OVERSIZE LOADS TYPES OF PERMITS ISSUED

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1 City of Moreno Valley Frederick Street Moreno Valley, CA (951) OVERSIZE LOADS TYPES OF PERMITS ISSUED 1. Annual Permits are valid from the date of issuance to the expiration date not to exceed three hundred and sixty-five (365) consecutive calendar days. Loads covered by annual permits shall not exceed twelve (12) feet in width, fourteen (14) feet in height, one hundred (100) tons in gross weight and seventy-five (75) feet in length, and conforming to the weight, axle number, and wheel loading requirements of the State as provided in the California Vehicle Code, Section and Travel routes through residential streets are not permitted unless authorized by City agents under a separate permit. Note: A list of all license numbers of the vehicles to be covered by this permit shall be attached to the application. 2. Annual Permits (Route Specific) are issued for loads between twelve (12) and eighteen (18) feet wide, fourteen (14) and eighteen (18) feet high and are limited to a specific route. 3. One-Way Permits (Within Limits) are valid for a maximum of three (3) consecutive calendar days. The load shall not exceed the limitations listed under the Annual Permits section. 4. One-Way Permits (Over Limits) are issued for loads exceeding the limitations listed under the Annual and One-Way Permits sections. Over Limit Loads will be reviewed by the City s Transportation Engineering Division on a case by case basis. The permitee may require (if greater than 16 in width or 18 in height) an escort by the City. In addition, the permitee may be restricted to a specific route, as defined by the City Traffic Engineer. If it is determined that a City escort is necessary, an additional fee to cover overtime costs (with a four hour minimum) will be required. The fee is based upon standard overtime rates per the City s annual adopted compensation fee schedule as approved by the City Council.

2 City of Moreno Valley Frederick Street Moreno Valley, CA (951) OVERSIZE LOADS SPECIAL PROVISIONS 1. The City requires a minimum of three working days to process and issue oversize load permits after the permittee s certificate of liability insurance has been approved by the City Attorney s office. The City Attorney s office may need up to ten (10) days to review and approve insurance documents. To expedite the insurance review process, the permittee should obtain and submit all insurance documents as specified and required by the City. Applications received after 4:00 P.M. will be held for over to the next business day for processing. 2. The City of Moreno Valley assumes no duty and makes no representation regarding the route selected or as to the safety on any proposed route. It is the duty of all permit applications to insure the proposed route will be of adequate height, width, and safe for the needs of the oversized load. This includes contacting utilities to resolve potential conflicts with any surface mounted or overhead facilities. 3. Applicant shall save, keep, and hold harmless to the City of Moreno Valley, its officers or agents from all damages, cost or expenses in law or equity that may at any time arise or be set up because of or in the course of performing work authorized by this permit which may be occasioned by act or omission of the permitee. 4. All permits issued shall be of original nature with no items being crossed out or changed. 5. Permit is only valid for designated truck routes with exception to site, and/or delivery within city limits. These routes are subject to review by the City Traffic Engineer. 6. The City Traffic Engineer or his representative may at the time of issuance of said permit, reduce the gross weight limitations stated herein, provided the specific designated City truck routes to be used in moving said oversize loads would, in the City Traffic Engineer s opinion, be materially damaged. In addition, it is the responsibility of the permitee to maintain valid insurance throughout the duration of the permit. The minimum amount of liability insurance required is one million dollars. Also, the City shall be listed as additional insured under the policy. Failure to maintain current insurance shall cause the permit to be null and void. 7. The permit applicant is responsible for all permit fees per the latest City Fee schedule.

