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Insurance - Robin B. Hamers & Associates, Inc. 2019-06-21,4coirr�® CERTIFICATE OF LIABILITY INSURANCE .--'" DATE (MM/DD/YYY ) 06/21/2019 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 CONTACT Cora Lim NAME: SelectSolutions Insurance Services HONK (866) 500-6359 ac, No : (925) 951-0077 1107 Investment Blvd E-MAIL coral@selectsolutionsins.com ADDRESS: Suite 100 INSURER(S) AFFORDING COVERAGE NAIC # EI Dorado Hills CA 95762 INSURERA: Travelers Property Casualty Company of Arnericae 25674 INSURED INSURER B: The Hanover American Insurance Company/ 36064 Robin B. Harriers & Associates, Inc. INSURER C: The Hanover Insurance Company7 22292 234 E. 17th Street, Suite 205 INSURER D: INSURER E: Costa Mesa CA 92627 INSURER F: CnVFRAGF.R CFRTIFICATF NIIMRFR• 19-20 GL WC EO RFVICInN NI IMRGR- 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 CONTRACTOR 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 INSURANCE ADOL INSD SUISR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 A Y 680-1J616034-19-47 06/01/2019 06/01/2020 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑X PRO JECT LOC PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Included in GL Ea accident BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 680-1J616034-19-47 06/01/2019 06/01/2020 BODILY INJURY (Per accident) $ X HIRED X NON -OWNED PROPERTY DAMAGE $ Per accident AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION PER XIN AND EMPLOYERS' LIABILITY Y� STATUTE ETH E.L. EACH ACCIDENT $ 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? NIA WZF9012529 03/23/2019 03/23/2020 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 Per Claim $1,000,000 Professional Liability C LHFD32755801 07/27/2018 07/27/2020 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS 1 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 their elected and appointed officials, agents, officers, volunteers, and employees are included as Additional Insured on General Liability policy, if required by written contract per attached endorsement. General Liability policy is primary and non-contributory per the attached endorsement. CERTIFICATE HOLDER CANCFI 1 ATInN ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District ! ACCORDANCE WITH THE POLICY PROVISIONS. 290 Paularino Avenue �! l,� AUTHORIZED REPRESENTATIVE /// Costa Mesa CA 92626 - - ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD PDLDCYJ<UMBI]l 680-lJ616034-19-47 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The folowing is added to SECTION U — WHO IS ANUNSURED: Any person or organization that you agree in a 11written contract requiring insurance*' to include as anadditional insured onthis Coverage Part. but: m. Orly with respect toliability for "bodily hnjury'. "property damage" or"personal injug/^;and b' if, and only to the extent that, the injury or da -nage is caused by acts or omissions of you or your subcontractor in the performance of "your k" to which the "written contract requiring insurance" applies, or in connection with premises owned bymrrented toyou. The person o, organization does not qualify asam additional insured: o. With the independent acts or omissions ofsuch person urorganization; or d. For "bodily injury", "property damage' or "personal injury" for which such person or organization has assumed liability in a contract uragreement. The insurance provided tosuch additional insured is limited as follows: e. 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. f. This insurance does not apply to the rendering of o/ failure to render any "Professional services". g. In the event that the Limits of Insurance of the Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance^, the insurance provided to the additional insured shall be limited to the limits of liability required bythat "written contract requiring insurance". This endorsement does not increase the limits of insurance described in Section \|U — Limits CfInsurance. h. This insurance does not apply to ~bmd|h/ injury" or "property da caused by"your work" and included in the "products - completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insmred, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that occurs before the end of the period of time for which the "written contract requiring insurance" requires you to provide such coverage or the end of the policy period. whichever isearlier. 2. The following is added to Paragraph 4.a' of SECTION |V — COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible other insurance. whether primary, excess, contingent or on any other bauis, that is available to the additional insured fora loss we cover. Hmmever, if you specifically agree in the "written contract requiring insurance" that this insurance provided tuthe additional insured under this Coverage Part must apply on a primary basis ora primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person mrorganizations as a named insured for such k»ss, and we will not share with the other insurance, provided that: (1) The "bodily i 'uly' or "property damage" for which coverage issought occurs; and (2) The "personal injury" for which coverage is sought arises out nfmnoffense committed: after you have signed that "written contract requiring insurance". But this insurance provided to the additional insured still is excess over valid and collectible other insmnance, whether primary. excess` cmntinaentor on any other basis, that is available to the additional insured when that person or organization is an additional insured under any other insurance. CG D3 81B9 15 vxmmsThe rm,elem Indemnity Company. All rignis reserved. Page 1of2 Includes 1he capyriqhted malerial of Insurance Services Office, Inc., with Js permission COMMERCIAL GENERAL LIABILITY 3. Thofo lowing is added toParagraph BL, Transfer Of Rights Of Recovery Against Others TwUs, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right 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, oronyour beha|f, done under a'%,vrittencontract requiting insurance" with that person or organization. We waive this right only where you have agreed to do so as part of the "written contract requiring insurance" with such person or organization signed by you before, and in effect when. the "bodily injury" or " damage" occurs, urthe "personal injury" offense iscommitted. 4. The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part mfany written contract under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" anc "property damage" occurs and the "personal injury" is caused byanoffense committed: e. After you have signed that written contract; b. While that part of the written contract is in effect, and c. Before the end of the policy period. Page 2of2 moo10The Travelers Indemnity All rights reserved. CG 03 81 00 15 Includes the cap�,rrWhted material ofInsurance Services Office, /,c.,with 'is permission