Insurance CMSD Certificate of Coverage 2018-11-05NON-MEMBER'S CERTIFICATE OF COVERAGE Issue Date
11/5/2018
Special District Risk Management Authority
1112 'I' Street, Suite 300
Sacramento, California 95814800.537.7790 www.sdrma.org
Provider
Costa Mesa Sanitary District
290 Paularino Avenue
Costa Mesa, California 92626
Member Number: 6819Member
Certfcate Number: 23
This is to certfy that coverages listed below have been issued to the Member named above for the period indicated. This certfcate is not an insurance
policy or an agreement of coverage and does not amend, extend or alter the coverage aforded by the agreements listed herein. Notwithstanding any
requirement, term, or conditon of any contract or other document with respect to which this certfcate may be issued or may pertain, the coverage
described herein is subject to all the terms, exclusions, and conditons of the specifc coverage document. This certfcate of coverage evidences the limits
of liability in efect at the incepton of the agreements shown; limits shown may have been reduced by paid claims. This certfcate is issued as a mater of
informaton only and confers no rights upon the certfcate holder.
Type of Coverage LimitsExpiraton DateEfectve DatePolicy Number
7/1/20197/1/2018LCA-SDRMA-201819Auto Liability
Per OccurrenceAuto Bodily Injury $10,000,000
Auto Property Damage $10,000,000
7/1/20197/1/2018LCA-SDRMA-201819Auto Physical Damage
DeductbleAuto PD - Collision $1,000
Auto PD - Comp $500
7/1/20197/1/2018LCA-SDRMA-201819General Liability
Per OccurrenceBodily Injury $10,000,000
Property Damage $10,000,000
Environmental Rental Services is named as an additonal covered party in respects to rented 2014 Kenworth T470 valued at $422,000.
Environmental Rental Services is named as loss payee in respects to rented 2014 Kenworth T470 valued at $422,000.
Cancellaton: Should any of the above-described policies be cancelled before the expiraton dates thereof, the issuing company will mail 30 days
writen notce to the above-named certfcate holder, but failure to mail such notce shall impose no obligaton or liability of any kind upon the company.
Paul Frydendal - Chief Operatng Ofcer
endeaver to
Certfcate Dates:Additonal Covered PartyX
Evidence of Coverage
X Loss Payee
Certfcate Holder
Certfcate Type:Efectve Date
11/5/2018
Expiraton Date
11/17/2018
Environmental Rental Services LTD.
PO Box 192
Rockdale, TX 76567
This endorsement changes the Liability Coverage Agreement. Please read it carefully.
COVERAGE PERIOD: 11/5/2018 through 11/17/2018
MEMBER AGENCY
Costa Mesa Sanitary District
290 Paularino Avenue
Costa Mesa, California 92626
ADDITIONAL COVERED PARTY
Environmental Rental Services LTD.
PO Box 192
Rockdale, TX 76567
This endorsement modifies the Liability Coverage Agreement provided under the following:
Auto Liability - Auto Bodily Injury - LCA-SDRMA-201819 - Per Occurrence - $10,000,000
Auto Liability - Auto Property Damage - LCA-SDRMA-201819 - Per Occurrence - $10,000,000
General Liability - Bodily Injury - LCA-SDRMA-201819 - Per Occurrence - $10,000,000
General Liability - Property Damage - LCA-SDRMA-201819 - Per Occurrence - $10,000,000
It is hereby agreed that this endorsement is added to the Liability Coverage Agreement issued to Costa Mesa Sanitary District by Special
District Risk Management Authority (“SDRMA”) adding the following as an Additional Covered Party.
Environmental Rental Services is named as an additional covered party in respects to rented 2014 Kenworth T470 valued at $422,000.
Unless required by a contract between Costa Mesa Sanitary District and Environmental Rental Services LTD., coverage afforded by this
ENDORSEMENT shall be excess and non-contributory with respect to any other valid and collectible insurance or risk financing providing
coverage to Environmental Rental Services LTD., including any self-insured retention the Environmental Rental Services LTD. may have,
and any other insurance or risk financing providing coverage to the Environmental Rental Services LTD. shall be considered primary to this
coverage. If required by a contract between Costa Mesa Sanitary District and Environmental Rental Services LTD., the coverage afforded
by this ENDORSEMENT shall be primary with respect to any other valid and collectible insurance or risk financing providing coverage to the
Environmental Rental Services LTD. including any self-insured retention the Environmental Rental Services LTD. may have, and any
other insurance or risk financing providing coverage to the Environmental Rental Services LTD. shall be considered excess to this
coverage. The coverage afforded by this ENDORSEMENT is afforded only with respect to liability arising out of the ongoing operations of the
SDRMA Member named above and provided further that this coverage does not apply to the sole negligence of the additional covered party
named above. Coverage shall not be extended for the active negligence of the Environmental Rental Services LTD. in any case where an
agreement to indemnify the additional named party would be invalid under Subdivision (b) of Section 2782 of the Civil Code.
All other terms and conditions remained unchanged.
Coverage provided by this endorsement, under the terms, conditions and exclusions contained in the Liability Coverage Agreement issued by
SDRMA to Costa Mesa Sanitary District shall not be reduced or canceled without 30 days written notice given to the Environmental Rental
Services LTD. via certified mail.
THIS ENDORSEMENT CHANGES THE LIABILITY COVERAGE AGREEMENT. PLEASE READ IT CAREFULLY.
The inclusion of more than one Covered Party shall not operate to impair the rights of one Covered Party against another Covered Party and
the coverages afforded shall apply as though separate policies have been issued to each Covered Party except that the inclusion of more
than one covered party shall not increase the limit of liability of SDRMA.
