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Insurance - Sancon Engineering Inc. - 2013-09-30
• • �� A`R D CERTIFICATE OF LIABILITY INSURANCE 9/30/2013) 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 endorsement(s). PRODUCER CONTACT Pamela De Guzman NAME: Poms & Associates Insurance Brokers, Inc. LYCO.NNo.EM),. (800)578-8802 (A/C,No):(818)449-9321 CA License #0814733 E-MAIL omsassoc.corn PDe uzman@ ADDRESS:PDeguzman@pomsassoc.com 5700 Canoga Ave. #400 INSURER(S)AFFORDING COVERAGE NAIC# Woodland Hills CA 91367 INSURERA:Travelers Indemnity Co. of Ct 25682 INSURED INSURERB:Liberty Surplus Ins. Corp. 10725 Sancon Engineering, Inc. INSURERC:Travelers Property & Cas Co. 25674 5841 Engineer Drive INSURERD: INSURER E: Huntington Beach CA 92649 INSURERF: COVERAGES CERTIFICATE NUMBER:10/1/13 - 10/1/14 ALL 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 TYPE OF INSURANCE • ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR � INSR WVD POLICY NUMBER - (MM/DD/YYYY) (MMIDDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR X Y DT22-C0-9181R93A-TCT-13 10/1/2013 10/1/2014 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY n Fjr2i LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ C ALLOWNED SCHEDULED BA-9181R93A-TIL-13 10/1/2013 10/1/2014 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS x NON-OWNED PROPERTY DAMAGE $ _ AUTOS (Per accident) X Comp$1000 X Coll$1,000 $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 C EXCESS LIAR CLAIMS-MADE AGGREGATE $ 4,000,000 DED X RETENTION$ 10,000 DTSM-CUP-9181R93A-TIL-13 10/1/2013 10/1/2014 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' C LIABILITY X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A DTJ-UB-9181R93A-TIL-13 10/1/2013 10/1/2014 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 B Contractors Pollution T1ELA104833113 10/1/2013 10/1/2014 EACH CLAIM 2,000,000 Liability DEDUCTIBLE: 25,000 EACH AGGREGATE LIMIT 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: All Operations . It is agreed that the Costa Mesa Sanitary District is named as Additional Insured per the attached endorsement. It is further agreed that said insurance is Primary and that Waiver of Subrogation apply. See attached endorsements. *10 Days Notice of Cancellation will apply for non-payment of premium. CERTIFICATE HOLDER CANCELLATION + SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE JTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary DistriC 6\lik A CCORDANCE WITH THE POLICY PROVISIONS. 628 West 19th Street Costa Mesa, CA 92627 AUTHORIZED REPRESENTATIVE Pamela De Guzman/CHAR '""Illigiv ,` ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025r?mnnctni Thn ACf1Rf namc and Innn aru rcnictmrnrl marlrc of A('.flan • • Sancon Engineering, Inc. Travelers Property Casualty Company of America COMMERCIAL GENERAL LIABILITY Policy# DT22-C0-9181R93A-TCT-13 Eff : 10/01/2013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for"bodily injury", requiring insurance" specifically requires you "property damage"or"personal injury"; and to provide such coverage for that additional insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance" applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the "written contract requiring insurance", the in- "written contract requiring insurance" specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" surance". This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III—Limits Of Insurance. for such loss, and we will not share with that b) The insurance provided to the additional in- other insurance . But the insurance provided to the additional insured by this endorsement still is sured does not apply to "bodily injury", "prop- excess over any valid and collectible "other in- erty damage" or "personal injury" arising out surance", whether primary, excess, contingent or of the rendering of, or failure to render, any on any other basis, that is available to the addi- professional architectural, engineering or sur- tional insured when that person or organization is veying services, including: an additional insured under such "other insur- I. The preparing, approving, or failing to ance". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, approving, or failing to prepare or ap- a) The additional insured must give us written prove, drawings and specifications; and notice as soon as practicable of an "occur- fl. Supervisory, inspection, architectural or rence" or an offense which may result in a engineering activities. claim. To the extent possible, such notice should include: CG D2 46 08 05 ©2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 • • COMMERCIAL GENERAL LIABILITY I. How, when and where the "occurrence" any provider of"other insurance"which would or offense took place; cover the additional insured for a loss we ii. The names and addresses of any injured cover under this endorsement. However, this persons and witnesses;and condition does not affect whether the insur- ance provided to the additional insured by iii. The nature and location of any injury or this endorsement is primary to "other insur- damage arising out of the"occurrence"or ance" available to the additional insured offense. which covers that person or organization as a b) If a claim is made or"suit" is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V. I. Immediately record the specifics of the —DEFINITIONS: claim or"suit"and the date received; and "Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement The additional insured must see to it that we under which you are required .to include a receive written notice of the claim or"suit"as person or organization as an additional in- sured on this Coverage Part, provided that soon as practicable. the "bodily injury" and "property damage"oc- c) The additional insured must immediately curs and the"personal injury" is caused by an send us copies of all legal papers received in offense committed: connection with the claim or"suit", cooperate a. After the signing and execution of the with us in the investigation or settlement of contract or agreement by you; the claim or defense against the "suit", and otherwise comply with all policy conditions. b. While that part of the contract or d) The additional insured must tender the de- agreement is in effect; and fense and indemnity of any claim or "suit" to c. Before the end of the policy period. Page 2 of 2 4 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 5ancon,Engineering,Inc. Travelers Property Casualty Co. of Ameri•olicy#DT22-CO-9181R93A-TCT-1 Ef f : 10/01/2013 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE—Provisions A.-H. and J.-N.of this endorsement broaden coverage, and provision I. of this endorsement may limit coverage. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the PROVISIONS of this endorsement carefully to determine rights, duties, and what is and is not covered. A. Broadened Named Insured H. Additional Insured—State or Political Subdivisions B. Extension of Coverage—Damage To Premises I. Other Insurance Condition Rented To You J. Increased Supplementary Payments • Perils of fire,explosion, lightning, smoke,water • Cost of bail bonds increased to$2,500 • Limit increased to$300,000 • Loss of earnings increased to$500 per day C. Blanket Waiver of Subrogation K. Knowledge and Notice of Occurrence or Offense D. Blanket Additional Insured—Managers or Lessors L. Unintentional Omission of Premises E. Incidental Medical Malpractice M. Personal Injury—Assumed by Contract N. Blanket Additional Insured—Lessor of Leased F. Extension of Coverage—Bodily Injury Equipment G. Contractual Liability—Railroads PROVISIONS 3. This Provision A. does not apply to any per- A. BROADENED NAMED INSURED son or organization for which coverage is ex- 1. The Named Insured in Item 1. of the Declara- chided by endorsement. tions is as follows: B. EXTENSION OF COVERAGE — DAMAGE TO PREMISES RENTED TO YOU The person or organization named in Item 1. of the Declarations and any organization, 1. The last paragraph of COVERAGE A. BOD- other than a partnership, joint venture or Iim- ILY INJURY AND PROPERTY DAMAGE Li- fted liability company, of which you maintain ABILITY (Section I — Coverages) is deleted ownership or in which you maintain the major- and replaced by the following: ity interest on the effective date of the policy. Exclusions c.through n. do not apply to dam- However, coverage for any such additional age to premises while rented to you, or tem- organization will cease as of the date, if any, porarily occupied by you with permission of during the policy period, that you no longer the owner,caused by: maintain ownership of, or the majority interest a. Fire; in,such organization. 2. WHO IS AN INSURED (Section II) Item 4.a. b. Explosion; is deleted and replaced by the following: c. Lightning; a. Coverage under this provision is afforded d. Smoke resulting from such fire,explosion, only until the 180th day after you acquire or lightning; or or form the organization or the end of the e. Water. policy period,whichever is earlier. A separate limit of insurance applies to this coverage as described in Section Iii Limits Of Insurance. CG D3 16 07 04 Copyright,The Travelers Indemnity Company, 2004 Page 1 of 6 • • COMMERCIAL GENERAL LIABILITY 2. This insurance does not apply to damage to 5. This Provision B. does not apply if coverage premises while rented to you, or temporarily for Damage To Premises Rented To You of occupied by you with permission of the COVERAGE