3 City of Moreno Valley OVERSIZE LOAD PERMIT APPLICATION PAGE 1 OF 2 IN COMPLIANCE WITH YOUR REQUEST AND SUBJECT TO ALL THE TERMS, CONDITIONS AND RESTRICTIONS WRITTEN BELOW AND IN THE ACCOMPANIMENTS, PERMISSION IS HEREBY GRANTED TO: NAME: ADDRESS: CITY/STATE/ZIP OFFICE PHONE NUMBER (Including Area Code) ANNUAL SINGLE TRIP VARIANCE CITY ESCORT FROM: TO: MOVEMENT AUTHORIZED: SATURDAY: SUNDAY: DARKNESS: (CVC280): PERMIT VALID: OFFICE FAX NUMBER (Including Area Code): PERMIT NUMBER PERMIT SPECIAL REQUIREMENTS PILOT CAR PILOT CAR WITH VERTICAL MEASURING DEVICE 2 PILOT CARS CITY ESCORT DESCRIPTION OF THE LOAD OR EQUIPMENT AND MODEL NO.: HAUL DRIVE TOW ROUTE SURVEY DIMENSIONS OF LOAD: DESCRIPTION OF HAULING EQUIPMENT: VEHICLE WIDTH: SEMI-TRAILER LENGTH: KINGPIN TO LAST AXLE: COMB. VEHICLE LENGTH: MAXIMUM ALLOWABLE WEIGHT AXLE NUMBER NUMBER OF TIRES PER AXLE DISTANCE BETWEEN AXLES WIDTH OF AXLES AT TIRE SIDEWALL LOADED HEIGHT: NOT TO EXCEED DIMENSIONS SHOWN BELOW OR AXLE WEIGHTS SHOWN ABOVE LOADED WIDTH: LOADED OVERALL LENGTH: LOADED OVERHANG: GROSS WEIGHT: ORIGIN: DESTINATION: AUTHORIZED CITY ROUTES - STATE AND/OR COUNTY PERMITS MAY BE REQUIRED PERMIT VALID FOR POSTED TRUCK ROUTES ONLY with local access for pickup/delivery according to Section of the CVC REQUESTED ROUTE: Applicant agrees to abide by the Oversize Loads Special Provisions, the Oversize Load Permit Liability Insurance Requirements, and any other provisions or requirements attached to this Application. Pursuant to California Vehicle Code, Section 35780, this permit does NOT exempt the permittee from meeting the requirements set forth by the California Department of Transportation to operate extra-legal loads within the state right-of-way. APPLICANT CONTACT PERSON (PRINT) APPLICANT SIGNATURE DATE INSURANCE EXP. DATE FEE NUMBER OF TRIPS AUTHORIZED CITY AGENT $ NOTE TO APPLICANT: The accuracy of this permit is your responsibility. Make sure the application is correct DATE and all the conditions and special requirements are included. Each vehicle MUST possess its original permit Frederick Street Moreno Valley, Ca (951) permits to: wideloadpermits@moval.org

4 PERMIT NUMBER City of Moreno Valley OVERSIZE LOAD PERMIT APPLICATION PAGE 2 OF 2 ADDITIONAL AXLE INFORMATION: AXLE NUMBER NUMBER OF TIRES PER AXLE DISTANCE BETWEEN AXLES WIDTH OF AXLES AT TIRE SIDEWALL ADDITIONAL REQUIREMENTS - CONDITIONS - ROUTING INFORMATION Frederick Street Moreno Valley, Ca (951) permits to: wideloadpermits@moval.org

5 OVERSIZE LOAD PERMIT LIABILITY INSURANCE REQUIREMENTS 1. The most current version of Insurance Services Office (ISO) Commercial General Liability Coverage Form CG 00 01, which shall include insurance for "bodily injury," "property damage" and "personal and advertising injury" with coverage for premises and operations, products and completed operations, and contractual liability. 2. The most current version of Insurance Service Office (ISO) Business Auto Coverage Form CA 00 01, which shall include coverage for all owned, hired, and non-owned automobiles or other licensed vehicles (Code 1- Any Auto). 3. Workers' Compensation insurance as required by the California Labor Code and Employer's Liability Insurance. 4. Professional Liability (Errors and Omissions) insurance appropriate to Consultant's profession. Minimum Limits of Insurance Consultant shall maintain limits of liability of not less than: 1. General Liability: $1,000,000 per occurrence for bodily injury and property damage $1,000,000 per occurrence for personal and advertising injury $2,000,000 aggregate for products and completed operations $2,000,000 general aggregate 2. Automobile Liability: $1,000,000 per accident for bodily injury and property damage 3. Employer's Liability: $1,000,000 each accident for bodily injury $1,000,000 disease each employee $1,000,000 disease policy limit

6 4. Professional Liability (Errors and Omissions): $1,000,000 per claim/occurrence $2,000,000 policy aggregate Umbrella or Excess lnsurance ln the event Consullant purchases an Umbrella or Excess insurance policy(ies) to meet the "Minimum Limits of lnsurance," this insurance policy(ies) shall "follow form" and afford no less coverage than the primary insurance policy(ies). Deductlbles and Self-lnsured Retentions Consultant shall be responsible for payment of any deductibles contained in any insurance policy(ies) required hereunder and Consultant shall also be responsible for payment of any self-insured retentions. Any deductibles or self-insured retentions must be declared to, and approved by, the city Manager or his/her designee. At the option of the city Manager or his/her designee, either (i) the insurer shall reduce or eliminate such deductibles or selfinsured retentions as respects City, CSD, Housing Authority and each of their officers, officials, employees, agents and volunteers, or (ii) Consultant shall provide a financial guarantee, satisfactory to the City Manager or his/her designee, guaranteeing payment of losses and related investigations, claim administration and defense expenses. At no time shall City be responsible for the payment of any deductibles or self-insured retentions. Other lnsurance Provisions The General Liabilitv and Automobile Liabilitv insurance policies are to contain, or be endorsed to contain, the following provisions: 1. City, CSD, Housing Authority and each of their officers, ofiicials, employees, agents and volunteers are to be covered as additional insureds. 2. The coverage shall contain no special limitations on the scope of protection afforded to City, CSD, Housing Authority and each of their officers, officials, employees, agents and volunteers. 3. Consultant's insurance coverage shall be primary and no contribution shall be required of City. The Workers' Comoensation insurance policv is to contain, or be endorsed to contain, the following provision: Consultant and its insurer shall waive any right of subrogation against City, CSD, Housing Authority and each of their officers, officials, employees, agents and volunteers.

