Insurance - Discovery Science Center of Orange County - 2017-03-242]1069
ACORO® CERTIFICATE OF LIABILITY INSURANCE
11i3/24/2017
°A'c'rd"°°°Y"Y'
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(iss) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS Will 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
Commercial Lines -213-253-6700
Wells Fargo Insurance Services, Inc. - CA Lic#: OD08408
OAMEACT Ronald Rodriguez
PHONE 818-447.2014 FAXANO.
Ext: Arc Np:
MAIL
ADDRESS: ron.rodriguez@wellsfargo.com
333 S. Grand
INSURER(S) AFFORDING COVERAGE MAIC#
Los Angeles, CA 90071
INSURER A: Philadelphia Indemnity Insurance Company 16058
INSURED
INSURER B: Travelers Property Casualty CO Of America 25674
Discovery Science Center of Orange County
INSURER C
dba Discovery Cube Orange County
INSURER D
2500 N. Main Street
INSURER E;
Santa Ana, CA 92705
INSURER F:
COVERAGES CERTIFICATE NUMBER: 115901548 REVISION NUMBER: See below
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 INSURANCE
ADDL
UBR
POLICYNUMBER
POLICY EFF
MMR7DIYYYY
POLICY EXP
MNIDDIYYY
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE N OCCUR
X
PHPK1590101
12/15/2016
7/1/2018
EACH OCCURRENCE $ 1,000,000
PREMISES Ea accurrence $ 1,000,000
MED EXP (Any one person) $ 5,000
PERSONAL B ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY 0 JECTPRO- ❑ LOC
OTHER:
GENERAL AGGREGATE $ 2,OD0,000
PRODUCTS-COMP/OP AGG 8 2,000,000
Sexual AbusalMolectrlion $ Included
A
AUTOMOBILE
X
X
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLYAUTOS
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
PHPK1590101
12/15/2016
7/1/2018
COMBINED SINGLE LIMIT $ 1,000,000
BODILY INJURY (Per person) $
BODILY INJURY Per.cricked) $
PROPERTYDAMAGE $
Par accident
$
UMBRELLAUAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE $
AGGREGATE $
DED I I RETENTION$
$
B
WORKERS COMPENSATION
AND EMPLOVERS'LIABILITV YIN
ANYPROPRIETOR/PARTNERIEXECUTIVE
OFFICERIMEMBEREXCLUDED9 C
(Mandatory in NH)
K yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
PJUB3J26338517
04/01/17
04/01/16
PER OTH-
X STATUTE ER
E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
E.L. DISEASE - POLICY LIMIT S 1,1100,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES IACORD 101, Additional Remarks Schedule, may be attached it more space is required)
The Costa Mesa Sanitary District, its elected and appointed officials, agents, officers, volunteers and employees are included as an Additional Insured for
General Liability, but only as respects to claims arising out of the negligence of the Named Insured per attached form.
CERTIFICATE HOLDER CANCELLATION
Costa Mesa Sanitary District
290 Paularino Ave
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Costa Mesa, CA 92626 —9��
I�\ II" '
AUTHORIZED REPRESENTATIVE
The ACORD name and logo are registered marks of ACORD @ 1988.2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) II II II II II II II II III II II II 1111 II II II it
-creaiApaopprarroamapmrwpe
PI -GL -005 (07/12)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
PRIMARY AND NON-CONTRIBUTORY INSURANCE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization (Additional Insured): costa Mesa Sanitary District
Effective Date: 12tw2o16
SECTION 11— WHO IS AN INSURED is amended to include as an additional insured the person(s) or
organization(s) shown in the endorsement Schedule, but only with respect to liability for "bodily injury,"
"property damage" or "personal and advertising injury" arising out of or relating to your negligence in the
performance of "your work" for such person(s) or organization(s) that occurs on or after the effective date
shown in the endorsement Schedule.
This insurance is primary to and non-contributory with any other insurance maintained by the person or
organization (Additional Insured), except for loss resulting from the sole negligence of that person or
organization.
This condition applies even if other valid and collectible insurance is available to the Additional Insured
for a loss or "occurrence" we cover for this Additional Insured,
The Additional Insured's limits of insurance do not increase our limits of insurance, as described in
SECTION III — LIMITS OF INSURANCE.
All other terms, conditions, and exclusions under the policy are applicable to this endorsement and
remain unchanged.
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Includes copyrighted material of Insurance Services Office, Inc., with its permission.
POLICY NUMBER: PHPK1590101
COMMERCIAL GENERAL LIABILITY
CG 20 26 0413
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
290 Paularino Ave
Costa Mesa, CA 92626
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 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
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section 111 — 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.
m Insurance Services Office, Inc., 2012
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'CY601 A000007' MN110101310-