A. BODILY INJURY AND owner,caused by: PROPERTY DAMAGE LIABILITY (Section I— a. Rupture, bursting, or operation of pres- Coverages)is excluded by endorsement. sure relief devices; C. BLANKET WAIVER OF SUBROGATION b. Rupture or bursting due to expansion or We waive any right of recovery we may have swelling of the contents of any building or against any person or organization because of structure, caused by or resulting from wa- payments we make for injury or damage arising ter; out of: premises owned or occupied by or rented c. Explosion of steam boilers, steam pipes, or loaned to you; ongoing operations performed steam engines,or steam turbines. by you or on your behalf, done under a contract 3. Paragraph 6. of LIMITS OF INSURANCE with that person or organization; "your work"; or 9 P "your products". We waive this right where you (Section III) is deleted and replaced by the have agreed to do so as part of a written contract, following: executed by you before the "bodily injury" or Subject to 5. above, the Damage To Prem- "property damage" occurs or the "personal injury" ises Rented To You Limit is the most we will or"advertising injury"offense is committed. pay under COVERAGE A. for the sum of all D. BLANKET ADDITIONAL INSURED — MANAG- damages because of "property damage" to ERS OR LESSORS OF PREMISES any one premises while rented to you, or temporarily occupied by you with permission WHO IS AN INSURED (Section II) is amended to of the owner, caused by: fire; explosion; light- include as an insured any person or organization Wing; smoke resulting from such fire, explo- (referred to below as "additional insured") with sion, or lightning; or water. The Damage To whom you have agreed in a written contract, exe- Premises Rented To You Limit will apply to all cuted before the "bodily injury" or"property dam- "property damage" proximately caused by the age" occurs or the "personal injury" or "advertis- same "occurrence", whether such damage ing injury" offense is committed, to name as an results from: fire; explosion; lightning; smoke additional insured, but only with respect to liability resulting from such fire, explosion, or light- arising out of the ownership, maintenance or use ping; or water; or any combination of any of of that part of any premises leased to you, subject these causes. to the following provisions: The Damage To Premises Rented To You 1. Limits of Insurance. The limits of insurance Limit will be the higher of: afforded to the additional insured shall be the a. $300,000; or limits which you agreed to provide in the writ- ten contract, or the limits shown on the Decla- b. The amount shown on the Declarations rations, whichever are less. for Damage To Premises Rented To You 2. The insurance afforded to the additional in- Limit. sured does not apply to: 4. Paragraph a. of the definition of"insured con- a. Any "bodily injury" or "property damage" tract" (DEFINITIONS — Section V) is deleted that occurs,or"personal injury"or"adver- and replaced by the following: tising injury" caused by an offense which a. A contract for a lease of premises. How- is committed, after you cease to be a ten- ever, that portion of the contract for a ant in that premises; lease of premises that indemnifies any b. Any premises for which coverage is ex- person or organization for damage to cluded by endorsement;or premises while rented to you, or tempo- rarily occupied by you with permission of c. Structural alterations, new construction or the owner, caused by: fire; explosion; demolition operations performed by or on lightning; smoke resulting from such fire, behalf of such additional insured. explosion, or lightning; orwater, is not an 3. The insurance afforded to the additional in- "insured contract"; sured is excess over any valid and collectible Page 2 of 6 Copyright,The Travelers Indemnity Company, 2004 CG D3 16 07 04 • • COMMERCIAL GENERAL UABILITY "other insurance" available to such additional together with all related acts or omissions in insured, unless you have agreed in the writ- the furnishing of the services described in ten contract that this insurance must be pri- paragraph 1. above to any one person will be mary to, or non-contributory with, such "other deemed one"occurrence". insurance". 