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Insurance - Environmental Engineering & Contracting - 2014-04-29
AFRO® CERTIFICATE OF LIABILITY INSURANCE Dnr4/29/20 4 YI 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 endorsement(s). PRODUCER Garrett/Mosier /Griffith /Sistrunk Risk Management & Insurance Services 12 Truman Irvine, CA 92620 CONTACT PHONE FAX Ext (949)559-6700 AIC No: 949 559 -6703 ADDRESS: INSURERS AFFORDING COVERAGE NAICk INSURER A: Peerless Insurance Companv 24198 www.gmgs.com 0864519 INSURED Environmental Engineering & Contracting, Inc. 501 Parkcenter Drive INSURER B: $ INSURER C: MED EXP (Any one person) INSURER D: Santa Ana CA 92705 INSURER E: $ GENT AGGREGATE LIMIT APPLIES PER POLICY D JEST LOC OTHER: INSURER F: $ PRODUCTS- COMP/OPAGG COVERAGES CERTIFICATE NUMBER: 20014695 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 ADDLSUBR INSD WVD POLICYNUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY) LIMITS COMMERCIAL GENERALUABILITY CLAIMS -MADE 1-1 OCCUR EACHOCCURRENCE $ A AGET RENTED PREMISES Ea occun¢noe $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER POLICY D JEST LOC OTHER: GENERAL AGGREGATE $ PRODUCTS- COMP/OPAGG $ $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS ✓ AUTOS CBP9589097 4/30/2014 10/31/2014 2, .n SINGLE LIMIT $ 1000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per acc ) itlent $ PROPERTY DAMAGE Per accment $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below NIA I OTH- STATUTE ER E. L. EACH ACCIDENT $ E . DISEASE - EA EMPLOYE $ E . DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCgT E CIM �C EJUdditional Remarks Schedule, may be affached if more space Is required) MAY 0 12214E LJ 0 wMA MbA WIWI OISIRICI Costa Mesa Sanitary istrict SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 628 W. 19th Street ry / r THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa CA 92627 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Grill Griffith \ ©1988 -2014 ACORD CORPORATION. All riahts reserve ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 20014695 MaeiaSa Remo 4/29/2014 1:20:18 PM (PM Page 1 of 1