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Insurance - Plumbers DepotACOR" CERTIFICATE OF LIABILITY INSURANCE li DATE (MMIDD Y ) 12/12/2013 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 endorsements). PRODUCER MPX Insurance Services, Inc. 26800 Aliso Viejo Pkwy # 130 Allso Viejo, CA 92656 License MOH49306 CONTACT Jackie Chapman PHONE (949 )334-5330 ac No: 949251-2877 Eed E -MAIL ADDRESS: supportftmpxinsurance.com INSURERS AFFORDING COVERAGE NAICk Costa Mesa, CA 92627 -2716 02BP7615146 0910412013 INSURER A ENCE INSURED INSURER B; Golden Eacile Insurance 94739 INSURER C: State Compensation In r n Fund Plumbers Depot Inc INSURER O: 3921 W 139th St INSURERE: one arson) IGENERALAGGREGATE Hawthorne, CA 90250 INSURER F: $ 1.000.000 COVERAGES CERTIFICATE NUMBER: 00000410 - 569418 REVISION NUMBER: 18 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 ADD SUBR POLICYNUMBER POLICYEFF MMIDDIYri POLICYEXP MMIDDI LIMITS A GENERALLIABILITY y Costa Mesa, CA 92627 -2716 02BP7615146 0910412013 09/0412014 ENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR oao ence $ 1 ODO UDD one arson) IGENERALAGGREGATE $ 10,000 DV INJURY $ 1.000.000 REGATE $ 2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: OMPIOP AGO $ 2.000.000 X POLICY PRO- LOC $ B AUTOMOBILE LIABILITY y 24CC29578910 09/1312013 09/1312014 COMBINED SINGLE LIMIT 00 $ X ANY AUTO BODI LY I NJURY(Per person) ALL OWNED SCHEDULED AUTOS X AUTOS BODILY INJURY (Peraaitlenry $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Pereccd no $ $ X Deductible $1, 00 UMBRELLAUAB h OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS MADE DED I I RETENTIONS $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE� 400136925 0912612013 0912612014 X VuC STAT,' oTH- E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) NIA E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes, OF OPERATIONS belay E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AEditienal Remarks Schedule, if mare apace is required) Costa Mesa Sanitary District, its directors, officials, officers, employees, agents and volunteers shall be covered as additional Insured with respect to the Work or operations performed by or on behalf of the Consultant, including materials, parts or equipment furnished in connection with such work; and (2) the insurance coverage shall be primary insurance as respects the Costa Mesa Sanitary District, its directors, officials, officers, employees, agents and volunteers, or if excess, shall stand in an unbroken chain of coverage excess of the Consultant's scheduled underlying coverage. Any insurance or self- insurance maintained by the Costa Mesa Sanitary District, its directors, officials, officers, employees, agents and continued on ACORD 101 Additional Remarks Schedule CERTIFICATE HOLDER CANCELLATION ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Printed by JJM on December 12, 2013 at 09:24AM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Costa Mesa Sanitary District ///1�� THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 628 W. 19th Street \(1 / Costa Mesa, CA 92627 -2716 1� \ (/{ AUTHORIZED REPRESENTATIVE JJM ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Printed by JJM on December 12, 2013 at 09:24AM AGENCY CUSTOMER ID: 00000410 _ LOC #: ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY MPX Insurance Services, Inc. NAMED INSURED Plumbers Depot Inc POLICY NUMBER NIA CARRIER Multiple Carriers NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (continued from Description of Operations) volunteers shall be excess of the Consultant's insurance and shall not be called upon to contribute with it in any way. 101 (2008/01) © 2008 ACORD CORPORATION. The ACORD name and logo are registered marks of ACORD Printed by JJM on December 12, 2013 at 09:24AM - REPRINTEDFROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS - Liberty Mutual. INSURANCE NETWORKED INSURANCE AGENTS 988 MCCOURTNEY RD # B GRASS VALLEY, CA 95949 PLUMBERS DEPOT, INC. 3921 W 139TH ST HAWTHORNE, CA 90250 Thank you for placing your business with Liberty Mutual Insurance. NORTHEAST 2S C -040) CB INSURED COPY PREPARED 12 -06 -13 6 -2413 (2 -91) AFP-MEfA2-06- PRINT001 -0153- 0001 -W - REPRINTEDFROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS -- Your Independent Liberty Mutual Insurance Agent: NETWORKED INSURANCE AGENTS 988 MCCOURTNEY RD # B GRASS VALLEY, CA 95949 (530) 274 -3102 PLUMBERS DEPOT, INC. 3921 W 139TH ST HAWTHORNE, CA 90250 Your ULTRA SELECT POLICY Liberty Mutual. INSURANCE AMERICAN ECONOMY INSURANCE COMPANY A Stock Company Sateco Plaza Seattle, WA 98185.0001 Coverl 09 03 EP AFP- META2- 06- PRINT001 0153- 0003 -W °° REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS "^ If You Have a Claim Liberty Mutual has an unparalleled history of being there when our customers need us the most. Our state -of- the -art, 24 -hour claim service ensures your claim will be handled quickly. We'll do everything we can to get you and your business back on track as quickly as possible. The telephone number for all claims is: 1- 800 - 332 -3226 Please note. For Workers CompensationPolicies, some states assess fines and /or penalties for failure to report employee injuries in a timely manner. Thank you for allowing Liberty Mutual to fulfill your insurance needs. If you have any questions regarding your policy, please contact your independent insurance agent. Liberty Mutual. INSURANCE COVBK 8/03 EP AFP -META2 06 PRINT001 0153 0004 -W °" REPRINTEDFROMTHEARCHNE THEORIGINALTRANSACTIONMAY INCLUDE ADDITIONAL FORMS °" AMERICAN ECONOMY INSURANCE COMPANY PAGE 1 Liberty Mutual. SEATTLE, WASHINGTON INSURANCE ULTRA SELECT POLICY NAMED PLUMBERS DEPOT, INC. AMENDED DECLARATIONS INSURED 3921 W 139TH ST EFFECTIVE: 11 -20 -13 MAILING HAWTHORNE, CA 90250 POLICY NUMBER 02 -BP- 761514 -6 ADDRESS RENEWAL OF 02 -BP- 761514 -5 09 -08 SEE NAMED INSURED EXTENSION POLICYPERIOD FROM 09 -04 -13 TO 09 -04 -14 12:01 AM STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE. FORM OF BUSINESS: CORPORATION AGENT NETWORKED INSURANCE AGENTS NAME 988 MCCOURTNEY RD # B AND ADDRESS GRASS VALLEY, CA 95949 04 -21594 (530) 