5. This Provision E. does not apply if you are in E. INCIDENTAL MEDICAL MALPRACTICE the business or occupation of providing any of 1. The following is added to paragraph 1. Insur- the services described in paragraph 1. above. ing Agreement of COVERAGE A. — BODILY 6. The insurance provided by this Provision E. INJURY AND PROPERTY DAMAGE LIABIL- shall be excess over any valid and collectible ITY(Section I—Coverages): "other insurance" available to the insured, "Bodily injury" arising out of the rendering of, whether primary, excess, contingent or on or failure to render, the following will be any other basis, except for insurance that you deemed to be caused by an"occurrence": bought specifically to apply in excess of the Limits of Insurance shown on the Declara- a. Medical,surgical, dental,laboratory, x-ray tions of this Coverage Part. or nursing service, advice or instruction, F. EXTENSION OF COVERAGE — BODILY IN- or the related furnishing of food or bever- JURY ages; b. The furnishing or dispensing of drugs or The definition of "bodily injury" (DEFINITIONS — medical, dental, or surgical supplies or Section V) is deleted and replaced by the follow- appliances; ing: c. First aid;or "Bodily injury" means bodily injury, mental an- guish, mental injury, shock, fright, disability, hu- d. "Good Samaritan services." As used in miliation, sickness or disease sustained by a per- this Provision E., "Good Samaritan ser- vices" are those medical services ren- any time. dered or provided in an emergency and G. CONTRACTUAL LIABILITY—RAILROADS for which no remuneration is demanded or received. 1. Paragraph c. of the definition of"insured con- 2. Paragraph 2.a.(1)(d) of WHO IS AN IN- tract" (DEFINITIONS — Section V) is deleted SURED (Section II) does not apply to any and replaced by the following: registered nurse, licensed practical nurse, c. Any easement or license agreement; emergency medical technician or paramedic 2. Paragraph f.(1) of the definition of "insured employed by you, but only while performing contract" (DEFINITIONS — Section V) is de- the services described in paragraph 1. above leted. and while acting within the scope of their em- ployment by you. Any "employees" rendering H. ADDITIONAL INSURED — STATE OR POLITI- "Good Samaritan services" will be deemed to CAL SUBDIVISIONS—PERMITS be acting within the scope of their employ- WHO IS AN INSURED (Section 11) is amended to ment by you. include as an insured any state or political subdi- 3. The following exclusion is added to paragraph vision, subject to the following provisions: 2. Exclusions of COVERAGE A. — BODILY 1. This insurance applies only when required to INJURY AND PROPERTY DAMAGE LIABIL- be provided by you by an ordinance, law or ITY(Section I—Coverages): building code and only with respect to opera- (This insurance does not apply to:) "Bodily in- tions performed by you or on your behalf for jury" or "property damage" arising out of the sued atpe state or political subdivision has is- willful violation of a penal statute or ordinance relating to the sale of pharmaceuticals com- 2. This insurance does not apply to: miffed by or with the knowledge or consent of a. "Bodily injury," "property damage," "per- the insured. sonal injury" or"advertising injury" arising 4. For the purposes of determining the applica- out of operations performed for the state ble limits of insurance, any act or omission or political subdivision; or CG D3 16 07 04 Copyright,The Travelers Indemnity Company, 2004 Page 3 of 6 • • COMMERCIAL GENERAL LIABILITY b. "Bodily injury" or "property damage" in- insured under any other policy, cluded in the "products-completed opera- including any umbrella or excess tions hazard". policy. I. OTHER INSURANCE CONDITION When this insurance is excess, we A. COMMERCIAL GENERAL LIABILITY CON- will have no duty under Coverages A or B to defend the insured against DITIONS (Section IV), paragraph 4. (Other any "suit" if any provider of"other in- Insurance) is deleted and replaced by the fol- surance" has a duty to defend the in- lowing: sured against that "suit". If no pro- 4. Other Insurance vider of "other insurance" defends, we will undertake to do so, but we will If valid and collectible "other insurance" is be entitled to the insureds rights available to the insured for a loss we against all those providers of "other cover under Coverages A or B of this insurance". Coverage Part, our obligations are limited as follows: When this insurance is excess over a. Primary Insurance "other insurance", we will pay only our share of the amount of the loss, if This insurance is primary except any, that exceeds the sum of: when b. below applies. If this insur- (1) The total amount that all such ance is primary, our obligations are "other insurance" would pay for not affected unless any of the "other the loss in the absence of this in- insurance" is also primary. Then, we surance; and will share with all that "other insur- The total of all deductible and ance by the method described in c. (2) below. self-insured amounts under that "other insurance". b. Excess Insurance We will share the remaining loss, if This insurance is excess over any of any, with any"other insurance"that is the "other insurance", whether pri- not described in this Excess Insur- mary, excess, contingent or on any ance provision. other basis: (1) That is Fire, Extended Coverage, c. Method Of Sharing Builder's Risk, Installation Risk, If all of the "other insurance" permits or similar coverage for "your contribution by equal shares, we will work"; follow this method also. Under this approach each provider of insurance (2) That is Fire insurance for prem- ises rented to you or temporarily contributes equal amounts until it has occupied by you with permission paid its applicable limit of insurance of the owner; or none of the loss remains, which- of comes first. (3) That is insurance purchased by If any of the "other insurance" does you to cover your liability as a not permit contribution by equal tenant for "property damage" to shares, we will contribute by limits. premises rented to you or tempo- Under this method, the share of each rarily occupied by you with per- provider of insurance is based on the mission of the owner; or ratio of its applicable limit of insur- (4) If the loss arises out of the main- ance to the total applicable limits of tenance or use of aircraft, insurance of all providers of insur- "autos", or watercraft to the ex- ance. tent not subject to Exclusion g. of B. The following definition is added to DEFINITIONS Section I — Coverage A — Bodily (Section V): Injury And Property Damage Li- ability; or "Other insurance": (5) That is available to the insured a. Means insurance, or the funding of losses, when the insured is an additional that is provided by,through or on behalf of: Page 4 of 6 Copyright,The Travelers Indemnity Company, 2004 CG D3 16 07 04 • • COMMERCIAL GENERAL LIABILITY (1) Another insurance company; 2. Notice of an "occurrence" or of an offense (2) Us or any of our affiliated insurance corn- which may result in a claim will be deemed to panies, except when the Non cumulation be given as soon as practicable to us if it is of Each Occurrence Limit section of given in good faith as soon as practicable to Paragraph 5 of LIMITS OF INSURANCE your workers' compensation insurer. This ap- (Section III)or the Non cumulation of Per- plies only if you subsequently give notice of sonal and Advertising Injury limit sections the "occurrence" or offense to us as soon as of Paragraph 4 of LIMITS OF INSUR- practicable after you, one of your "executive ANCE (Section Ill)applies; officers" (if you are a corporation), one of your (3) Any risk retention group; partners who is an individual (if you are a partnership), one of your managers(if you are (4) Any self-insurance method or program, a limited liability company), or an "employee" other than any funded by you and over (such as an insurance, loss control or risk which this Coverage Part applies; or manager or administrator) designated by you (5) Any similar.risk transfer or risk manage- to give such notice discovers that the "occur- ment method. rence"or offense may involve this policy. b. Does not include umbrella insurance, or ex- 3. This Provision K. does not apply as respects cess insurance, that you bought specifically to the specific number of days within which you apply in excess of the Limits of Insurance are required to notify us in writing of the shown on the Declarations of this Coverage abrupt commencement of a discharge, re- Part. lease or escape of "pollutants" that causes J. INCREASED SUPPLEMENTARY PAYMENTS "bodily injury" or "property damage" which may otherwise be covered under this policy. Paragraphs 1.b. and 1.d. of SUPPLEMENTARY L. UNINTENTIONAL OMISSION PAYMENTS—COVERAGES A AND B (Section I —Coverages)are amended as follows: The following is added to COMMERCIAL GEN- 1. In paragraph 1.b., the amount we will pay for ERAL LIABILITY CONDITIONS (Section IV), paragraph 6. (Representations): the cost of bail bonds is increased to$2500. The unintentional omission of, or unintentional 2. In paragraph 1.d., the amount we will pay for error in, any information provided by you which loss of earnings is increased to$500 a day. we relied upon in issuing this policy shall not K. KNOWLEDGE AND NOTICE OF OCCUR- prejudice your rights under this insurance. How- RENCE OR OFFENSE ever, this Provision L. does not affect our right to 1. The following is added to COMMERCIAL collect additional premium or to exercise our right GENERAL LIABILITY CONDITIONS (Section of cancellation or nonrenewal in accordance with IV), paragraph 2. (Duties In The Event of Oc- applicable state insurance laws, codes or regula- currence, Offense, Claim or Suit): tions. Notice of an "occurrence" or of an offense M. PERSONAL INJURY — ASSUMED BY CON- which may result in a claim must be given as TRACT soon as practicable after knowledge of the 1. The following is added to Exclusion e. (1) of "occurrence" or offense has been reported to Paragraph 2., Exclusions of Coverage B. you, one of your "executive officers" (if you Personal Injury, Advertising Injury, and are a corporation), one of your partners who Web Site Injury Liability of the Web XTEND is an individual (if you are a partnership), one Liability endorsement: of your managers (if you are a limited liability Solely for the purposes of liability assumed in company), or an "employee" (such as an in- an "insured contract", reasonable attorney surance, loss control or risk manager or ad- fees and necessary litigation expenses in- ministrator) designated by you to give such curred by or for a party other than an insured notice. are deemed to be damages because of"per- Knowledge by any other "employee" of an sonal injury"provided: "occurrence" or offense does not imply that (a) Liability to such party for, or for the cost you also have such knowledge. of, that party's defense has also been as- CG D3 16 07 04 Copyright,The Travelers Indemnity Company, 2004 Page 5 of 6 • COMMERCIAL GENERAL LIABILITY sumed in the same "insured contract"; N. BLANKET ADDITIONAL INSURED — LESSOR and OF LEASED EQUIPMENT (b) Such attorney fees and litigation ex- WHO IS AN INSURED (Section II) is amended to penses are for defense of that party include as an insured any person or organization against a civil or alternative dispute reso- (referred to below as "additional insured") with lution proceeding in which damages to whom you have agreed in a written contract, exe- which this insurance applies are alleged. cuted before the "bodily injury" or"property dam- 2. Paragraph 2.d. of SUPPLEMENTARY PAY- age" occurs or the "personal injury" or "advertis- MENTS — COVERAGES A AND B (Section I ing injury" offense is committed, to name as an — Coverages) is deleted and replaced by the additional insured, but only with respect to their li- following: ability for"bodily injury", "property damage", "per- sonal injury" or "advertising injury" caused, in d. The allegations in the "suit" and the in- whole or in part, by your acts or omissions in the formation we know about the "occur- maintenance, operation or use of equipment rence"or offense are such that no conflict leased to you by such additional insured, subject appears to exist between the interests of PP to the following provisions: the insured and the interests of the in- demnitee; 1. Limits of Insurance. The limits of insurance afforded to the additional insured shall be the 3. The third sentence of Paragraph 2 of SUP- limits which you agreed to provide in the writ- PLEMENTARY PAYMENTS — COVERAGES ten contract, or the limits shown on the Decla- A AND B (Section I — Coverages) is deleted rations, whichever are less. and replaced by the following: 2. The insurance afforded to the additional in- Notwithstanding the provisions of Paragraph sured does not apply to any "bodily injury" or 2.b.(2) of Section I—Coverage A— Bodily In- "property damage" that occurs, or "personal jury And Property Damage Liability, or the injury" or"advertising injury" caused by an of- provisions of Paragraph 2.e.(1) of Section I — fense which is committed,after the equipment Coverage B— Personal Injury, Advertising In- lease expires. jury And Web Site Injury Liability, such pay- ments will not be deemed to be damages for 3 inThe - sured insurance s excess overdany tval d and dcollectible "bodily injury" and "property damage", or damages for"personal injury", and will not re- "other insurance" available to such additional duce the limits of insurance. insured, unless you have agreed in the writ- ten contract that this insurance must be pri- 4. This provision M. does not apply if coverage mary to, or non-contributory with, such "other for "personal injury" liability is excluded by insurance". endorsement. Page 6 of 6 Copyright,The Travelers Indemnity Company, 2004 CG D3 16 07 04 • Ilhe.O ENGINEERING INC. SANCON ENGINEERING, INC. LETTER OF TRANSMITTAL 5841 ENGINEER DRIVE HUNTINGTON BEACH, CA 92649 (714) 891-2323 FAX (714) 891-2524 To: Rob Flames, PE Date: May 7, 2014 Re: #197-B Full Length Lining by CIPP WE ARE SENDING YOU: ITEM# DATE QUANTITY DESCRIPTION 1 05/07/14 3 Agreements 1 05/07/14 1 Insurance Certificate 1 05/07/14 1 Performance Bond-Public Works 1 05/07/14 1 Labor&Material Payment Bond THESE ARE TRANSMITTED as checked below: ❑ For Approval ❑ For Your Use ❑ Resubmit Copies ❑ Approved as Submitted ❑ Approved as Noted ❑ As Requested Distribution ❑ Returned for Corrections ❑ Return Corrected Prints ❑ Submit Copies for Distribution ❑ For Review & Comment REMARKS: Respectfully, Chuck Parsons Chuck @sancon.com 5841 ENGINEER DRIVE HUNTINGTON BEACH, CA 92649 (714) 891-2323 (800) 726-2664