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Insurance - Discovery Science Center - 2015-12-22
211069 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDCIYYYY) 12/22/2015 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 pollcy(les) 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 endorsementiel. PRODUCER Commercial Lines - (818) 464-9300 Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 NAMECONTACT Catherine Cory TYPE OF INSURANCEADDLSUBR PHC. N 818-464-9458 FAAIX C No,866-968-5687 : E-MAIL Aooseas: catherine.co Wellsfa o.com rY@ r9 POLICY EXP MMIOD/YYYY 15303 Ventura Boulevard, 7th Floor Sherman Oaks, CA 91403-3197 A INSURER(S) AFFORDING COVERAGE NAIC # INSURER A. Philadelphia Indemnity Insurance Company 18058 INSURED Discovery Science Center of Orange County INSURER s: Employers Compensation Ins Cc 11512 INSURER C: PERSONAL &ADV INJURY $ 1000,000 dba Discovery Cube Orange County INSURER D PRODUCTS - COMPIOP AGG $ 2.000,000 sexual AbuselMolostation $ Included 2500 N. Main Street INSURER E LIABILITY AUTO AOSCHEDULED AUU TOSS AUTOS HIRED AUTOS X NON -OWNED AUTOS Santa Ana, CA 92705 INSURER F 12/15/2015 12/15/2016 COVERAGES CERTIFICATE NUMBER: 9919102 BODILY INJURY (Per person) $ RPVISITIN NIIMRPR• Reehclmu 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 INSURANCEADDLSUBR POLICY NUMBER POLICY EFF MMIDOIYYYY POLICY EXP MMIOD/YYYY LIMIT A X COMMERCIAL GENERAL LIABILITY � CLAIMS -MADE IJ OCCUR X PHPK1432448 12/15/2015 12/15/2016 EACH ENCS IS 1,000.000 ffT57t PREMISES Ea occurrence) $ 1,000.000 MED EXP (Any one person) $ 20,000 PERSONAL &ADV INJURY $ 1000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JE� LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2.000,000 sexual AbuselMolostation $ Included A AUTOMOBILE XANY X LIABILITY AUTO AOSCHEDULED AUU TOSS AUTOS HIRED AUTOS X NON -OWNED AUTOS PHPK1432448 12/15/2015 12/15/2016 COMBINED SliTCLE LIMIT $ 1000,000 E a0idenl BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident r$ -- UMBRELLA UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEC I I RETENTION $ B WORKERS COMPENSATION ANDEMPLOYERS'LIABILrTY YIN ANY PROPRIETORIPARTNEWEXECUTIVE1 OFFICERIMEMBER EXCLUDED? �,N/q (Mandatory in NH) If Yes, describe under DESCRIPTION OF OPERATIONS below EIG1453813-03 04/01/15 04/01/16 X PER oTH- STATUTE Eft E.L. EACH ACCIDENT $ 000,000 E.L. DISEASE - EA EMPLOYEE It 1 000,000 E L DISEASE - POLICY LIMIT $ 1,000000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACDRD IDI, Additional Remark. Schedule, may be attached If more apace Is required) Certificate Holder is included as an Additional Insured for General Liability, but only as respects to claims arising out of the negligence of the Named Insured. Costa Mesa Sanitary District628 West Costa Mesa, Califoth rnia 92627 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD @ 1988-2014 ACORD ACORD 25 (2014/01) 1111111111111111111111111111 1111111 II1111111111111111111111111111111111111111111111111111 reserved. POLICY NUMBER: PHPK1432448 COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED 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): Costa Mesa Sanitary District 628 West 19th Street Costa Mesa, California 92627 A. Section 11 — 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 in "property damage" or 'personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 26 04 13 in the 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 applicable Limits of Declarations. © Insurance Services Office, Inc., 2012 shall not increase the Insurance shown in the Page 1 of 1 'cveoi nzv003646mw011a000-