274 -3102 THE CHANGE IN YOUR POLICY RESULTS IN NO CHANGE IN PREMIUM. ADD ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION PER FORM BP7057: Costa Mesa Sanitary District IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. ADDL INSD -BLDG MGR/LESSOR MARY WELLS PREMISES 001 W G WELLS 3921 W 139TH ST HAWTHORNE, CA 90250 THE FOLLOWING FORMS CURRENTLY APPLY TO THIS POLICY: BP7057(0702) ADDTIL INSD- DESIG.PERSON OR OR BP0003(0106) BUSINESSOWNERS SPECIAL COVERAG BP8187(0706) CA - ORDINANCE OR LAW COVE BP7059(0105) COMMERCIAL FINE ARTS COV FORM BP0523(0108) CAP ON LOSSES CERTIFIED ACTS BP0159(0808) WATER EXCLUSION ENDORSEMEN BP0430(0106) PROTECTIVE SAFEGUARDS BP8068(0702) EXCLUSION - ASBESTOS BP0455(0106) BUSINESS LIAB COV - TENANT BP0417(0702) EMPLOYMENT RELATED PRACT. EXCL BP8128(0502) EMPLOYMENT PRACTICES LIABILITY ADDL INSD- DESIGNATED PERSON CITY OF EL SEGUNDO PREMISES 001 ATTN CITY CLERK EL SEGUNDO, CA 90245 BP8191(0606) BP7076(0606) BP0402(0106) BP8136(0108) BP8206(0606) BP0601(0107) IL7201(0392) BP8029(0702) BP0441(0106) BP8186(0706) ADDITIONAL INSURED - BY WR ULTRA PLUS ADDTIONAL INSURED - MANAGERS /LE EQUIPMENT BREAKDOWN ENDORSEMEN ID RECOVERY COV FOR DEFINE EXCL OF LOSS DUE TO VIRUS COMPANY COMMON POL CONDITIONS AMENDMENT- AGGREGATE LIMITS OF BUSINESS INCOME CHANGES - CA CHANGES (DATE) BY (AUTAORIZED REPRESERTATITE) 9- BP(11 -BB) COMPANY USE ONLY NORTHEAST 25 (JAMMOE) INSURED COPY PREPARED 12 -06 -13 CB AF- META2-0GPRINT001- 0153 - 0005 -W —REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDEADDITIONAL FORMS Liberty Mutual. INSURANCE NAMED INSURED EXTENSION PAGE 2 AMERICAN ECONOMY INSURANCE COMPANY SEATTLE, WASHINGTON POLICY NUMBER: 02 —BP- 761514 -60 The following is a complete list of the named insureds: PLUMBERS DEPOT, INC. 9 -BP (1188) COMPANYUSEONLY ADDLNAMINS089461 NORTHEAST 25 (JAMMOE) PREPARED 12 -06 -13 AFP -META2 06 PRINT001 -0153- 0009 -W "" REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS - PAGE 3 POLICY DECLARATIONS EXTENSION NAMED INSURED: PLUMBERS DEPOT, INC. POLICY NUMBER: 02 -BP- 761514 -6 THE FOLLOWING FORMS CURRENTLY APPLY TO THIS POLICY (CONTINUED FROM PREVIOUS PAGE): AFP- META2 -05- PRINT001-0153- 0007 -W —REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS PAGE 4 POLICY DECLARATIONS EXTENSION NAMED INSURED: PLUMBERS DEPOT, INC. POLICY NUMBER: 02 -BP- 761514 -6 PREMISES 1 BUILDING 1 3921 W 139TH ST CONSTRUCTION: HAWTHORNE, CA 90250 OCCUPANCY: FRAME PLUMBING SUPPLIES AND FIXTURES APPLICABLE TO THESE PREMISES LIMITS OF INSURANCE EXCEPT WHERE NOTED BELOW, A DEDUCTIBLE OF $ 500 APPLIES BUSINESS PERSONAL PROPERTY $ 121,000 BUSINESS INCOME (NOT EXCEEDING 12 CONSECUTIVE MONTHS) ACTUAL LOSS SUSTAINED DEDUCTIBLE: NONE DAMAGE TO PREMISES RENTED TO YOU $ 1,000,000 DEDUCTIBLE: NONE EQUIPMENT BREAKDOWN INCLUDED OUTDOOR SIGNS (DEDUCTIBLE: $ 250) $ 7,500 MONEY AND SECURITIES (DEDUCTIBLE: $ 250): INSIDE THE PREMISES $ 10,000 OUTSIDE THE PREMISES $ 5,000 ACCOUNTS RECEIVABLE $ 25,000 COMMERCIAL FINE ARTS $ 10,000 VALUABLE PAPERS AND RECORDS $ 25,000 SEWER OR DRAIN BACK -UP $ 5,000 ORDINANCE OR LAW - COVERAGES B AND C - COMBINED LIMIT FOR DEMOLITION COST COVERAGE AND INCREASED COST OF $ 150,000 CONSTRUCTION COVERAGE BUSINESS INCOME CAUSED BY DEPENDENT PROPERTIES $ 5,000 ELECTRONIC DATA $ 25,000 AFP- META2-06- PRINT001 -0153. 0011 -W *" REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS PAGE 5 POLICY DECLARATIONS EXTENSION NAMED INSURED: PLUMBERS DEPOT, INC. POLICYNUMBER: 02 -BP- 761514 -6 PREMISES 2 BUILDING 1 17965 SILVERTON AVE STE 1309 CONSTRUCTION: SAN DIEGO, CA 92126 OCCUPANCY: JOISTED MASONRY PLUMBING SUPPLIES AND FIXTURES APPLICABLE TO THESE PREMISES LIMITS OF INSURANCE EXCEPT WHERE NOTED BELOW, A DEDUCTIBLE OF $ 500 APPLIES BUSINESS PERSONAL PROPERTY $ 121,000 BUSINESS INCOME (NOT EXCEEDING 12 CONSECUTIVE MONTHS) ACTUAL LOSS SUSTAINED DEDUCTIBLE: NONE DAMAGE TO PREMISES RENTED TO YOU $ 1,000,000 DEDUCTIBLE: NONE EQUIPMENT BREAKDOWN INCLUDED OUTDOOR SIGNS (DEDUCTIBLE: $ 250) $ 7,500 MONEY AND SECURITIES (DEDUCTIBLE: $ 250): INSIDE THE PREMISES $ 10,000 OUTSIDE THE PREMISES $ 5,000 ACCOUNTS RECEIVABLE $ 25,000 COMMERCIAL FINE ARTS $ 10,000 VALUABLE PAPERS AND RECORDS $ 25,000 SEWER OR DRAIN BACK -UP $ 5,000 ORDINANCE OR LAW - COVERAGES B AND C - COMBINED LIMIT FOR DEMOLITION COST COVERAGE AND INCREASED COST OF $ 150,000 CONSTRUCTION COVERAGE BUSINESS INCOME CAUSED BY DEPENDENT PROPERTIES $ - 5,000 ELECTRONIC DATA $ 25,000 AFP- MEfA2 -06-PRINT001- 0153 - 0012 -W "" REPRINTEDFROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCLUDE ADDITIONAL FORMS PAGE 6 POLICY DECLARATIONS EXTENSION NAMED INSURED: PLUMBERS DEPOT, INC. POLICY NUMBER: 02 -BP- 761514 -6 APPLICABLE TO ALL PREMISES YOU OWN, RENT OR OCCUPY LIMITS OF INSURANCE BUSINESS LIABILITY: LIABILITY (INCLUDING PRODUCTS AND COMPLETED $ 1,000,000 OPERATIONS) AND MEDICAL EXPENSES MEDICAL EXPENSES (ANY ONE PERSON) $ 10,000 AGGREGATE LIMITS $ 2,000,000 EMPLOYEE DISHONESTY (DEDUCTIBLE: NONE) $ 15,000 FORGERY OR ALTERATION (DEDUCTIBLE NONE) $ 25,000 EMPLOYMENT PRACTICES (DEDUCTIBLE: NONE): EACH INCIDENT LIMIT $ 10,000 AGGREGATE LIMIT $ 10,000 RETROACTIVE DATE OF 09/04/08 IDENTITY RECOVERY COVERAGE EXPENSE REIMBURSEMENT $ 25,000 PREMIUM FOR CERTIFIED ACTS OF TERRORISM $ 21.00 TERM PREMIUM $ 5,256.00 TOTAL TERM PREMIUM $ 5,277.00 ARP- MEfA2 -06 PRINT001- 0153 -0013-W "" REPRINTED FROM THE ARCHIVE. THE ORIGINAL TRANSACTION MAY INCIUDEADDITIONAL FORMS - POLICY DECLARATIONS EXTENSION NAMED INSURED: PLUMBERS DEPOT, INC. POLICY NUMBER: 02 -BP- 761514 -6 ADDL INSD- DESIGNATED PERSON ADDL INSD- DESIGNATED PERSON COUNTY SANITATION DISTRICT OF COUNTY OF LOS ANGELES PREMISES 001 LOS ANGELES PREMISES 001 DEPARTMENT OF PUBLIC WORKS PO BOX 4998 900 SOUTH FREMONT AVENUE WHITTIER, CA 90607 ALHAMBRA, CA 91803 AI /BP7057 AI DESIGNATED PERSON /ORG ADDL INSD - DESIGNATED PERSON CITY OF SANTA MONICA PREMISES 001 FINANCE DEPARTMENT 1717 4TH STREET, SUITE 270 SANTA MONICA, CA 90401 PAGE 7 ADDL INSD- DESIGNATED PERSON COSTA MESA SANITARY DISTRICT PREMISES 001 628 W. 19TH STREET COSTA MESA, CA 92627 AI DESIGNATED PERSON /ORG AFP-MEfA2 -06- PRINT001- 0153- 0014W.L