TEMECULA, CA 92592 CONTRACTOR: PERMIT NO. LD24-1464 NAME DATE DON P. TRAN 03/29/24 TRAFFIC CONTROL GENERAL NOTES (REV'D. 08/26/20): 1.ALL TRAFFIC CONTROL DEVICES SHALL CONFORM TO THE LATEST EDITION OF THE CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES (CALIFORNIA MUTCD) AND THE STANDARD SPECIFICATIONS FOR PUBLIC WORKS CONSTRUCTION. 2.THE CITY ENGINEER OR HIS REPRESENTATIVE HAS THE AUTHORITY TO INITIATE FIELD CHANGES TO ASSURE PUBLIC SAFETY. 3.ALL TRAFFIC CONTROL DEVICES SHALL BE REMOVED FROM VIEW WHEN NOT IN USE. 4.WORK HOURS SHALL BE RESTRICTED TO THE PERIOD BETWEEN 8:30 A.M. AND 3:30 P.M., MONDAY THROUGH FRIDAY, UNLESS APPROVED OTHERWISE. WHEN NIGHT WORK IS REQUIRED, WORK HOURS SHALL BE 9 P.M. TO 5 A.M., SUNDAY THROUGH THURSDAY. 5.TRENCHES MUST BE BACK FILLED OR PLATED DURING NON-WORKING HOURS. STEEL PLATES SHALL HAVE ASPHALTIC CONCRETE BERM ON ALL EDGES. ALL DIRT, DUST, AND DEBRIS SHALL BE REMOVED FROM STREET AT END OF EACH DAY AND AT THE END OF THE JOB. THE STREET SHALL BE IN DRIVABLE CONDITION AT ALL TIMES. 6.PEDESTRIAN CONTROLS SHALL BE PROVIDED AS SHOWN ON THE PLANS. 7.TEMPORARY "NO PARKING" SIGNS WILL BE POSTED 24 HOURS PRIOR TO COMMENCING WORK. 8.ACCESS TO DRIVEWAYS WILL BE MAINTAINED AT ALL TIMES UNLESS OTHER ARRANGEMENTS ARE MADE. 9.THE CONTRACTOR SHALL REPLACE WITHIN 72 HOURS, ALL TRAFFIC SIGNAL LOOP DETECTORS DAMAGED DURING CONSTRUCTION. 10.THE CONTRACTOR SHALL REPLACE WITHIN 24 HOURS, ALL STRIPING REMOVED OR DAMAGED BY CONSTRUCTION WORK. (STRIPING MAY BE REPLACED TEMPORARILY WITH TAPE.) 11.ALL WORKERS SHALL BE EQUIPPED WITH AN ORANGE VEST (OR A REFLECTIVE VEST AT NIGHT). ALL FLAGGERS SHALL ALSO BE EQUIPPED WITH A HARD HAT, C28 "STOP/SLOW" PADDLE AND SHALL BE TRAINED IN THE PROPER FUNDAMENTALS OF FLAGGING TRAFFIC. 12.ANY WORK THAT DISTURBS NORMAL TRAFFIC SIGNAL OPERATIONS SHALL BE COORDINATED WITH THE CITY OF TEMECULA'S TRAFFIC DIVISION, 48 HOURS PRIOR TO BEGINNING CONSTRUCTION. CONTACT THE CITY'S TRAFFIC DIVISION AT (951) 694 -6411. 13.THE CONTRACTOR SHALL MAINTAIN ALL TRAFFIC CONTROL DEVICES 24 HOURS PER DAY AND 7 DAYS PER WEEK. 14.A MINIMUM OF TWELVE (12) FOOT TRAVEL LANES MUST BE MAINTAINED UNLESS OTHERWISE APPROVED BY THE DEPARTMENT OF PUBLIC WORKS. 15.ALL NIGHT WORK WILL REQUIRE WRITTEN APPROVAL FROM THE DEPARTMENT OF PUBLIC WORKS. LANE CLOSURES, ROAD DETOURS, ROAD CLOSURES, AND TRAFFIC SIGNAL MODIFICATIONS ASSOCIATED WITH OVERNIGHT CONSTRUCTION ACTIVITIES WILL REQUIRE WARNING SIGNS BE PLACED AT LEAST ONE WEEK IN ADVANCE OF STARTING CONSTRUCTION. 16.A SOLAR POWERED FLASHING ARROW BOARD SHALL BE REQUIRED ON ALL ARTERIAL STREET LANE CLOSURES. 17.IF THE PERMIT APPLICANT DETERMINES THAT CONDUIT INSTALLATION WILL BE BY THE BORING MACHINE METHOD, THE TRENCH PATCH FOR THE UTILITY OBSERVATION EXCAVATION WILL BE THE SAME AS FOR OPEN TRENCH EXCAVATION METHOD. THIS WILL PROVIDE A SINGLE CONTINUOUS SURFACE RESTORATION ELIMINATING THE MULTIPLE PENETRATION INTO THE PUBLIC ROADWAY TO ALL REQUIREMENTS IN CITY STANDARD DRAWING # 407 (SHEET 1 AND 2) FOR TRENCH PATCH. 18.ANY WORK THAT CREATES AN UNDUE SAFETY RISK OR CREATES SEVERE CONGESTION MAY BE SHUT DOWN BY CITY TRAFFIC ENGINEERS, CITY FIELD INSPECTION, OR THE POLICE DEPARTMENT. 19.CONES AND DELINEATORS SHALL HAVE REFLECTORIZED SLEEVES FOR NIGHT WORK. 20.IF PARKING IS ALLOWED IN ADVANCE WARNING AREA, ADVANCE WARNING SIGNS SHALL BE MOUNTED ON HIGH LEVEL DEVICES. APPLICANT IS RESPONSIBLE FOR FULL AND COMPLETE REPRESENTATION OF THE ACTUAL ROAD CONDITIONS SHOWN ON THIS PLAN INCLUDING, BUT NOT LIMITED TO EXISTING STRIPING, SIGNING, SIDEWALKS, AND BIKE LANES. AT LEAST TWO DAYS UG SERVICE ALERT OF SOUTHERN CALIFORNIA BEFORE YOU DIG DIGALERT Call: TOLL FREE 1-800-227-2600 PID5257994 ZONE: 11 WORK AREA VICINITY MAP N.T.S. N SCOPE OF WORK: (CITY OF TEMECULA) CITY OF TEMECULA COVER