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Insurance-Jimni Systems Inc - 2012-03-29SMCH I TtRTIFICATE OF LIABILITY INSURANCE OAT D/VYVV) 3//29/229 /2012 THIS CEEfr�RT����jj���iQQ��i�cI I D AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERT 90" XA LCONSTITUTE TBETWEEN OTHER NSURANCOE DOES NOT CONTRACT ISSUING NSURER(S)TAUTHOR AUTHORIZED :PRESENTATIVE 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 (888) 825 -4322 Bowermaster & Associates P.O. Box 6026 10805 Holder Street - Suite 350 Cypress, CA 90630 CONTACT Christine Smile PHONE FAX No E,11,7114-733-6200 214 LAIC No): 714- 252 -8253 E-MAIL ADDRESe'Rcsmiley bowermaster.com CUSTOMER to a, SOCPAC -003 4/1/2012 41112013 EACH OCCURRENCE INSURER(S) AFFORDING COVERAGE NAIC q INSURED Jimni Systems, Inc. INSURERA:Scottsdale Insurance Company $. Excluded 25295 Cinnamon Road INSURER B: American States Ins Lake Forest, CA 92630 INSURER c: RSUI Indemnity Company GENERALAGGREGATE INSURER D: Zurich American Insurance Company GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT LOC PRODUCTS- COMP /OP AGO INSURER E: $ INSURER F: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 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 TR TYPE OF INSURANCE INSR R POLICY NUMBER POLICY EFF (MM/DDNYYYI POLICY EXP IMMIDDNYYYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I—XI OCCUR X BCS0024583 4/1/2012 41112013 EACH OCCURRENCE $ 1,000,00 PREMISES (E. occurrence) $ 100,00 MED EXP(Any one person) $. Excluded PERSONAL &ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT LOC PRODUCTS- COMP /OP AGO $ 2,000,00 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X 24CC3006271 4/1/2012 4/1/2013 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY uindent) AGE (Peratlenq $ X X $ $ C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE NHA225944 411/2012 411/2013 EACH OCCURRENCE $ 3,000,00 X AGGREGATE $ 3,000,00 DeoucneLE I RETENTION $ Nil $ X _ IS D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVEY /N OFFICER /MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC966063001 4/112012 4/1/2013 X I WC STATU- OTH- T RY LIMITS ER E.L. EACH ACCIDENT Is 1,000,00 L. E. DISEASE -EA EMPLOYEE $ 1,000,00 EL .DISEASE - POLICY LIMIT Is 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Costa Mesa Sanitary District is Additional Insured as respects General Liability per form GLS294S310 and Auto Liability per form CA7110307. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE j if I . V THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District �J' Ij(t) ACCORDANCE WITH THE POLICY PROVISIONS. 628 W. 19th Street Costa Mesa, CA 92627 - AUTHORIZED REPRESENTATIVE ©1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD A SCOTTSDALE INSURANCE COMPANY" ENDORSEMENT NO. oo1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED- OWNERS, LESSEES OR CONTRACTORS SPECIAL CONDITION For coverage provided in the following endorsements as indicated by an "X' in the box below: • Additional. Insured —Owners, Lessees Or Contractors — Scheduled Person Or Organization (CG 2010). • Additional Insured —Owners, Lessees Or Cur tractors— Auturnatic Status When Required In Construction Agreement With You (CG 2033). • Additional Insured— Owners, Lessees Or Contractors — Completed Operations (CG 20 37). The insurance provided is amended to be (indicated by an "x" in one box below):. • Primary and noncontributory. • Primary. o Noncontributory. ❑ If this box Is checl<ed, this endorsement applies only to the following additional insured(s): AUTHORIZED REPRESENTATIVE DATE GLS -294s (3 -10) Page 1 of 1 ATTACHEO TO AND ENOORSEtdENT EFFECTIVE OAT[ FORMING A PART OF OORSEM.1.5TANOAFO TIME) MANED INSURED AGENT NO - POLICY NUMBER BCS0024583 04101/2012 Jimni Syslems, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED- OWNERS, LESSEES OR CONTRACTORS SPECIAL CONDITION For coverage provided in the following endorsements as indicated by an "X' in the box below: • Additional. Insured —Owners, Lessees Or Contractors — Scheduled Person Or Organization (CG 2010). • Additional Insured —Owners, Lessees Or Cur tractors— Auturnatic Status When Required In Construction Agreement With You (CG 2033). • Additional Insured— Owners, Lessees Or Contractors — Completed Operations (CG 20 37). The insurance provided is amended to be (indicated by an "x" in one box below):. • Primary and noncontributory. • Primary. o Noncontributory. ❑ If this box Is checl<ed, this endorsement applies only to the following additional insured(s): AUTHORIZED REPRESENTATIVE DATE GLS -294s (3 -10) Page 1 of 1 Jimni Systems, Inc. "'• REPRINTED FROM THE FORMS LIBRARY . "• COMMERCIAL AUTO CA 71 10 03 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following:. BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement EXTENDED CANCELLATION CONDITION Paragraph 2.b. of the