7 Please see for further information. UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS-MADE DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below CERTIFICATE OF LIABILITY INSURANCE PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 EACH OCCURRENCE $ AGGREGATE $ $ DATE (MM/DD/YYYY) 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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). PRODUCER INSURED COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY)/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE XX OCCUR PREMISES (Ea occurrence) $ EEAC MED EXP (Any one person) $ YY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS Y / N SA ZZZ333 N/A ZZZ CONTACT NAME: PHONE (A/C, No, Ext): ADDRESS: INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) PER STATUTE SAMPLE LE DE FAX (A/C, No): GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC OTHER: AUTOMOBILE LIABILITY OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 $ $ NAIC # DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Moreno Valley, the City of Moreno Valley Community Services District, the Moreno Valley Housing Authority and each of their officers, officials, employees, agents and volunteers are additional insureds as respects to General Liability and Auto Liability insurance. This insurance is primary, and our obligations are not affected by any other insurance carried by such additional insured whether primary, excess, contingent, or on any other basis. Waiver of subrogation for Workers Compensation and Employer s Liability insurance as respects to the City of Moreno Valley, the City of Moreno Valley Community Services District, the Moreno Valley Housing Authority and each of their officers, officials, employees, agents and volunteers. CERTIFICATE HOLDER City of Moreno Valley Attn: (Insert name of contract person) Frederick Street Moreno Valley, CA CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD

8 POLICY NUMBER: XX COMMERCIAL GENERAL LIABILITY CG 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 Name Of Additional Insured Person(s) Or Organization(s) SCHEDULE The City of Moreno Valley, the City of Moreno Valley Community Services District, the Moreno Valley Housing Authority and each of their officers, officials, employees, agents and volunteers Location(s) Of Covered Operations Information required to complete this Schedule, e, 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; sions; 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. SAMPLE E CG Insurance Services Office, Inc., 2012 Page 1 of 2

9 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. SAMPLE Page 2 of 2 Insurance Services Office, Inc., 2012 CG

10 POLICY NUMBER: XX COMMERCIAL GENERAL LIABILITY CG THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance 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 ry and would not seek contribution from any other insurance available to the additional insured. SAMPLE CG Insurance Services Office, Inc., 2012 Page 1 of 1

11 POLICY NUMBER: XX COMMERCIAL GENERAL LIABILITY CG 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 Name Of Additional Insured Person(s) Or Organization(s) The City of Moreno Valley, the City of Moreno Valley Community Services District, the Moreno Valley Housing Authority and each of their officers, officials, employees, agents and volunteers SCHEDULE 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. SAMPLE PLE 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG Insurance Services Office, Inc., 2012 Page 1 of 1

12 POLICY NUMBER: YY COMMERCIAL AUTO CA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE 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 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 does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception n date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name Of Person(s) Or Organization(s): The AMy City of Moreno y y y y Valley Housing A Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization n 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 Paragraph A.1. of Section II Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I Covered Autos Coverages of the Auto Dealers Coverage Form. The City of Moreno Valley, the City of Moreno Valley Community Services District, the Moreno Valley Housing Authority and each of their officers, officials, employees, agents and volunteers SAMPLE CA Insurance Services Office, Inc., 2011 Page 1 of 1

13 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the workers' compensation premium otherwise due on such remuneration. Minimum Premium: $ Person or Organization Schedule The City of Moreno Valley, the City of Moreno Valley Community Services District, the Moreno Valley Housing Authority and each of their officers, officials, employees, agents and volunteers Job Description ATTACHED TO AND FORMING A PART OF POLICY NO: ZZZ NAMED INSURED: EFFECTIVE DATE OF ENDORSEMENT: ENDORSEMENT NO: DATE OF ISSUE: SAMPLE

SPECIAL EVENTS INSURANCE REQUIREMENTS

Permit Center 210 Lottie Street, Bellingham, WA 98225 Phone: (360) 778-8300 Email: pwpermits@cob.org Web: www.cob.org/permits SPECIAL EVENTS INSURANCE REQUIREMENTS Permit Applicant: Give this memorandum