Loading...
Insurance - C & R Drains - 2013-09-10a R CERTIFICATE OF LIABILITY INSURANCE It. DATE (MMRDYVYY) _ 9/1HOLDE 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 Ileu of such endorsements . PRODUCER Wigmore Insurance Agency, Inc. 2970 Harbor Blvd. #215 -- - � � ED License #0811959 Costa Mesa CA 92626 SEP , ' 2013 LeU Jpppp N T NAME: PHONE FAX me E -MAIL ADDRESS INSURE S AFFORDING COVERAGE NAIC# INSURER A: I INSURERS: Surance COmDa Y 00448493 INSURED �JIII�(r� C & R Drains, Inc. Ronco Plumbing, Inc. 1525 W, MacArthur Blvd. #11 /10/2014 INSURERC: OCCURRENCE INauRER D: PREMISES INSURER E: $50,000 $Excluded Costa Mesa CA 92626 INSURER r: PERSONAL B ADV INJURY 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 LTR TYPE OF INSURANCE AD Im BR me POLICY NUMBER W DICYEFF MIL P WDDYE %P LIMITS B I GENERAL X LIABILITY COMMERCIALGENERALLIABILITY CLAIMS -MADE OCCUR Y Y 00448493 /10/2013 /10/2014 EACH OCCURRENCE $1,000,000 PREMISES NT $50,000 $Excluded occurrence) MED EXP(Any one person) PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE POLICY LIMIT APPLIES PER: X PRO- LOC ECT PRODUCTS - COMP /OPAGG $2000,000 $ A AUTOMOBILE LIABILITY N q CCA0000776 /19/2013 /19/2014 INULE LIMIT Ea aaitlent $1_000,000 BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON OWNED AUTOS BODILYINJURY(Peracdtlent) $ PRROacERTYDAMAGE $ UMBRELLA LIAB EXCESS LIAS OCCUR CUIMS -MADE EACH OCCURRENCE $ AGGREGATE $ C DIED RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N OFFICEMMEMBER EXCLUDED? (Mandatory dese in under Ifyyee Eeacrlbe antler NIA y PL502449100 /1012013 /10/2014 X WC STATU- OTH. $ E.L. EACH ACCIDENT $1,000,000 DISEASE -EA EMPLOYE $1000,000 E. L. DISEABE- POLICY LIMB $1000000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (Attach ACORD 101, ANEltlonal Remarks SChetlule, if morespace lataqulrs4) CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED WHEN REQUIRED BY WRITTEN CONTRACTOR AGREEMENT (GENERAL LIABILITY) PER FORM CG2010 -0704. COMPLETED OPERATIONS LANGUAGE PER FORM CG2037 -0704. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT (GENERAL LIABILITY) PER FORM AP5004US -1106. PRIMARY AND NON - CONTRIBUTORY LANGUAGE PER FORM AP5031 US -0410. WORKERS COMPENSATION INCLUDES BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT FORM WC 99 06 34. CANCELLATION NOTICE IS 10 DAYS IN THE EVENT OF NON PAYMENT OF PREMIUM. COSTA MESA 68W1 9TH ST SANITARY DISTRI�y/ COSTA MESA CA 92627 �� 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 ©1988 -2010 1 ne AUUHu name and logo are registered marks of ACORD reserved. Oct 09 2013 1117AM C and R Inc 714- 641 -3189 POLICY NUMBER, ©o o 6193 page 2 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 Name OFAdditlonal Insured Person(s) required by written contract or agreement A. Section II — Who Is An Insured Is amended to include as an additional insured the persons) of organlzatlon(s) shown in the Schedule, but only with respect to fiability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: Your acts or omissions; or 2. The ads or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu. slons apply This insurance does not apply to "bodily injury" or "property damage" occurring after. 1. All work, Including materials, parts or equip• ment fumished 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 locetion 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 in- tended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a princi. Pat as a part of the same project. CG 20 10 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 ❑