PAGE 32240 TEMECULA PKWY 1 4 RECOMMENDED BY:DATE: ACCEPTED BY:DATE: R.T.E. NO. ERICK ESCOBEDO TRAFFIC ENGINEER 3002 SCOPE OF WORK:WORK HOURS: WORK DURATION: TOTAL COAX PULLTHRU EX. CONDUIT (Rod & Rope)1325 LF TOTAL PROPOSED UNDERGROUND EXCAVATION 4 LF INLAND ENGINEERING SERVICES , INC 05/16/24 05/16/24 CAMP A N U L A W Y (30 M P H ) MEA D O W P K W Y (45 M P H ) H H T V TV TV TV HH TV TV PHASE 1 OF 3 0 SCALE: 1" = 40' CITY OF TEMECULA TRAFFIC CONTROL PLAN 32240 TEMECULA PKWY A DEDICATED INDIVIDUAL WILL BE ASSIGNED THE RESPONSIBILITY OF ESCORTING PEDESTRIANS THROUGH THE WORK AREA IN ACCORDANCE WITH THREE MAJOR CONSIDERATIONS: 1.PEDESTRIANS SHOULD NOT BE LED INTO DIRECT CONFLICT WITH WORK SITE VEHICLES, EQUIPMENT OR OPERATIONS 2.PEDESTRIANS SHOULD NOT BE LED INTO DIRECT CONFLICT WITH MAINLINE TRAFFIC MOVING THROUGH OR AROUND THE WORK SITE 3.PEDESTRIANS SHOULD BE PROVIDED WITH A REASONABLY SAFE, CONVENIENT AND ACCESSIBLE PATH THAT REPLICATES AS NEARLY AS PRACTICAL THE MOST DESIRABLE CHARACTERISTICS OF THE EXISTING SIDEWALK OR FOOTPATH PEDESTRIAN NOTES FLAGGER TO ASSIST PEDESTRIANS THROUGH WORK AREA CONTACT PROPERTY OWNER(S) 72 HOURS PRIOR TO START OF WORK CONTRACTOR TO PROVIDE ACCESS TO DRIVEWAYS AT ALL TIMES AN INDIVIDUAL WILL BE ASSIGNED TO MAINTAIN THE CONES WHILE THE WORK ZONE IS IN PLACE PUBLIC WORKS - TRAFFIC ENGINEERING DIVISION CITY OF TEMECULAENGINEER'S INFORMATIONENGINEER'S SEAL FOR TRAFFIC CONTROL PLANS 32240 TEMECULA PKWY. TEMECULA, CA 92592 CONTRACTOR: PERMIT NO. LD24-1464 NAME DATE DON P. TRAN 03/29/24PID5257994 ZONE: 11 RECOMMENDED BY:DATE: ACCEPTED BY:DATE: R.T.E. NO. 4 2 80'40' LEGEND: "NO PARKING" SIGNS SHALL BE POSTED 72 HOURS PRIOR TO STARTING OPERATION ERICK ESCOBEDO TRAFFIC ENGINEER 3002 INLAND ENGINEERING SERVICES , INC 05/16/24 HH TV TV TV TVCAMPANULA WY 30 MPH MEADOW PKWY (45 MPH) TE M E C U L A P K W Y (5 0 M P H ) CAMPANU L A W Y (40 MPH) R/ W R/ W R/ W R/ W R/ W R/ W R/ W R/ W R/ W R/ W LEGEND: PHASE 2 OF 3 0 SCALE: 1" = 40' CITY OF TEMECULA TRAFFIC CONTROL PLAN 32240 TEMECULA PKWY A DEDICATED INDIVIDUAL WILL BE ASSIGNED THE RESPONSIBILITY OF ESCORTING PEDESTRIANS THROUGH THE WORK AREA IN ACCORDANCE WITH THREE MAJOR CONSIDERATIONS: 1.PEDESTRIANS SHOULD NOT BE LED INTO DIRECT CONFLICT WITH WORK SITE VEHICLES, EQUIPMENT OR OPERATIONS 2.PEDESTRIANS SHOULD NOT BE LED INTO DIRECT CONFLICT WITH MAINLINE TRAFFIC MOVING THROUGH OR AROUND THE WORK SITE 3.PEDESTRIANS SHOULD BE PROVIDED WITH A REASONABLY SAFE, CONVENIENT AND ACCESSIBLE PATH THAT REPLICATES AS NEARLY AS PRACTICAL THE MOST DESIRABLE CHARACTERISTICS OF THE EXISTING SIDEWALK OR FOOTPATH PEDESTRIAN NOTES FLAGGER TO ASSIST PEDESTRIANS THROUGH WORK AREA CONTACT PROPERTY OWNER(S) 72 HOURS PRIOR TO START OF WORK CONTRACTOR TO PROVIDE ACCESS TO DRIVEWAYS AT ALL TIMES AN INDIVIDUAL WILL BE ASSIGNED TO MAINTAIN THE CONES WHILE THE WORK ZONE IS IN PLACE PUBLIC WORKS - TRAFFIC ENGINEERING DIVISION CITY OF TEMECULAENGINEER'S INFORMATIONENGINEER'S SEAL FOR TRAFFIC CONTROL PLANS 32240 TEMECULA PKWY. TEMECULA, CA 92592 CONTRACTOR: PERMIT NO. LD24-1464 NAME DATE DON P. TRAN 03/29/24PID5257994 ZONE: 11 RECOMMENDED BY:DATE: ACCEPTED BY:DATE: R.T.E. NO. 4 3 80'40' ERICK ESCOBEDO TRAFFIC ENGINEER 3002 INLAND ENGINEERING SERVICES , INC 05/16/24 TV HH TV HH TEMEC U L A P K W Y (50 MP H ) MEAD O W P K W Y (45 M P H ) R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W R/W LEGEND: PHASE 3 OF 3 0 SCALE: 1" = 40' CITY OF TEMECULA TRAFFIC CONTROL PLAN 32240 TEMECULA PKWY A DEDICATED INDIVIDUAL WILL BE ASSIGNED THE RESPONSIBILITY OF ESCORTING PEDESTRIANS THROUGH THE WORK AREA IN ACCORDANCE WITH THREE MAJOR CONSIDERATIONS: 1.PEDESTRIANS SHOULD NOT BE LED INTO DIRECT CONFLICT WITH WORK SITE VEHICLES, EQUIPMENT OR OPERATIONS 2.PEDESTRIANS SHOULD NOT BE LED INTO DIRECT CONFLICT WITH MAINLINE TRAFFIC MOVING THROUGH OR AROUND THE WORK SITE 3.PEDESTRIANS SHOULD BE PROVIDED WITH A REASONABLY SAFE, CONVENIENT AND ACCESSIBLE PATH THAT REPLICATES AS NEARLY AS PRACTICAL THE MOST DESIRABLE CHARACTERISTICS OF THE EXISTING SIDEWALK OR FOOTPATH PEDESTRIAN NOTES FLAGGER TO ASSIST PEDESTRIANS THROUGH WORK AREA CONTACT PROPERTY OWNER(S) 72 HOURS PRIOR TO START OF WORK CONTRACTOR TO PROVIDE ACCESS TO DRIVEWAYS AT ALL TIMES AN INDIVIDUAL WILL BE ASSIGNED TO MAINTAIN THE CONES WHILE THE WORK ZONE IS IN PLACE PUBLIC WORKS - TRAFFIC ENGINEERING DIVISION CITY OF TEMECULAENGINEER'S INFORMATIONENGINEER'S SEAL FOR TRAFFIC CONTROL PLANS 32240 TEMECULA PKWY. TEMECULA, CA 92592 CONTRACTOR: PERMIT NO. LD24-1464 NAME DATE DON P. TRAN 03/29/24PID5257994 ZONE: 11 RECOMMENDED BY:DATE: ACCEPTED BY:DATE: R.T.E. NO. 4 4 80'40' ERICK ESCOBEDO TRAFFIC ENGINEER 3002 INLAND ENGINEERING SERVICES , INC 05/16/24 04/09/2024 Acrisure 2655 Camino Del Rio North #200 San Diego CA 92108 Hope Perry (Zamichieli) (619) 683-9990 (619) 683-9999 hperry@acrisure.com Inland Engineering Services Inc. 1373 Old Temescal Rd. Corona CA 92881 Middlesex Insurance Co 23434 Florists' Mutual Insurance Company 13978 Certain Underwriters at Lloyds 15642 At-Bay Specialty Insurance Company 19607 Mt. Hawley Insurance Company 37974 24-25 All Lines A Y Y A0248653004 04/15/2024 05/01/2025 1,000,000 500,000 5,000 1,000,000 3,000,000 2,000,000 PROJ. AGGREGATE 10,000,000 A Y Y A0248653001 04/15/2024 05/01/2025 1,000,000 COMP/COLL DED 100/250 A 0 A0248653006 04/15/2024 05/01/2025 5,000,000 5,000,000 B Y Y A0248653005 05/01/2024 05/01/2025 1,000,000 1,000,000 1,000,000 C Professional Liability ANE5429827.24 04/15/2024 05/01/2025 Policy Aggregate Limit $2,000,000 Each Claim Limit $2,000,000 City of Temecula is afforded Additional Insured, Primary Non-contributory and Waiver of Subrogation where required by written contract per attached Endorsements. City of Temecula 41000 Main St. Temecula CA 92590 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY Inland Engineering Services Inc.Acrisure 25 Certificate of Liability Insurance: Notes INSURER D: At-Bay Specialty Insurance Company NAIC# 19607 Cyber Liability Policy #AB-6653839-03 Policy Period: 5/1/2024 - 5/1/2025 POLICY AGGREGATE LIMIT: $1,000,000 INSURER E: Mt. Hawley Insurance Company NAIC# 37974 Pollution Liability Policy #EGL0011705 Policy Period: 4/29/2024 - 5/1/2025 POLICY AGGREGATE LIMIT: $5,000,000 EACH POLLUTION INCIDENT: $5,000,000 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: POLICY NUMBER: A0248653004 © Insurance Services Office, Inc., 2018 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s)Location And Description Of Completed Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If 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. B.With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If 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 insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 1 of 1CG 20 37 12 19 04/08/2024A0248653 Middlesex Insurance Company 00001 0000000000 24099 0 N1 49a51b0d-df71-471d-8ad6-786ec2926a3449a51b0d-df71-471d-8ad6-786ec2926a34 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, or damage All locations and jobs performed that have a written contract, agreement or permit. Page 1 of 2CG 20 10 12 19 04/08/2024A0248653 Middlesex Insurance Company © Insurance Services Office, Inc., 2018 POLICY NUMBER: A0248653004 COMMERCIAL GENERAL LIABILITY 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 CG 20 10 12 19 Name Of Additional Insured Person(s) Or Organization(s)Location(s) Of Covered Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" 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 for the 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.If 