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Insurance - 201-08-09 Utility Cost Management LLCUTILCOS-01 VirZAN'YI CERTIFICATE OF LIABILITY INSURANCE D 08/09/2017 ) 08/09/2017 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 have ADDITIONAL INSURED provisions or 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 2RAJaCT Verity Racht, CISR Der Manouel Insurance & Financial Services, Inc. 548 W Cromwell Ave Ste 101 Fresno, CA 93711 PHONE FAX A/C, No, Ext): (559) 447-0600 334 (ac, No):(559) 447-4586 EfAAIL . vracht@dmig.com INSURERS AFFORDING COVERAGE NAICe 02/0412017 INSURER A: Allied Insurance ' 42579 DAMAGE TOREMISESE RENTED 300,00 INSURED INSURER B: Employers Compensation Ins Cor 11512 INSURERC: Philadelphia Insurance Co — 18058 Utility Cost Management LLC INSURER O: 1100 W. Shaw Avenue, Suite 126 Fresno, CA 93711 Emp Ben. 11000,000 A .SURE I:: INSURER F : COVERAGES CFRTIFICATF NIIMRFR-. REVISION NUMBER: 1 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 TYPE OF INSURANCE ADOL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR 0210412018 LIMITS A X COMMERCIAL GENERAL LIABIUTY CLAIMS -MADE FA] OCCUR X ACP7822036862 02/0412017 EACH OCCURRENCE $ 1,000,000 DAMAGE TOREMISESE RENTED 300,00 MED EXP (Anyone arson $ 5,000 X I Hired/Non-OwnedA PERSONAL B ADV INJURY $ 1'000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY [:] JECT LOC OTHER: GENERAL AGGREGATE $ 2'000'000 PRODUCTS-COMP/OPAGG 2,000,000 Emp Ben. 11000,000 A AUTOMOBILE Ix LIABILITY ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY X AIOITNO ONLY ACP7822036862 02/0412017 0210412018 COMBINEDnt)SINGLE LIMIT 1,000,000 BODILY INJURY Per arson BODILY Per accident RINJURY P.0acatlent AMAGE A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ACP7822036862 0210412017 0210412018 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I I RETENTION$ B WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE AAq (ManCaioryln NH)EXCLUDEO? IF yes, describe under DESCRIPTION OF OPERATIONS below N/A X F N032700213 02/04/2017 0210412018 X PER OTH- E.L. EACH ACCIDENT $ 1'000000 E.L. DISEASE - EA EMPLOYE 1,000,000 E.L. DISEASE- POLICY LIMIT 1,000,000 C C Prof Liability Prof Liability PHSD1236151 PHSD1236151 05123/2017 05123/2017 05/2312018 0512312018 Claims Made 1,000,000 Rentention 25,000 DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space Is required) Additional Insured/ Certificate Holder: All operations: Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers, and employees listed as Additional Insured — Pursuant to attached endorsements PB 6003 0411, PB6072 0711 WC 040306 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Costa Mesa SanitaryDistrict THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 290 Paularino Ave. -rl �l7 ACCORDANCE WITH THE POLICY PROVISIONS. Costa Mesa, CA 92626 �t' ✓ 1/1 7 AUTHORIZED REPRESENTATIVE At:UKU ZO (ZUIbIUJ) (01983.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACP7822036862 BUSINESSOWNERS PB60030d11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - MUNICIPALITIES OR PUBLIC AGENCY -INSURED PROVIDING PROFESSIONAL SERVICES This endorsement modules insurance provided ureter the fallowing: PRt: PER bUU 3f :tiS30VYNEHS LIAdI Li l Y CQVLRAGL f-URM The following is added to Section II. WHO IS AN IMSUR F -D: The Municipality ancuor putAlc agency designaled In the Schedule of this endorsement is also an insured, but only with respect to liability for "bodily injury", 'property damage" or'personai and advertising injury° caused ,in whole or in part, by your acts or omissions or the acts or omissions of chose acting on your behalf in connection with your operations, other than the rendering of or the failure to render professional services, advitne of instruction, subject to the fDilowing additional exotufslDn: This insurance, including duty we tieve to defend "suits", does not apply to `"bodily injury", "properly danvW or "pore real and advcrticing injury" that arises out of, in whole or in part, or is a result of, In whole or In part, the sebve or primary negligence of the municilpahly ardor public eaency designated in the aohedule of this endorsement, whether or not such Mg/rgence has been assumes! by You in a contract or agreement All terms and conditions of this policy apply unless modified by this endorsement. Municipaiily and/or Public Agency. The Costa Mesa Sanitary District, its elected and appointed officials, agents, officers, volunteers and employees are additional insureds ps6003ontl Page IofI BUSINESSOWNERS PB 60 72 0711 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT TO OTHER INSURANCE CLAUSE FOR ADDITIONAL INSUREDS - PRIMARY AND NOW CONTRIBUTORY WHEN REQUIRED IN A WRITTEN AGREEMENT OR CONTRACT WITH YOU This endorsement modifies insurance provided under the following: PREMIER BUSINESSOWNERS COMMON POLICY CONDITIONS Only with resrent to any additional insured, in the COMMON POI ICY CONIDITIONS. form PR nn ng, i order condition H. OTHER INSURANCE, paragraph 2.a. is replaced by the following: H. OTHER INSURANCE 2. Under any liability coverage provided by this policy, a. If for injury or loss we cover, there is other valid and collectible insurance available to any additional insured under another policy, our obligations are limited as follows: (1) Issued by another insurer, or if there is self insurance or similar risk retention that applies to a loss covered by this policy, then this insurance provided by us shall be excess over such other insurance, unless you have agreed in a written contract or written agreement signed prior to the loss that this insurance shall be primary: (a) Then this insurance is primary. If other insurance is also primary, we will share with all that other insurance as described in d. below; and (b) The coverage afforded by this insurance is non-contributory with the additional insured's own insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured to any other person or organization's policy.; or (2) Issued by us or any of our affiliate companies, that applies to a loss covered by this policy, then only the highest applicable Limit of Insurance shall apply to such loss. This condition does not apply to any policy issued by us that is designed to provide Excess or Umbrella liability insurance. All terms and conditions of this policy apply unless modified by this endorsement. PB 60 72 07 11 Includes copyrighted material of Insurance Services office, Inc., with its permission. Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' oompensatibn premium otherwise due on such remuneration. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER. This policy is subject to a minimum charge of 8250 for the issuance of waivers of subrogation This endorsement changes the policy to which it is attached and Is off active on the date n suad unless otherwise stated. rths ertonnauon below is required anty when this andorsonwot is isswd sub"Went to preparation of tM policy.! This endorsement, effective 02/04/2017 Policy No. FN 0327002 13 at 12:01 AM standard time, forms a part of Of the EMPLOYERS PREFERRED INS. CO. Issued to UTILITY COST MANAGEMENT LLC Premium Countersigned at on Carrier Code 00920 Endorsement No. By: �t Authorized nepnaernaew WC 04 03 06 Md. 4.84) 4 1998 by the Workers' Compensation Insurance Rating Bureau of Caiiforne. All rights reserved.