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Insurance - Southern California Fleet Services Inc. - 2018-04-06
A� o® CERTIFICATE OF LIABILITY INSURANCE DATE 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 YouZoom Insurance Services, Inc 6900 College Blvd Ste 1000 Overland Park KS 66211 CONTACT PHONE FAX ' 888-240-8803 INC Not, 877-835-1833 Ep AIL s: AMServiceCenteraarrowheadgrp.com INSURERS AFFORDING COVERAGE NAIL# INSURER A: Zurich American Insurance Corrpan5L 16535 INSURED SOUTCAL42 Southern California Fleet Service Inc 34211 Pacific Coast Hwy INSURER B: Travelers Properly Casualty Cc of America 25674 INSURER C: American Zurich Insurance Company / 40142 INSURERD: Dana Point CA 92629 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 1619064673 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 TYPE OF INSURANCEJUM ADDL SUSR POLICYNUMBER POLICY EFF MM/DD POLICY EXP M 161 LIMITS A X COMMERCIAL GENERAL LIABILITY V CPO1640285 1 3/112018 3/1/2019 EACH OCCURRENCE $1.000,OOD CLAIMS -MADE M OCCUR DAMAGE TO RENTED PREMISES Eeoccurrence $1,00D.Wo MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 POLICY 0 JEQ F-1 LOC PRODUCTS-COMP/OP AGS $2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS Per accitlent BODILY INJURY ( ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ Peraccid.ru 8 B X UMBRELLALIAB X OCCUR ZUP71M9342318NF &1/2018 3/WO19 EACH OCCURRENCE $4,000.000 EXCESS LIAR CLAIMS -MADE AGGREGATE $6,000.000 DED I X I RETENTION$ ProdlCam Op A $4.000,000 WORKERS COMPENSATION I PEROTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER EACH ACCIDENT $ ANYPROPRIETOWPARTNEWEXECUTIVEE-1EL OFFICEMEMBEREXCLUDED? R/ NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ C Garage Keepers/Direct Primary CP01141285-01 W112018 3/1/2019 Limit See Descrip of Ops DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Garage Keepers Limits (per location): Loc 01: 2855 Sampson Ave., Corona, CA 92879 - Limit: $1,000,000 Loc 02: 9690 Black Mountain Rd., San Diego, CA 92126 - Limit $500,000 Loc 03: 450 Corporate Drive, Escondido, CA 92029 - Limit $800,000 Loc 04: 11752 Mariposa Rd., Hesperia, CA 92345 - Limit $500,000 Loc 05: 20420 S Susana Rd., Carson, CA 90810 - Limit $800,000 Loc 07: 3301 Sunrise Blvd #H, Rancho Cordova, CA 95742 - Limit $500,000 Loc 08: 1215 N. Fee Ana Street, Anaheim, CA 92807 - Limit $1,500,000 See Attached... Costa Mesa Sanitary District / �k 290 Paularino Avenue �j—/�� J/ {,�//L Costa Mesa CA 92626 Y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988.2015 ACORD CORPORATION. All ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ACORO® L� AGENCY CUSTOMER ID: SOUTCAL-02 LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY YouZoom Insurance Services, Inc NAMED INSURED Southern Califomia Fleet Service Inc 34211 Pacific Coast Hwy Dana Point CA 92629 POLICY NUMBER CARRIER NAIL CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE 09:4380 Donovan Way, North Las Vegas, NV 89030 - Limit 10: 5000 E McDowell Rd, Mesa, AZ 85215 - Limit $500,000 Keepers includes On -Hook coverage. Liability is provided under the General Liability coverage part of the policy. e and Non -Contributory applies. The Costa Mesa Sanitary District, its elected and appointed officials, agents, officers, volunteers, and employees are as Additional Insured. Day Notice of Cancellation applies. I_CK�7:7�i[ILI 172008 ACORD CORPORATION. All riahts reserved. The ACORD name and logo are registered marks of ACORD Notification to Others of Cancellation 0 ZURICH Policy No. Elf. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add'1. Prem Retum Prem. CPO 1640285-01 03/01/2018 03/01/2019 03/01/2018 76965000 INCL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part Liquor Liability Coverage Part Products/Completed Operations Liability Coverage Part A. If we cancel this Coverage Part(s) by written notice to the first Named Insured for any reason other than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation: 1. To the name and address corresponding to each person or organization shown in the Schedule below; and 2. At least 10 days prior to the effective date of the cancellation, as advised in our notice to the first Named Insured, or the longer number of days notice if indicated in the Schedule below. B. If we cancel this Coverage Part(s) by written notice to the first Named Insured for nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or organization shown in the Schedule below at least 10 days prior to the effective date of such cancellation. C. If notice as described in Paragraphs A. or B. of this endorsement is mailed, proof of mailing will be sufficient proof of such notice. SCHEDULE Name and Address of Other Person(s) / Organization(s): Number of Days Notice: COSTA MESA SANITARY DISTRICT, ITS ELECTED AND APPOINTED 30 OFFICIALS, AGENTS, OFFICERS, VOLUNTEERS AND EMPLOYEES 290 PAULARINO AVENUE COSTA MESA, CA 92626 All other terms and conditions of this policy remain unchanged. U -GL -1446-A CW (05110) Page 11 of 11 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Other Insurance Amendment — Primary And Non - Contributory 0 ZURICH Policy No. Eff Date of Pot. Exp. Date of Pot. Ef. . Date of End. Producer No. Add'I. Prem Retum Prem. CPO 1640285-01 1 03/01/2018 03/01/2019 03/01/2018 76965000 INCL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: Address (including ZIP Code): This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part 1. The following paragraph is added to the Other Insurance Condition of Section IV — Commercial General Liability Conditions: This insurance is primary insurance to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by a written contract or written agreement that this insurance would be primary and would not seek contribution from any any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV — Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same 'occurrence", offense, claim or "suit'. This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis. All other terms and conditions of this policy remain unchanged. U -GL -1327-B CW (04/13) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: CPO 1640285-01 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, ITS ELECTED AND APPOINTED OFFICIALS, AGENTS, OFFICERS, VOLUNTEERS AND EMPLOYEES 290 PAULARINO AVENUE COSTA MESA, CA USA 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. B. 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 26 04 13 ©insurance Services Office, Inc., 2012 Page 1 of 1