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. B.With 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 organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 00001 0000000000 24099 0 N1 3d9d26e6-1a1c-4191-9943-6029a2cb9c673d9d26e6-1a1c-4191-9943-6029a2cb9c67 All locations and jobs performed that have a written contract, agreement or permit 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, or damage C.With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If 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 insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. © Insurance Services Office, Inc., 2018 CG 20 10 12 19Page 2 of 2 04/08/2024A0248653 Middlesex Insurance Company COMMERCIAL GENERAL LIABILITY CG 71 25 06 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS BLANKET ADDITIONAL INSUREDS, PRIMARY & NONCONTRIBUTORY, WAIVER OF SUBROGATION This endorsement modifies the coverage provided under the following Coverage Form(s): COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE 1.Additional Insureds - Automatic Status for 13 Additional Insured Types Section II - Who Is An Insured is amended to include the following as additional insureds when you have agreed to add that person or organization as an Additional Insured on your policy in a written contract or written agreement with that person or organization, or because of a permit issued by a state or political subdivision; provided the injury or damage occurs subsequent to the execution of the contract or agreement or issuance of the permit and while the contract, agreement or permit remains in effect. A.Owners, Lessees Or Contractors - Automatic Status When Required In A Written Construction Agreement With You 1)A person or organization with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a.Your acts or omissions; or b.The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Coverage enhancements are listed below. For details of each coverage, please read the corresponding policy provisions in the body of this endorsement. 1.Additional Insureds - Automatic Status for 13 Additional Insured Types A.Owners, Lessees Or Contractors - Automatic Status When Required In A Written Construction Agreement With You B.Owners, Lessees Or Contractors - Automatic Status When Required In Written Construction Agreement With You (Completed Operations) C.State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations D.Lessor of Leased Equipment E.Owners or Other Interests From Whom Land Has Been Leased F.Manager or Lessor of Premise G.Mortgagee, Assignee, or Receiver H.Controlling Interest I.Co-owner Of Insured Premises J.Executors, Administrators, Trustees Or Beneficiaries K.State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises L.Vendors M.Grantor of Franchise 2.Primary and Noncontributory - Other Insurance Condition 3.Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5CG 71 25 06 22 04/08/2024A0248653 Middlesex Insurance Company 00003 0000000000 24099 0 N1 3e095d27-f0df-4c74-acc1-f5f0bd75c2ce3e095d27-f0df-4c74-acc1-f5f0bd75c2ce POLICY NUMBER: A0248653004 A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. 2)With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a."Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 1.The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2.Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. b."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 organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. B.Owners, Lessees Or Contractors - Automatic Status When Required In Written Construction Agreement With You (Completed Operations) 1)Any person(s) or organization(s) with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" performed for that additional insured and included in the "products-completed operations hazard", but only when that portion of the “products-completed operations hazard” is not excluded by endorsement. 