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Insurance-Paciic Data Electric-2014-05-16ACCPRbr CERTIFICATE OF LIABILITY INSURANCE `� DATE(MN/DDNYYY) 5/16/2014 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 Bolton & Company 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 J 13181S10aAVIon CONTACT PHONE 62s 799 -7000 FAX No: 626 583 -2117 EMAIL ADDRES INSURERS AFFORDING COVERAGE INSURER A: HDI-Gerling America Insurance Co NAIC# YP VS3Wd1S0� www.boltonco.com 0008309 INSURED W Pacific Data Electric, Inc. PDE Total Energy Solutions 9970 Bell Ranch Drive, Ste 109 Santa Fe Springs CA 90670 INSURERe: Scottsdale Insurance Company EGGCC000126714 INSURER C: 3/1/2015 INSURER D: $ 1,000,000 INSURER E: $ 100,000 INSURER F: MED EXP (Any one person) $ COVERAGES CERTIFICATE NUMBER: 9r79e1 17 REVISION NUMBER: 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 TYPEOFINSURANCE ADDL SUBS POLICY NUMBER POLICY EFF IMMIDD/YYYYI POLICY EXP MIN DfYYYYI LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F OCCUR ,� EGGCC000126714 3/1/2014 3/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGET RENTED PREMISES R.141E enrR $ 100,000 MED EXP (Any one person) $ PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 0 JEC LOG GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2,000,000 $ OTHER: A AUTO MOBILE LIABILITY EAGCC000126714 3/1/2014 3/1/2015 COMBINED SINGLE LIMIT $ 1000000 ✓ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident t ) $ ✓ NON -OWNED HIRED AUTOS ✓ AUTOS -PROPERTY -DAMAGE Per accident $ B UMBRELLA LIAB OCCUR XLS0092059 3/112014 3/1/2015 EACH OCCURRENCE $ 7,000,00 AGGREGATE IS 7,000,000 ✓ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A AND EMPLOYERS'LAB?LOITY YIN ANY OFFICER/MEMBER EXCLUDED NIA ✓ EWGCC000126714 311/2014 3/1/2015 '/ STATUTE I I ORH E. L. EACH ACCIDENT $ 1,000,000 t$ E.L. DISEASE - EA EMPLOYEd $ 1,000,000 (Mandatory in NH) If yea, tlesnibe under E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Job: #14067C. GL Additional Insured applies per CG20100413 & CG2037 0704 attached, only if required by written contract/agreement. GL Primary Wording applies per EN Al PNC 04 11 attached. WC Waiver of Subrogation applies per W0000313 attached. Additional Insured(s): The Costa Mesa Sanitary District, its directors, officials, officers, employees, agents and volunteers. Subject to Policy Terms, Conditions, Limitations and Exclusions. Costa Mesa Sanitary istrict /�J�y/ \ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 628 W 19th Street ry /� /I 1 �.1 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN "\ ACCORDANCE WITH THE POLICY PROVISIONS. Costa Mesa, CA 92627 n, Q� V� AUTHORIZED REPRESENTATIVE ! j Kim Sautter -Ramos ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserve The ACORD name and logo are registered marks of ACORD CERT NO.: 20224137 CLIENT CODE: PACIDAT -01 Nancy Cadwallader. 5/16/2014 3:07:41 PM (PDT) Page 1 of 6 POLICY NUMBER: EGGCC000126714 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 0413 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 CERT NO.: 20224137 CLIENT COOS: PACIDAT -01 Nancy Cadwallader 5116/2014 3:07:91 PM (PDT) Page 2 of 6 Page 1 of 1 POLICY NUMBER: EGGCC000126714 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. © Insurance Services Office, Inc., 2012 CERT NO.: 20224137 CLIENT CODE: PACIDAT -01 Nancy Cadwallader 5/16/2014 3:07:41 PM (PDT) Page 2 Of 6 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured' is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits Insurance shown in the Declarations; whichever is less. This endorsement shall not increase applicable Limits of Insurance shown in Declarations. of the the Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 CERT NO.: 20224137 CLIENT CODE: PACIDAT -01 Nancy Cadwallader 5/16/2014 3:07:41 PM (PDTI Page 4 of 6 EGGCC000126714 CONMIERCIAL GENERAL LIABILITY EN Al PNC 04 11 THIS ENDORSEMENT CHANGES THE POLICY - PLEASE READ IT CAREFULLY ADDITIONAL INSURED = PRIMARY AND NON - CONTRIBUTORY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Name of Person(s) or Organization(s) Where required by written Contract This insurance shall be excess over any other insurance naming the scheduled additional insured as an insured on a primary, excess, contingent, or on any other basis unless: 1. A written contract or agreement specifically requires that this insurance be primary and noncontributory. 2. The written contract is signed and executed by the named insured and additional insured prior to any "bodily injury", "property damage" or "personal and advertising injury ". 3. This policy does not apply for defense or indemnity of the additional insured if state or federal law does not permit indemnification of the additional insured by the Named Insured for the claim of a third party. 4. This insurance does not apply to the additional insured's liability to indemnify, defend or hold harmless a third parry. EN Al PNC 04 11 Page 1 of 1 CENT NO.: 20224137 CLIENT CODE: PACIDAT -01 Nancy Cadwallader 5/16/2014 3:07:41 PM (PDT) Page 5 of 6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4 -84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone riot named in the Schedule. Schedule Where required by Written contract This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement in issued subsequent to preparation of the policy.) Endorsement Effective: 3/1/2014 Policy No. EWGCC000126714 Endorsement No. Premium $ Insurance Company HDI Gerling America Insurance Cc Countersigned by WC 00 03 13 (Ed. 4 -84) Copyright 1983 National Council on Compensation Insurance. Heart Forms @Services RearderNo. 14-4888 CERT NO.: 20224139 CLIENT CODE: PACIDAT -el Nancy Cadwallader 5/16/2014 3:07:41 PM (PDT) Page 6 of 6