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Insurance - Environmental Education Services and Programs 2017-02-23A� & CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODYYYY) 2/23/2017 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 Linda Worthington NAME: g Conrey Ins Brokers & Risk Managers Lictt0543173 PABOONE Ext: (714)838-5835 1 AX �-(714)838-8166 17821 East 17th Street 11100 ADDRESS: lworthington@siatt.com INSURERtSI AFFORDING COVERAGE NATO p Tustin _ CA 92780 INSURED Environmental Education Services And Programs, Inc Po Box 3021 INSURER C INSURER D (Huntington Beach CA 92605 (INSURER F: COVFRAr;FS CFRTIFICATE NLIMRER-CL1722305430 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 TYPEOFINSURANCE A i51fBR (NSD MD -j POLICY NUMBER POLIOY EFF MMIDDIYYYY POLICY EXP MMIDDR'YYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADEX OCCUR - DAMAGE TO RENTED PREMISES_LEa occurrence) _-__ $ 100,000 X IMP0004008010520 3/1/2017 3/1/2018 MED EXP (Any one person) $ 5,000 ,PERSONAL &ADV INJURY $ 1,000,000 GENE AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY I] Jn ECT L LOC PRODUCTS - COMPIOP AGO $ 2,000,000 OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANV AUTO BODILY INJURY (Per person) $ BODILY INJURY(Peracciden[) PROPERAUTOS Per sobdent $ ALL OWNED SCHEDULED _ AUTOS AUTOS • HIRED AUTOS OWNED $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE r A GG REGATE $ DED 'RETENTION$ I $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNEWEXECUTIVE PER OTT STATUTE ER E . EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? �� NIA (Mandatory in NH) E.L. DISEASE- EA EMPLOYE $ h yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RESPECTING ALL OPERATIONS OF THE NAMED INSURED: Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers and employees listed as Additional Insured - Pursuant to attached endorsement CG20100413 AS REQUIRED PER WRITTEN CONTRACT. POLICY CONTAINS 30 DAY CANCELLATION CLAUSE. 10 DAYS NOTICE IN THE EVENT OF CANCELLATION FOR NON-PAYMENT. This certificate was revised and reissued on 3-20-17 and 3-27-17. CFRTIFICATF HOLDER CANCELLATION © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD I NS02519nl4cn 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The Costa Mesa Sanitary District 290 Paularino Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Costa Mesa, CA 92626 AUTHORIZED REPRESENTATIVE I�FLII TMJ Linda Worthington/LKW © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD I NS02519nl4cn 1 MESA UNDERWRITERS SPECIALTY SCHEDULE OF FORMS AND ENDORSEMENTS INSURANCE COMPANY Named Insured ENVIRONMENTAL EDUCATION SERVICES AND PROGRAMS, INC Policy Number Effective Date: MP0004008010520 03/01/2017 Forms Applicable - COMMON POLICY FORMS MUS 01 01 10001 0412 POLICY JACKET MUS 01 01 10002 1116 COMMON POLICY DECLARATION MUS 01 01 10003 1013 SCHEDULE OF FORMS & ENDORSEMENTS MUS 01 01 10007 1013 MINIMUM EARNED PREMIUM ENDORSEMENT MUS 01 01 10043 1013 PRIVACY NOTICE IL 00 17 11 98 COMMON POLICY CONDITIONS MUS 0101 10013 0711 CA Disclosure— Non Admitted Carrier Notice D-2 0711 MUS 0101 10018 1013 CA SERVICE OF SUIT ILN 018 09 03 CA FRAUD STATEMENT Forms Applicable - GENERAL LIABILITY MUS 01 Ot 20001 1116 GENERAL LIABILITY COVERAGE PART DECLARATIONS MUS 01 01 20004 0916 LIABILITY DEDUCTIBLE _ MUS 01 Ot 20057 1013 EXCL - ABUSE OR MOLESTATION MUS 01 Ot 20058 0816 EXCL - LEAD CONTAMINATION MUS 01 01 20063 0816 EXCL - PUNITIVE DAMAGES MUS 01 01 20080 0816 EXCL - EARTH MOVEMENT MUS 01 01 20082 0816 EXCL-ASBESTOS MUS 01 01 20084 0816 NON -STACKING OF LIMITS ENDORSEMENT MUS 01 0120094 1013 AMENDMENT OF CONDITIONS - PREMIUM AUDIT MUS 01 0120099 1013 LIMITED COVERAGE -ABUSE OR MOLESTATION LIAR (DEFENSE W/IN LMTS) MUS 01 01 20112 1013 EXCL - OCCUPATIONAL DISEASE MUS 01 01 20125 0915 EXCL - INJURY TO EMPLOYEES, "TEMPORARY WORKERS' AND CONTRACTORS CG 00 0104 13 COMMERCIAL GENERAL LIABILITY COVG FORM CG 20 10 04 13 At - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION CG 20 11 04 13 At - MANAGERS OR LESSORS OF PREMISES CG 20 12 04 13 Al - STATE OR POLITICAL SUBDIVISIONS - PERMITS CG 21 16 04 13 EXCL - DESIGNATED PROFESSIONAL SERVICES CG 21 47 12 07 EMPLOYMENT-RELATED PRACTICES EXCLUSION CG 21 55 09 99 EXCL - TOTAL POLLUTION EXCLUSION WITH A HOSTILE FIRE EXCEPTION CG 21 67 12 04 EXCL - FUNGI OR BACTERIA CG 21 96 03 05 EXCL-SILICA OR SILICA -RELATED DUST CG 22 30 07 98 EXCL - CORPORAL PUNISHMENT CG 22 71 04 13 COLLEGES OR SCHOOLS (LIMITED FORM) CG 22 72 04 13 COLLEGES OR SCHOOLS CG 24 26 04 13 AMENDMENT OF INSURED CONTRACT DEFINITION IL 00 2109 08 NUCLEAR ENERGY LIABILITY EXCL ENDT MUS 01 01 20083 1013 CA - EXCL - PRE -TENDER LEGAL FEE CG 21 73 0115 EXCL OF CERTIFIED ACTS OF TERRORISM MUS 01 01 10003 1013 INSURED POLICY NUMBER: MP0004008010520 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 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 AUTOMATIC STATUS - COPIES OF EACH AS REQUIRED IN WRITTEN CONTRACT WITH CERTIFICATE ISSUED IS ON FILE WITH THE THE NAMED INSURED INSURANCE COMPANY AND/OR THEIR LEGAL REPRESENTATIVE 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 B. 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 0413 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 INSURED 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 of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2