2)With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury" or "property damage" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a.The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b.Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C.State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Any state or governmental agency or subdivision or political subdivision, subject to the following provisions: 1)This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. 2)This insurance does not apply to: Includes copyrighted material of Insurance Services Office, Inc., with its permission. CG 71 25 06 22Page 2 of 5 04/08/2024A0248653 Middlesex Insurance Company a."Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b."Bodily injury" or "property damage" included within the "products-completed operations hazard". D.Lessor of Leased Equipment 1)Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). 2)With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. E.Owners or Other Interests From Whom Land Has Been Leased 1)Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the land leased to you by the additional insured person(s) or organization(s). 2)With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a.Any "occurrence" which takes place after you cease to lease that land; b.Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured person(s) or organization(s). F.Manager or Lessor of Premise Any person(s) or organization(s) with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of the premises leased to you by the additional insured person(s) or organization(s), subject to the following additional exclusions: This insurance does not apply to: 1)Any "occurrence" which takes place after you cease to be a tenant in that premises. 2)Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. G.Mortgagee, Assignee, or Receiver Any person(s) or organization(s) with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of a premises by you. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for such additional insured person(s) or organization(s). H.Controlling Interest 1)Any person(s) or organization(s) with respect to their liability arising out of: a.Their financial control of you; or b.Premises they own, maintain or control while you lease or occupy these premises. 2)This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. I.Co-owner Of Insured Premises Any person(s) or organization(s) with respect to their liability as co-owner of a premises co-owned by you and covered under this insurance. J.Executors, Administrators, Trustees Or Beneficiaries Any executor, administrator, trustee or beneficiary of your estate or living trust while acting within the scope of their duties as such. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 5CG 71 25 06 22 04/08/2024A0248653 Middlesex Insurance Company 00003 0000000000 24099 0 N3 3e095d27-f0df-4c74-acc1-f5f0bd75c2ce3e095d27-f0df-4c74-acc1-f5f0bd75c2ce K.State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises Any state or governmental agency or subdivision or political subdivision, subject to the following additional provision: This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: 1)The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or 2)The construction, erection or removal of elevators; or 3)The ownership, maintenance or use of any elevators covered by this insurance. L.Vendors 1)Any person(s) or organization(s) (referred to throughout this endorsement as vendor), but only with respect to liability for "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However: a.The insurance afforded to such vendor only applies to the extent permitted by law; and b.If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. 