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Insurance - Eco Partners, Inc. - 2017-01-10
'gym b® CERTIFICATE OF LIABILITY INSURANCE DTE (MWD0/ 7Y) 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(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 endorsement(s). PRODUCER CONTACT Jamie Ia.nigr0 Shepherd Insurance, LLC. PHON. (317)846-5554 FA/C No): (317) 846-5444 aOORIESS:Jianigro@shepherdins.com 111 Congressional Boulevard Suite 100 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Westfield Insurance Company 24112 Carmel IN 46032 INSURED INSURER B, INSURER C: ECO Partners, Inc. INSURER D, INSURER E: PO BOX 496 1 INSURER F: Carmel IN 46082-0496 COVERAGES CERTIFICATE NUMBER:CL171952461 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 LM TYPE OF INSURANCE ADDLSUBR lam IMIL POLICY NUMBER MWDDY EFF MM/DDT EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CRP7701560 07/17/2016 07/17/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1XI OCCUR PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 X PERSONAL B ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY[7JECT C- LOC E PRODUCTS - COMP/OP AGO $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COM ED SINGLE LIMIT $ Ea accitla, BODILY INJURY (Per Person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ Peraccitlent UMBRELLA LIAB 11 OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN I PER 0TH_ - STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNER/MERIEXECUTIVE OFFICEMBER EXCLUDED? ❑NIA E.L. DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT I 5 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remark, Schedule, may be attached if more space is required) Per attached form C132010, Costa Mesa Sanitary District, it's elected and appointed officials, agents, officers and employees are listed as additional insureds for general liability when required by contract. Per attached for CG2804, 30 day cancellation notice applies for general liability. Per attached form CG2001, insurance is primary and non contributory for general liability. All only in accordance with policy terms, provisions and exclusions. Costa Mesa Sanitary District,it's elected and appointed officials, agents, officers and employees 290 Paularino Avenue Costa Mesa, CA 92626 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 Ianigro/JIANIG ©1988-2014 ACORD CORPORATION. All ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 on14mn POLICY NUMBER: CWP 7701560 COMMERCIAL GENERAL LIABILITY 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) Location(s) Of Covered Operations Costa Mesa Sanitary District, 290 Paularino Ave it's elected and appointed Costa Mesa, CA 92626 officials, agents, officers and volunteers and employees 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 adver- tising 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 oper- ations 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 per- mitted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, 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. B. With respect to the insurance afforded to these additional insureds, the following addi- tional exclusions apply: This insurance does not apply to 'bodily in- jury" 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 addi- tional 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 or- ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 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 of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the ap- plicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART SCHEDULE Number of Days' Notice 30 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in paragraph b. of either the CANCELLATION Condition (Section IV - Conditions) or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. Copyright, Insurance Services Office, Inc., 1992 CG 28 04 10 93 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insur- ance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance, and (2) You have agreed in writing in a con- tract or agreement that this insur- ance would be primary and would not seek contribution from any other insurance available to the additional insured. C, of,,e 1,,, 2012 CG 20 01 04 13 INSURANCE AGENCY: SHEPHERD INS & FINANCIAL SVCS 111 CONGRESSIONAL BLVD STE 100 CARMEL IN 46032-5638 AGENCY PHONE N 800-590-2806 DATE OF MEMO: 01/29/17 COSTA MESA SANITARY DISTRICT 290 PAULARINO AVENUE COSTA MESA CA 92626 NAMED INSURED: ECO PARTNERS INC. PO BOX 496 CARMEL IN 46082 POLICY NO.: CWP 7701560 POLICY TERM: 07/17/16 - 07/17/17 COMPANY: WESTFIELD INSURANCE COMPANY RE: EVIDENCE OF INSURANCE -- ADDITIONAL INSURED NOTICE YOU ARE SHOWN AS AN ADDITIONAL INSURED ON THE POLICY SHOWN ABOVE AND THE GENERAL LIABILITY LIMITS ARE DISPLAYED BELOW. THIS NOTICE IS EVIDENCE THAT INSURANCE HAS BEEN ISSUED TO THE NAMED INSURED(S). WE HAVE DISPLAYED BELOW THE NECESSARY INFORMATION FOR YOU. IF YOU DESIRE ANY ADDITIONAL INFORMATION PLEASE CONTACT THE AGENCY SHOWN ABOVE AND THEY WILL SECURE IT FOR YOU FROM WESTFIELD INSURANCE. POLICY LIMITS: GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS COMPLETED OPERATIONS) 12,000,000 PRODUCTS/COMPLETED OPERATIONS AGGREGATE LIMIT 2,000,000 PERSONAL & ADVERTISING INJURY LIMIT (PER PERSON OR ORGANIZATION) 1,000,000 EACH OCCURRENCE LIMIT 1 000,000 DAMAGE TO PREMISES RENTED TO YOU LIMIT (A Y ONE PREMISES) 100,000 MEDICAL EXPENSE LIMIT (ANY ONE PERSON) $5,000 RECE!A'v1' MAR 2 0 2017 COOS Mesh District Ohio Farmers Insurance Company Westfield Insurance Company Westfield National Insurance Company American Select Insurance Company Old Guard Insurance Company P.O. Box 5001 One Park Circle Westfield Center OH 44251-5001 AD 8052 (12-09)