CANCELLATION Common Policy Condition is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. TEMPORARY SUBSTITUTE AUTO — PHYSICAL DAMAGE COVERAGE Under paragraph C. — CERTAIN TRAILERS, MO- BILE EQUIPMENT AND TEMPORARY SUBSTITUTE AUTOS of SECTION 1 — COVERED AUTOS, the following is added` If Physical Damage coverage is provided by this Cov- erage Form, then you have coverage for: Any "auto" you do not own while used with the per- mission of .its owner as a temporary substitute for a covered "auto" you own that is out of service be- cause of its breakdown, repair, servicing, "loss" or destruction.. BROAD FORM. NAMED INSURED SECTION II - LIABILITY COVERAGE — A.1. WHO IS AN INSURED provision is amended by the addition of the following: d. Any business entity newly acquired or formed by you during the policy period provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisi- tion or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period- BLANKET ADDITIONAL INSURED SECTION II — LIABILITY COVERAGE =.A.1. WHO IS AN INSURED provision is amended by the addition of the following:: e. Any person or organization for whom you are re- quired by an "insured contract,, to provide insur- ance is an "insured ", subject to the following additional provisions: (1). The `insured- Contract" must be Jri - effect during the policy period shown in the. Decla- rations,. and must have been executed prior to the "bodily injury" or ,property damage (2) This person or organization is an insured" only to the extent you are liable due to your ongoing operations for that insured, whether the work is performed by you or for you, and only to the extent you are held liable for an "accident" occurring while a covered "auto" is being driven by you or one of your em- ployees, (3) There is no coverage provided to this person or organization for bodily injury" to its em- ployees, nor for "property damage" to its property. (4) Coverage- for this person: or organization shall be limited to the extent of your negli- gence or fault according to the applicable principles of comparative negligence or fault. (5) The defense of any claim or "suit" must be tendered by this person or organization as soon as practicable to all other insurers which potentially provide insurance for such claim or "suit ". Includes copyrighted material of Insurance Services Office, Inc -, with its permission. Copyright, Insurance Services Office, Inc -, 1997 Saleco and the Saleco logo are reptered eadema,ks of Saleco Coryoralion. CA 71 10 03 07 Page i W 6 EP "" REPRINT ED FROM THE FORMS UORNRY "" c. The market value of your damaged vehicle, not including any furnishings, parts or equip- ment not installed by the manufacturer or manufacturer's dealership. This coverage applies only to a covered "auto" of the private passenger, light truck or medium truck type (20,000 Ibs or less gross vehicle weight) and does not apply to initiation or set up costs associated with loans or leases. TWO OR.. MORE DEDUCTIBLES Under SECTION -III — PHYSICAL DAMAGE COV- ERAGE, if two or more "company" policies or cover- age forms apply to the same accident, the following applies to paragraph D. Deductible: a. If the applicable Business Auto deduct- ible is the smaller (or smallest) deduct- ible it will be waived; or b. If the applicable Business Auto deduct- ible is not the smaller (or smallest) de- ductible it will be reduced by the amount of the smaller (or smallest) deductible; or c. If the loss :involves two or more Busi- ness Auto coverage forms or policies . the smaller: (or smallest) deductible will be waived. For the purpose of this endorsement "company" means: a, Safeco Insurance Company of America b. American States Insurance Company c. General Insurance Company of America d. American Economy Insurance Company e. First National Insurance Company of America - f..American States Insurance Company of Texas a. Actual cash value of the damaged or stolen . property as of the time of the "loss ", less an adjustment for depreciation and physical condition; or b. Balance due under the terms of the loan or lease that the damaged covered "auto" is subject tout the time of, the "loss"., less any one or all of the following adjustments: (1) Overdue payment and financial penalties associated with those payments as of the date of the "loss ". _ (2) Financial penalties imposed under a lease due to high mileage, exces- sive use or abnormal wear and tear. (3) Costs for extended warranties, Cre- dit Life Insurance, Health; Accident or Disability Insurance. purchased. with the loan or lease. (4) Transfer or rollover balances from .previous loans or leases. (5) Final payment due under a `Balloon Loan ". (6) The dollar amount of any un- repaired damage that occurred prior to the `total loss" of a covered "auto ". (7) Security deposits not refunded