Insurance - TTS Engineering - 2012-09-26A� H Y , J
CERTIFICATE OF LIABILITY INSU E
DATE (MM DD YY Y)
9/26/2012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT&PILIFIoU ThEZUMTiFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER ' THE ppprCOVERAGE TAAFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BElvppply1111NRUntffMf ER(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
James G Parker Insurance Associates
License #0554959
1753 E Fir Ave
Fresno CA 93720
NAMeCT Mary Doig
PHONE (559)222 -7722 FAX (559)222 -1724
AC No:
nOORIEss.MaryDoig @jgparker. com
INSURERS AFFORDING COVERAGE
NAIC#
INSURER A:Praetoria . Insurance Compainy Company
37257
INSURED
T T S Engineering Inc DBA T T S Engineering
16835 Algonquin Street #453
,Huntington Beach CA 92649
INSURER B
INSURER C:
INSURER D:
INSURER E :
$
INSURER F:
raDy fCATC 6U IMDFD9 2 _ IA AT. Rd Renewal Onlv REVISION NUMBER:
V
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.
INS.
TR
TYPE OF INSURANCE
POLICY NUMBER
MMIDDYEFF
MMIOOrY�Y
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
-15A–M F P T ED—
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence
$
MED EXP(Any one person)
$
CLAIM S-MADE D OCCUR
PERSONAL 8 ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /OP AGG
S
$
POLICY PR0. LOU
I
I
AUTOMOBILE LIABILITY
Ea accCdentSINGLE LIMIT
$ 1,000,00
BODILY INJURY (Per person)
$
X
A
ANYAUTO
ALL OWNED SCHEDULED
01000069304
9/26/2012
9/26/2013
BODILY INJURY (Per accident)
$
AUTOS AUTOS
NON -OWNED
PeOa RTY DAMAGE
$
i{ g
HIRED AUTOS AUTOS
Uninsured motorist combined
$ 1,0 0 000
UMBRELLA LAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CLAIMCrMADE
DED RETENTION $
WORKERS COMPENSATION
WCKI M IT OTH-
A7
ANDEMPLOYERS'LIABILITY YIN
ANY PROPRIETORIPARTNER /EXECUTIVE❑
EL EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
OFFICERIMEMBER EXCLUDED?
NIA
(Mandatory In Ni
E.L. DISEASE - POLICY LIMIT
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
A
Rented /Leased Equipment
MHOI000069304
9/26/2012
9/26/2013
$1,000 Deductible $125,000
DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space Is required)
This represents the auto and inland marine coverage renewal only.
Costa Mesa Sanitary Districtr,J
District Engineering 1/61r Fu {I
628 W 19th Street
Costa Mesa, CA 92627
120101051
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
Parker III /MDOIG �—�K` -� 'zs i
0 1988-2010 ACORD CORPORATION. All rights reser
INS025 Colons,m The Ar.ni name and lone, are enicf.i mari of Aftf1RD
Other Named Insureds
im Wilson
PTS Engineering
Additional Named Insureds
Individual, Additional Named Insured
Individual, Doing Business As
OFAPPINF (02/2007) COPYRIGHT 2007, AIMS SERVICES INC
ADDITIONAL COVERAGES
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MEDPM
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5,000
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OFADTLCV Copyright 2001, AMS Services, Inc.