2)With respect to the insurance afforded to these vendors, the following additional exclusions apply: a.The insurance afforded the vendor does not apply to: 1)"Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; 2)Any express warranty unauthorized by you; 3)Any physical or chemical change in the product made intentionally by the vendor; 4)Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; 5)Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; 6)Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; 7)Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or 8)"Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1)The exceptions contained in Subparagraphs d. or f.; or Includes copyrighted material of Insurance Services Office, Inc., with its permission. CG 71 25 06 22Page 4 of 5 04/08/2024A0248653 Middlesex Insurance Company (2)Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. b.This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. M.Grantor of Franchise Any person(s) or organization(s) with respect to their liability as grantor of a franchise to you. However: 1.The insurance afforded to such additional insureds only applies to the extent permitted by law; and 2.If 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. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If 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 insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. If there is any difference in coverage afforded to an additional insured in this endorsement and that provided under another additional insured endorsement attached to this policy, the broader coverage will apply to that additional insured. 2.Primary And Noncontributory Insurance The following is added to the Other Insurance Condition and supersedes any provision to the contrary: This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1)The additional insured is a Named Insured under such other insurance; and (2)You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. 3.Waiver Of Transfer Of Rights Of Recovery Against Others To Us (Waiver Of Subrogation) - Automatic The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 5CG 71 25 06 22 04/08/2024A0248653 Middlesex Insurance Company 00003 0000000000 24099 0 N5 3e095d27-f0df-4c74-acc1-f5f0bd75c2ce3e095d27-f0df-4c74-acc1-f5f0bd75c2ce POLICY NUMBER: A0248653004 © Insurance Services Office, Inc., 2018 COMMERCIAL GENERAL LIABILITY CG 24 04 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ELECTRONIC DATA LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS SCHEDULE Name Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above. Page 1 of 1CG 24 04 12 19 04/08/2024A0248653 Middlesex Insurance Company 00001 0000000000 24099 0 N1 77171d79-070d-4055-b94f-04db6398c58b77171d79-070d-4055-b94f-04db6398c58b Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage POLICY NUMBER: A0248653001 SCHEDULE COMMERCIAL AUTO CA 76 01 06 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - PRIMARY AND NONCONTRIBUTORY - COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured: Inland Engineering Services, Inc. Endorsement Effective Date: 04/15/2024 Name Of Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in: (1)Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms; or (2)Paragraph D.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. B.Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other auto insurance issued to the person or organization in the schedule under your policy provided that: (1)The person or organization is a Named Insured under such other insurance; and (2)Prior to the “accident” you have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the person or organization. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1CA 76 01 06 15 04/08/2024A0248653 Middlesex Insurance Company 00001 0000000000 24099 0 N1 e5148181-0760-412b-98e2-6ef9e68926a4e5148181-0760-412b-98e2-6ef9e68926a4 Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage. Named Insured: Inland Engineering Services, inc. Endorsement Effective Date: 04/15/2024 Name(s) Of Person(s) Or Organization(s): POLICY NUMBER: A0248653001 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. SCHEDULE Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. © Insurance Services Office, Inc., 2011 Page 1 of 1CA 04 44 10 13 04/08/2024A0248653 Middlesex Insurance Company 00001 0000000000 24099 0 N1 45800998-7eb6-4231-ab16-e6e0de6b84f445800998-7eb6-4231-ab16-e6e0de6b84f4 Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage (Ed. 4-84) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Name: Address: Description of Waiver: JobID: (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement No. Premium Countersigned by This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. Page 1 of 1 03/29/2023 00002 0000000000 23088 0 N1 d817710f-8fba-466b-b831-82704acebcecd817710f-8fba-466b-b831-82704acebcec Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage Policy No. A0248653005Endorsement Effective 5/1//2024 Insured Inland Engineering Services, Inc. Florists' Mutual Insurance Company WC 00 03 13 (Ed. 4-84) © 1983 National Council on Compensation Insurance. A0192224005 Middlesex Insurance Company 1373 Old Temescal Rd Corona, CA 92881-3315 Blanket as Required by Written Contract or Written Agreement Executed Prior to Loss Land Development Encroachment Permit 41000 Main Street Temecula, Ca 92590 Phone: 951-694-6444 www.temeculaca.gov R:\LAND DEVELOPMENT DIVISION\FORMS\Permit Applications\Encroachment Permit App.docx Page 1 of 2 Revised: 06/03/2019 APPLICATION INFORMATION PA No.: PERMIT NO.: Type of Encroachment:  Street/Storm Drain  Sewer/Water  Utility Trenching  Signing & Striping  Traffic Signal  Miscellaneous (SPECIFY BELOW) The undersigned hereby applies to excavate, construct and otherwise encroach on City street right-of-way, as follows: Name(s) of street(s) and/or street address: Utility Work Order #: Start Date: End Date: In consideration of granting this application, all applicants including utility companies hereby agree to: 1. If applicable, submit two (2) sets of Construction Drawings along with two (2) sets of the appropriate Traffic Control Plans, proof of City Business License for all parties involved, proof of Contractor’s License along with this application at the time of submittal. See the Traffic Control Plan Checklist for details. 2. Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or dam age to persons or property happening or occurring as a proximate result of any work under taken under the permit granted pursuant to this application. (See below for specific liability insurance requirements.) 3. Remove/relocate any encroachment installed/maintained under this permit, upon written notice from the City Engineer. 4. Notify the Land Development Inspection Division via email at LDInspections@temeculaca.gov at least two (2) working days prior to commencing construction. Hold a pre-construction meeting prior to the start of construction. The developer/general contractor must be present for the timely request of inspections. 5. Comply with the Standard Specifications, most current Improvement Standard Drawings for Public Works Construction, City of Temecula Municipal Code Chapters 13.04 and 18.12, terms and conditions of the permit and all applicable rules and regulations for the City of Temecula and other public agencies having jurisdiction. LIABILITY INSURANCE REQUIREMENTS PROVIDE PROOF OF INSURANCE COVERAGE MEETING THE REQURIEMENTS STATED BELOW OR A CITY ATTORNEY APPROVED EQUIVALENT WITH THE CITY NAMED AS ADDITIONAL INSURED. IN THE EVENT THAT THE INSURANCE IS PROVIDED BY THE CONTRACTOR, THE CITY AND THE OWNER/DEVELOPER MUST BE NAMED AS ADDITIONAL INSURED. THIS REQUREMENT SHALL BE MET BY EITHER THE APPLICANT (DEVELOPER, OWNER, PUBLIC UTILITY AGENCY OR FRANCHISE) OR BY THE CONTRACTOR PERFORMING THE SUBJECT WORK, PRIOR TO BEGININNG ANY WORK PROPOSED UNDER THE SUBJECT ENCROACH MENT PERMIT. Tie-in to existing charter handhole; rod & rope new coax through existing Charter conduit to handhole; bore and stub to right of way and place bore pit. 32240 Temecula Pkwy Temecula CA 92592 5257994 1 week from approval 1 week after start date LD24-1464 4 CLEARED BY CITY OF TEMECULA PUBLIC WORKS Tricia.ortega 06/17/2024 06/17/2024 06/17/2024 06/17/20 Land Development Encroachment Permit 41000 Main Street Temecula, Ca 92590 Phone: 951-694-6444 www.temeculaca.gov R:\LAND DEVELOPMENT DIVISION\FORMS\Permit Applications\Encroachment Permit App.docx Page 2 of 2 Revised: 06/03/2019 Proof of coverage shall be by certificate (Accord or equivalent) naming the City of Temecula as certificate holder and the minimum limits of insurance coverage shall be as follows: a. General Liability: One million dollars ($1,000,000) per occurrence for bodily injury, personal injury and property damage. If Commercial General Liability Insurance or other form with a general aggregate limit is used, either the general aggregate lim it shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. b. Automobile Liability: One million dollars ($1,000,000) per accident for bodily injury and property damage. c. Worker’s Compensation as required by the State of California; Employer’s Liability: One million dollars ($1,000,000) per accident for bodily injury or disease. d. Course of Construction: Completed value of the project. There is a limited exception to this requirement. Owners of single family homes doing work on the home’s driveway approach located in the public right-of-way, may use their homeowners insurance with public liability and property damage coverage in at least the following minimum limits and which will name the City of Temecula as an additional insured for the duration of the encroachment permit: BODILY INJURY $250,000.00 EACH PERSON $500,000.00 EACH OCCURANCE $500,000.00 AGGREGATE PRODUCTS AND COMPLETED OPERATIONS PROPERTY DAMAGE $100,000.00 EACH OCCURANCE $250,000.00 AGGREGATE PRODUCTS AND COMPLETED OPERATIONS A combined single limit homeowner’s policy with aggregate limits in the amount of $1,000,000.00 will be considered equivalent to the required minimum limits. Homeowners: a copy of the required homeowners insurance and a Certificate of Insurance showing the City named as an additional insured shall be attached to the application. The undersigned applicant and/or contractor states that they have read and agrees to meet all the conditions on this application, including provisions of required liability insurance or a City Attorney approved equivalent, and acknowledges that this application will be made a part of the encroachment permit. APPLICANT’S INFORMATION (THIS SECTION MUST BE COMPLETED) Company Name: Mailing Address: Contact: Phone #: E-mail: I hereby warrant and represent to the City that I am authorized to execute this permit application on behalf of the permittee and bind the permittee to the agreements contained herein and any conditions of the permit. Authorized Signature: Date Applied: CONTRACTOR’S INFORMATION Company Name: Mailing Address: Contact: Phone #: 24-HR Emergency #: State Contractor’s License #: Class: City Business License #: Charter Communications 7337 Central Ave Riverside CA, 92504 Emily Osborn 714-897-6300 emily.osborn@vvdcomm.net 04/03/2024 Inland Engineering Services, Inc 1373 Old Temescal Rd Corona CA 92881 Carlos Cano 562-328-0255 931684 A