by a lessor. (8) All refunds 1payable or paid to you as a result of the early termination of a lease agreement or any war- ranty or extended service agree- ment on a covered "auto ": (9) Any amount representing taxes. (10) Loan . or lease. termination fees GLASS REPAIR WAIVER OF DEDUCTIBLE g. American States Preferred Insurance Under paragraph D. DEDUCTIBLE of SECTION III Company — PHYSICAL DAMAGE COVERAGE, the following Is h. Safeco Insurance Company of Illinois. added: LOAN /LEASE -GAP COVERAGE Under paragraph- C — LIMIT OF INSURANCE of SECTION III. — PHYSICAL DAMAGE COVERAGE, the following is. added: No deductible applies to glass damage if the glass is repaired rather than replaced. AMENDED DUTIES IN THE EVENT OF ACCI- DENT, CLAIM, SUIT OR LOSS 4. The most we will pay for a total "loss" in any one The requirement in LOSS CONDITION. 2.a. — "accident" is the greater of the following, subject DUTIES IN THE EVENT OF ACCIDENT, CLAIM, to a $1,500 maximum limit: SUIT OR .LOSS — of SECTION IV — BUSINESS AUTO CONDITIONS that you must notify us of an CA 71 10 03 07 Page 3 of 6 EP Rental Reimbursement CA 99 23. "" REPRINTED FROM THE FORMS LIBRARY "" Coverage Form AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE A. Coverage 1. We will pay with respect to -a covered "auto" for "loss" to any electronic equipment that receives or transmits audio, visual or data signals and that is not designed solely for the reproduction of sound. This coverage applies only if the equipment is permanently installed in the covered "auto" at the time of the "loss" or the equipment is removable from a housing unit which is permanently installed in the covered - "auto" at the time of the "loss'; and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto ". 2. We will pay with respect to a covered "auto" for "loss" to any accessories used with the electronic equipment described in paragraph A.1. above. However, this does not 'include tapes, records or discs. 3. If Audio, Visual and Data Electronic Equip- ment Coverage form CA 99 60 or CA 99 94 is attached to this Policy, then the Audio,'Vi- sual and Data Electronic Equipment Cover- age described above does not apply. B. Exclusions The exclusions that apply to PHYSICAL DAM- AGE COVERAGE, except for the exclusion relat- ing to Audio, Visual. and- Data Electronic ,Equipment, also apply to this coverage. In addi- tion, the following exclusions apply: We will not pay for either any electronic equip- ment or accessories used with such electronic equipment that is: 1. Necessary for the normal operation of the covered "auto" for the monitoring of the covered "auto's" operating system; or the manufacturer for the installation of a radio. C. Limit of Insurance With respect to this coverage, the LIMIT OF IN- $URANCE provision of PHYSICAL DAMAGE COVERAGE is replaced by the.. following: 1. The most we will pay for "loss" to audio, vi- sual or data electronic equipment and any accessories used with this equipment as a result of any one "accident" is the lesser of: -a. The actual cash value of the damaged or stolen property as of the time of the "loss "; or b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. -c. $1,000. 2. An adjustment for depreciation and physical condition will be made in determining actual cash value at the time of the "loss „,. 3. if a. repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment. D. Deductible P# 2. Both: a. an integral part of the same unit housing any sound reproducing equipment de- signed solely for the reproduction of sound if the sound reproducing 3 equipment is permanently installed in the covered "auto "; and b. permanently installed in the opening of the dash or console normally used by If "loss ".to.the audio, visual or data elec- tronic equipment or accessories used with this equipment is the result-of a "loss" to the covered "auto” under the Business Auto Coverage Form's Comprehensive or Colli- sion Coverage, then for each covered "auto" our obligation to pay for, repair, return or re- place damaged or stolen property will be re- duced by the applicable deductible shown in the Declarations.. Any Comprehensive Cov- erage deductible shown in the Declarations does not .apply to "loss" to audio, . visual or data electronic equipment caused by fire or lightning. If "loss" to the audio,. visual or data elec- tronic equipment or accessories used with this equipment is the result of a "loss" to the covered "auto" under the Business Auto Coverage Form's Specified Causes of Loss Coverage, then for each covered "auto" our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a 5100 deductible. If 'loss" occurs solely to the audio, visual or data electronic equipment or accessories used with this equipment, then for each cov- ered "auto" our obligation to pay for, repair; CA 71 10 03 07 Page 5 of 6 EP