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Insurance - Robin B. Hamers 2017-03-30A� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/ODYYYY) 3/30/2017 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(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 SelectSolutions Insurance Services 1350 Carlback Avenue Suite 100 Walnut Creek CA 94596 CONTACT NAME: Elizabeth Lee PNONN (866)500-6359 FAX No: (925)951-0077 E-MAIL elizabethl@ ibselect.com ADDRESS: pp INSURERS AFFORDING COVERAGE NAIC # INSURERA:Travelers Property Casualty Company 25674 INSURED Robin B. Hamers & Associates, Inc. 234 E. 17th Street, Suite 205 Costa Mesa, CA 92627INSURER INSURERB:The Hanover American Insurance 36064 INSURER C Atlantic Specialty Insurance 27154 INSURER D: E: INSURER F: COVERAGES CERTIFICATE NUMBER:16-17 GL EO -17-18 WC 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 R rypE OF INSURANCE AD LSUBR NUMBER POLPOLICY MMIDpY EFF Y MM/DDIY YY, LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE OCCUR DAMAGETORENTEI 300,000 PREMISES Es occurrence $ MED EXP (Any one person) $ 5,000 X 68D-829IN502-TIL-16 6/1/2016 6/1/2017 PERSONAL &ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRT LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea a.Id.nt $ 1,000,000 BODILY INJURY (Per person) $ A �I_ ANY AUTO ALL OWNED SCHEDULED _ X .AUTOS X NON -OWNED HIRED AUTOS AUTOS 680 -8291N502 -TIL -16 6/1/2016 6/1/2017 BODILY INJURY (Per accident) $ PROPERTY $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ I-- EXCESS LIAB CLAIMS -MADE DEO I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORPARTNER/EXECUTIVE YIN x PER ETH EL EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED] (Mandatory in NH) N ( A WZY9012529 3/23/2017 3/23/2010 EL DISEASE EA EMPLOYEE $ 1,000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT $ 1,000,000 C Professional Liability DPL5705-16 7/27/2016 7/27/2017 Per Claim $1,000,000 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: As Per Contract or Agreement on File with Insured. Costa Mesa Sanitary District is named as additional insured on the General Liability policy, if required by written contract per the attached endorsement. Costa Mesa Sanitary District 628 W. 19th Street Costa Mesa, CA 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 Trevino/LEEELI�-y"�"r' Co7feftltiY7iSCF.Cda7:7aZKa7:71a7:L\IIS] 2 Wc11FIniTE? ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025171`141HI POLICY NUMBER 6808291N502TIL16 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section II): Any person or organization that you agree in a "contract or agreement requiring insurance" to include as an additional insured on this Coverage Part, but only with respect to liability for "bodily injury", "property damage" or "personal injury" caused, to whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing operations; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products -completed operations hazard". Such person or organization does not qualify as an additional insured for "bodily injury", "property damage" or "personal injury" for which that person or organization has assumed liability in a contract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. e. This insurance does not apply to the rendering of or failure to render any "professional services". The limits of insurance afforded to the additional insured shall be the limits which you agreed in that "contract or agreement requiring insurance" to provide for that additional insured, or the limits shown in the Declarations for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section III) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Coverage Part must apply on a primary basis, or a primary and non- contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such additional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance". But this insurance still 'is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury' arising out of "your work" performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insurance" with such person or organization entered into by you before, and in effect when, the "bodily injury' or "property damage" occurs, or the "personal injury' offense is committed. CG D3 81 09 07 © 2007 The Travelers Companies, Inc. Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and 'property damage" occurs, and the "personal injury" is caused by an offense committed: COMMERCIAL GENERAL LIABILITY a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. CG D3 81 09 07 © 2007 The Travelers Companies, Inc. Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission.