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Insurance - Trimco Finish Inc - 2012-05-01ACORD CERTIFICATE OF LIABILITY INS CE GATE (MMIDD /YYY ) 5/1/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFLF THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER T E COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRAMAY 1NOE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. "- PORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies BROGATION IS WAIVED, subject to terms and conditions of the policy, certain policies may require an endorsement. A statement an this certificate does not confer rights to the ,- ftificate holder in lieu of such endorsement(s). PRODUCER CONTACT Julie Felix NAME: Venbrook Ins. Services, CA Lic OD80832 6320 Canoga Avenue PHONE (818)598 -8940 F Me, (818)598 -5686 ieri.ti,;(�2.-.'x@venbrook.com 12th Floor INSURE 5 ) AFFORDING COVERAGE NAIC# INSURER A:Insurance Company of the West 27847 Woodland Hills CA 91367 INSURED INSURERS: I INSURERC: Trimco Finish, Inc. Trimco Landscape, Inc. INSURER D: 3130 W. Harvard Street INSURERE: MED EXP (Any one person) Santa Ana CA 92704 INSURER F; DLA MS -MADE F� OCCUR COVERAGES CERTIFICATE NUMBER:12 -13 WC Only 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 LTR TYPE OF INSURANCE ADuLsu.K POLICY NUMBER POLICYEFF MM /DD/YYYY POLICYEXP MMIDDIY/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY ED PREMISES Ht:NI U $ MED EXP (Any one person) $ DLA MS -MADE F� OCCUR PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS- COMP /OP AGO $ POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) BODI LY INJURY (Par person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident ) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ I A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N 1. WC STATU- DTH- E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) N/A 502113200 /1/2012 /1/2013 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under E.L. DISEASE - POLICYLIMIT $ 1,00-0,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Waiver of Subrogation applies to Workers' Compensation. *10 Days Notice of Cancellation for Non - Payment of Premium, 30 Days All Others Costa Mesa Sanitary District 628 W. 19th Street Costa Mesa, CA 92627 ACORD 25 (2010/05) 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 Parnes /JFX © 1988 -20 INS025 (201005).01 The ACORD name and logo are registered marks of ACORD All riahts rPServad WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 (Ed. 8 -00) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT — BLANKET 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.) The additional premium for this endorsement shall be 3% of the total California Workers' Compensation premium otherwise due. SCHEDULE Person or Organization Job Description ANY PERSON OR ORGANIZATION ALL CALIFORNIA OPERATIONS WHEN REQUIRED BY WRITTEN CONTRACT Policy Number: WVE502113200 Endorsement Effective: 5 -01 -12 `-,sued Date: 05 -01 -12 WC 99 06 34 (Ed. 8 -00) Insured: Trimco Finish, Inc. Trimco Landscape, Inc. Coverage Provided by: Insurance Company of the West Countersigned by: