Insurance - Eco Partners, Inc. - 2018-07-10ECOPA-1 ___ OP ID: CD
.44CCMEPIDATE
k-�CERTIFICATE OF LIABILITY INSURANCE
1
0711012018
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 800.590-2748
Shepherd Ins. & Financial Svcs
2000 Polaris Parkway
Columbus, OH 43240
Shepherd Insurance House
cT Shepherd insurance House
PHONE 800-590.2748 Fax 514-796-7814
(AIC, No, Ext): 1Arc, No):
S,
CWP77CJ560
0711712018
INSURERINSURERISI AFFORDING NAIC
INSURER A: Westfield Insurance Company / 24112
INSURED Eco Partners Inc.
PO Box 496
INSURER B:
INSURER C:
Carmel, IN 46082
INSURER D:
GENERAL AGGREGATE $ $000,000
m9URER E
INSURER F
AUTOMOBILE
COVERAGES CERTIFICATE NUMRER' REVISION NIIMRFR-
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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE
ADDL D
U
POLICY NUMBERPOLX:Y
EFF
POLICY EXP
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
X
CWP77CJ560
0711712018
07/172019
EACH OCCURRENCE S 1,000,000
DAMAGE TO RENTED $ 100,000
PREMISES (Ea occuff M eel
MEQ EXP (Any one arson 5,000
PERSONAL& ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
POLICY F--] LOC
[:] JEC"T
OTHER
GENERAL AGGREGATE $ $000,000
PRODUCTS-COMPIOP AGG 3 2,000,000
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AIUPT�OpS ONLY AUTNOSSW Ep
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
Ea accident $
BODILY INJURY Per arson
BpOpDILY INJURY P.r.ccldent $
PPeOecEcniJn[ AMAGE $
UMBRELLA LAS
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE $
AGGREGATE 4
RNETgE7N�TNI.ION$
y/�gI(DEERDg ep p
Ar -U EMPLOVEMRSR ILQTY YIN
A FICROPR MTORR EXRRMER XECUTIVE CLUDED?❑NIA
WAA�Mpry`l`-1W)
If es, describe under
P R TIONS below
ER 0TH -
PSTA U F ER
E.L. EACH ACCIDENT $
E. L. DISEASE - EA EMPLOYEE 4
L. 2 A -P Y T
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addleorral RI Schedule, maybe attached B men spec* Ie nqulred)
The Costa Mesa Sanitary District, IYs elected and appointed
officials,aents,officers,volunteers and employees Is named as an additional
Insured wfth respect to ongoing and completed operations of the named
insured for the certificate holder when required by written contractor
agreement. The General Liability coverage is primary and noncontributory.
CERTIFICATE HOLDER CANCEI_I ATION
COSCO.8
Costa Mesa SanitaryDistrict
290 Paularino Avenue
Costa Mesa, CA 92626 r�Ql
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISION&
AUTHORIZED REPRESENTATIVE
�/ v /
ACORD 25 (2016/03) ®1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
INSURANCE AGENCY:
SHEPHERD INS & FINANCIAL SVCS
111 CONGRESSIONAL BLVD STE 100
CARMEL IN 46032-5638
AGENCY PHONE # 800-590-2806
DATE OF MEMO: 05/09/18
COSTA MESA SANITARY DISTRICT
SEE IL7032
290 PAULARINO AVENUE
COSTA MESA CA 92626
NAMED INSURED:
ECO PARTNERS INC.
PO BOX 496
CARMEL IN 46082
POLICY NO.: CWP 7701560
POLICY TERM: 07/17/18 - 07/17/19
COMPANY: WESTFIELD INSURANCE COMPANY
RE: EVIDENCE OF INSURANCE -- ADDITIONAL INSURED NOTICE
YOU ARE SHOWN AS AN ADDITIONAL INSURED ON THE POLICY SHOWN ABOVE AND THE GENERAL
LIABILITY LIMITS ARE DISPLAYED BELOW.
THIS NOTICE IS EVIDENCE THAT INSURANCE HAS BEEN ISSUED TO THE NAMED
INSURED(S).
WE HAVE DISPLAYED BELOW THE NECESSARY INFORMATION FOR YOU. IF YOU DESIRE
ANY ADDITIONAL INFORMATION PLEASE CONTACT THE AGENCY SHOWN ABOVE
AND THEY WILL SECURE IT FOR YOU FROM WESTFIELD INSURANCE.
POLICY LIMITS:
GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS COMPLETED OPERATIONS) $$$2,000,000
PRODUCTS/COMPLETED OPERATIONS AGGREGATE LIMIT $2,000,000
PERSONAL & ADVERTISING INJURY LIMIT (PER PERSON OR ORGANIZATION) 1,000,000
EACH OCCURRENCE LIMIT 1 000,000
PERSON)
DAMAGE TO PREMISES RENTED TO YOU LIMIT (ANY ONE PREMISES) 100,000
MEDICAL EXPENSE LIMIT (ANY ONE $5,000
Ohio Farmers Insurance Company Westfield Insurance Company
Westfield National Insurance Company American Select Insurance Company
Old Guard Insurance Company
P.O. Box 5001
One Park Circle
Westfield Center OH 44251-5001 AD 8052 (12-09)