Effective date of this endorsement is: 11/5/2018
SPECIAL DISTRICT RISK MANAGEMENT AUTHORITY
Paul Frydendal - Chief Operatng Ofcer
Signed by:
This endorsement changes the Memorandum of Coverage. Please read it carefully.
COVERAGE PERIOD: 11/5/2018 through 11/17/2018
MEMBER AGENCY
Costa Mesa Sanitary District
290 Paularino Avenue
Costa Mesa, California 92626
LOSS PAYEE
Environmental Rental Services LTD.
PO Box 192
Rockdale, TX 76567
This endorsement changes the Memorandum of Coverage provided under the following:
Auto Physical Damage - Auto PD - Comp - LCA-SDRMA-201819 - Deductible - $500
Auto Physical Damage - Auto PD - Collision - LCA-SDRMA-201819 - Deductible - $1,000
Actual cash value less deductible
It is hereby agreed that this endorsement is added to the Memorandum of Coverage issued to Costa Mesa Sanitary District by Special District Risk
Management Authority (“SDRMA”) adding the following as a Loss Payee:
Environmental Rental Services is named as loss payee in respects to rented 2014 Kenworth T470 valued at $422,000.
This endorsement is a modification of the Insurance Services Office endorsement form number CP 12 18 10 91 and modifies insurance provided as
follows:
A. LOSS PAYABLE
For covered property in which both Member/Agency and a Loss Payee shown in the Schedule have an insurable interest, SDRMA, pursuant and
limited to its obligations as outlined in the Memorandum of Coverage, or the insurer identified in the Declaration will:
1.Adjust losses with the Member/Agency; and
2.Subject to any deductible which is the responsibility of the Member/Agency, pay any claim for loss or damage jointly to the Member/Agency and
the Loss Payee, as interests may appear.
B. LENDER’S LOSS PAYABLE
1.The Loss Payee shown in the Schedule is a creditor, including a mortgage holder or trustee, whose interest in Covered Property is established
by such written instruments as:
a. Warehouse receipts;
b. A contract for deed;
c. Bills of lading;
d. Financing statements; or
e. Mortgages, deeds of trust or security agreements.
2.For Covered Property in which both the Member/Agency and a Loss Payee have an insurable interest:
a. SDRMA, pursuant and limited to its obligations as outlined in the Memorandum of Coverage, or the insurer identified in the Declaration will
pay for covered loss or damage to each Loss Payee in their order of precedence, as interests may appear.
b. The Loss Payee has the right to receive loss payment even if the Loss Payee has started foreclosure or similar action on the Covered
Property.
c. If SDRMA or the insurer identified in the Declaration denies the Member/Agency’s claim because of the Member/Agency’s acts or because
the Member/Agency has failed to comply with the terms of the Coverage Part, the Loss Payee will still have the right to receive loss payment if
the Loss Payee:
(1) Pays any premium due under this Coverage Part at our request if the Member/Agency has failed to do so;
(2) Submits a signed, sworn proof of loss within 60 days after receiving notice from SDRMA of the Member/Agency failure to do so; and
(3) Has notified SDRMA of any change in ownership, occupancy or substantial change in risk known to the Loss Payee.
All of the terms of this Coverage Part will then apply directly to the Loss Payee.
d. If SDRMA or the insurer identified in the Declaration pays the Loss Payee for any loss or damage and denies payment to the
Member/Agency because of the Member/Agency’s acts or because the Member/Agency has failed to comply with the terms of this Coverage Part:
(1) The Loss Payee’s rights will be transferred to SDRMA or the insurer identified in the Declaration to the extent of the amount SDRMA or
the insurer identified in the Declaration pays; and
(2) The Loss Payee’s rights to recover the full amount of the Loss Payee’s claim will not be impaired.
At our option, SDRMA, pursuant and limited to its obligations as outlined in the Memorandum of Coverage, or the insurer identified in the Declaration
may pay to the Loss Payee the whole principal on the debt plus any accrued interest. In this event, the Member/Agency will pay the Member/Agency
remaining debt to SDRMA or the insurer identified in the Declaration.
3.If the SDRMA cancels coverage, SDRMA will give written notice to the Loss Payee at least:
a. Ten (10) days before the effective date of cancellation if SDRMA cancels for the Member/Agency non-payment of premium; or
b. Thirty (30) days before the effective date of cancellation if SDRMA cancels for any other reason.
4.If SDRMA elects not to renew this policy, SDRMA will give written notice to the Loss Payee at least 10 days before the expiration date of this
policy.
C. CONTRACT OF SALE
1.The Loss Payee shown in the Schedule or in the Declaration Page is a person or organization the Member/Agency has entered a contract with
for the sale of Covered Property.
2.For Covered Property in which both the Member/Agency and the Loss Payee have an insurable interest, SDRMA, pursuant and limited to its
obligations as outlined in the Memorandum of Coverage, or the insurer identified in the Declaration will:
a. Adjust losses with the Member/Agency; and
b. Subject to any deductible which is the responsibility of the Member/Agency, pay any claim for loss or damage jointly to the Member/Agency
and the Loss Payee, as interests may appear.
3.The following is added to the OTHER INSURANCE Condition of the PEPIP policy:
For Covered Property that is the subject of a contract of sale, the words “Member/Agency” or “Insured” includes the Loss Payee.
All other terms and conditions remained unchanged.
Coverage provided by this endorsement, under the terms, conditions and exclusions contained in the Memorandum of Coverage issued by SDRMA
to Costa Mesa Sanitary District, shall not be reduced or canceled without thirty (30) days written notice given to the above named Loss Payee via
certified mail.
Effective date of this endorsement is: 11/5/2018
Paul Frydendal - Chief Operatng Ofcer
Signed by: