Insurance - TTS Engineering 2019-10-01ACC>RDr CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
10/01/2019
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
James G Parker Insurance Associates
License #0554959
P O Box 3947
Fresno OCTO 20 CA 93650
CONTACT Carrie Stubblefield CISR
PHONE (559) 222-7722 FAX (559) 222-1724
A/C No Ext): A/C, No
ADDRESS: CarrieStubblefield@jgparker.com
INSURER(S) AFFORDING COVERAGE NAIC #
INSURERA : American Zurich Ins Co 40142
INSURED
T T S Engineering Ir!
D B Equipment LLC
10731 Chestnut Ave
Stanton CA 90680
PSA\/C�A/►c@ ___ _...-____ — ....... .....
INSURER B: Zurich American Insurance 16535
INSURER C:
INSURER D
INSURER E :
INSURER F:
_- - - - ------ -- INV V wwn 1w OWur-M.
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 ADDLSUBR
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $
DAMAGE
CLAIMS -MADE FlOCCUR
PREMISES Ea occurrence $
MED EXP (Any one person) $
Y
PERSONAL &ADV INJURY $
GEN'LAGGREGATELIMITAPPLIES PER:
F-1 PRO- a
GENERAL AGGREGATE $
PRODUCTS-COMP/OPAGG $
POLICY JECT LOC
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $ 1,000,000
Ea accident
X ANYAUTO
BODILY INJURY (Per person) $
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
BAP106300801
10/01/2019
10/01/2020
BODILY INJURY Per accident $
( )
X HIRED v NON -OWNED
AUTOS ONLY /� AUTOS ONLY
PROPERTY DAMAGE $
Per accident
UMBRELLA LIAB
OCCUR
HCLAIMS-MADE
EACH OCCURRENCE $
EXCESS LIAR
AGGREGATE $
DED I RETENTION $
WORKERS COMPENSATION
$
_
AND EMPLOYERS' LIABILITY Y / N
X STA UTE ERH
E.L. EACH ACCIDENT $ 1,000,000
B
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
NIA
WC106300701
10/01/2019
10/01/2020
E.L. DISEASE- EA EMPLOYEE $ 1,000,000
Mandatory in
I
(f yes, describe under
E.L. DISEASE - POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS below
-
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Job: #18261 300 Fishcher Ave Costa Mesa, CA 92626
rCn'rIM^A"rr 110%1 M. —
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 Ave
AUTHORIZED REPRESENTATIVE
Costa Mesa CA 92626 /
U 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD