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Insurance - SOS Services, Inc. 01-14-2020AC'CJ�PLa® CERTIFICATE OF LIABILITY INSURANCE ...•-�'' DATE (MM/DDJYYYY) 01/14/2020 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(ies) 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 Orion Risk Management Insurance Services, An Alera Group Insurance Agenc License Number # OM70471 1800 QUAIL ST STE 110 NEWPORT BEACH CA 92660-2340 CONTACT NAME: Caesar De La Torre PHONN o. Ext): 9492638850 (A/C, No): E-MAIL cdelatorre@orionrisk.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: XL INSURANCE AMERICA INC. V A 24554 INSURED SOS Services, Inc. 12888 WESTERN AVE GARDEN GROVE CA 92841-4034 INSURER B. FALLS LAKE FIRE AND CASUALTY COMPANY 15884 INSURER C: INSURER D -, INSURER E: 1 INSURER F: COVERAGES CERTIFICATE NUMBER: EAOFE6 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 INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE ® OCCUR DAMAGERENTED PREMISESS ( Ea occurrence) $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 A X NPC100134200 08/19/2019 08/19/2020 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO - X PRO- ❑ POLICY � LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO A OWNED F� SCHEDULED AUTOS ONLY AUTOS NBA100134400 08/19/2019 08/19/2020 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB�HCLAIMS-MADE i DED RETENTION $ $ ! B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N OFFICER MEMBER EXCLUDED? UDED? ECUTIVE � ! I N / A FLA01327200 01 /01 /2020 01 /01 /2021 X STATUTE EORH E.L. EACH ACCIDENT $ 1,000,000 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 I I I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers, and employees are included as additional insured subject to the terms of the attached General Liability endorsement. Any other insurance maintained by Costa Mesa Sanitary District shall be excess and non-contributing With the insurance provided by this policy per the terms of the enclosed General Liability endorsement. 30 days notice of cancellation except 10 day notice for non payment of premium. CERTIFICATE HOLDER CANCELLATION 0 0 M SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 0 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN co ACCORDANCE WITH THE POLICY PROVISIONS. 0 LO Costa Mesa Sanitary District a �3�� V' AUTHORIZED REPRESENTATIVE Mo 290 PAULARINO AVE Q COSTA MESA, CA 92626-3314 co co ©1988-2015 ACORD CORPORATION. All rights reserved. CORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD C) C? m C? m 9 m LO CD 9 C) 00 CD 't Wj ASSURED CERTIFICATES, LLC 2159 INDIA ST STE 107 SAN DIEGO CA 92101 003155 3155 MB 0.291 T12 P1 *****AUTO**MIXED AADC 601 COSTA MESA SANITARY DISTR 290 PAULARINO AVE COSTA MESA CA 92626-3314 ASSURED CERTIFICANTES 2159 INDOk S -T S A N D I rE-- 111-�-; 0 C A ��J' 21101 as s u. r e, d c e r t J I i c at P s, co rn issumancte Date: januaiy 2020 Want to get faster service and reduce waste? Access your certificates online and sign up for digitall certificatesi delivery by visiting assuredcertificates.com./n, pedeas and entering the code below - Support: supportC@assuredcertificates.com 1858-239-0248 Vit? rnoerAOFIE6 0 9 co 9 'r- 9 LO co 0 9 0 co co co co 0 't N POLICY NUMBER: NPCIO0134200 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and T-1XIT0111W (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. 0 Insurance Services Office, Inc., 2012 MUM C. 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 e contract or agreement, the most we will pay on behalf of the additional insured is the amount ofinsurance: 1. Required bythe contract oragreement; or 2. Available under the applicable Umnhe of Insurance shown in the Declarations; whichever imless. This endorsement applicable Umho of Declarations. PInsurance Services Office, Inc., 2012 It shall not increase the Insurance shown in the CG 20 10 04 13 POLICY NUMBER: mPczooz34ouo COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Blanket as required by written contract Blanket as required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 Who Is An Insured is amended to include asanadditional insured the (s)or organization(s) hovvn in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, inwhole orinpart, by: 1. Your acts oromissions; or 2. The acts oromissions ofthose acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies tothe extent permitted by law; and 2. |fcoverage prov|dedtutheadditiona|1nauredky 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. CG 20 10 04 13 It Qrg B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parte or equipment furnished in connection with such work, on the project (other than aen/ica, maintenance orrepairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for e principal aoopart ofthe same project. QInsurance Services Office, Inc., 2012 POLICY NUMBER: mPC100134200 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 K91-11 ZI 41111111 wo oom ''I'r This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Blanket as required by written contract Blanket as required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section VU Who Is An Insured is amended to include aaan additional insured the (a) or organization(e) shown in the 8chedu|e, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part` by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "prod ucts-oornp|mted operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted bylaw; and 2. If coverage provided tothe 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. CG 20 37 04 13 "t 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 required by a contract or will pay on behalf of the amount ofinsurance: the additional insured is agreement, the most we additional insured is the 1. Required bythe contract oragreement; or 2. Available under the applicable UmKo of Insurance shown inthe Declarations; whichever ialess. This endorsement shall not increase the applicable @)Insurance Services Office, Inc., 2012 Page I of I