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Insurance - Orange Coast Electrict 2020-02-24
Westbluffs /® A!�oCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 2/24/2020 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). PRODUCERCONTACT Kimbrell Insurance Agency 950 E Katella Ave Ste 4 Orange, CA 92867 NAME: Jon Kimbrell A/CC. No Ext): 714-221-6612 FAX No): 714-538-8724 E-MAIL ADDRESS: Service@Kimbrell-insurance.com INSURER(S) AFFORDING COVERAGE NAIC # 0100071372-1 INSURER A: Kinsale Insurance Company A- VIII 38920 www.Kimbrell-Insurance.com 0619648 INSURED INSURER B: California Automobile Insurance Company A+ XII 38342 Orange Coast Electric 24062 Salero INSURER C: National Union Fire Ins Co Pittsburgh PA 19445 Mission Viejo CA 92691 INSURER D: INSURER E: PRODUCTS - COMP/OP AGG $ 2,000,000 INSURER F: B COVERAGES CERTIFICATE NUMBER: 54237756 REVISION NUMBER: F 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 LTR1= TYPE OF INSURANCE ADDL SUBR Wvp POLICY NUMBER MM/DD EFF MM/DD EXP LIMITS A ✓ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE D OCCUR ✓ 0100071372-1 8/10/2019 8/10/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 GEN'L ✓ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY PRO-- LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED ✓ AUTOS ONLY AUTOS HIRED NON -OWNED I,/ AUTOS ONLY AUTOS ONLY IBA040000029881 10/7/2018 10/7/2019 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE $ Per accident $ C ✓ UMBRELLA LIAB EXCESS LIAB �/ OCCUR CLAIMS -MADE EBU028196450 10/8/2019 8/10/2020 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DEDT I RETENTION $ No Deductible or SIR $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A O STATUTE ERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) "All operations: Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers, and employees listed as Additional Insured — Pursuant to attached endorsement. CERTIFICATE HOLDER CANCELLATION Costa Mesa Sanitary District Wastewater Maintenance Superintendent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 290 Paularino Ave Costa Mesa CA 92626 AUTHORIZED REPRESENTATIVE Jon Kimbrell ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 54237756 1 OCELE 1 19/20 GL/EX(Aug)/BA (Oct) I Jon Kimbrell 1 2/24/2020 8:39:52 AM (PST) I Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Attached To and Forming Part of Policy Effective Date of Endorsement Named Insured 0100071372-1 08/10/2019 12:01AM at the Named Insured Orange Coast Electric address shown on the Declarations Additional Premium: Return Premium: $0 $0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE A. SECTION II - WHO IS AN INSURED is amended to include any person or organization you are required to include as an additional insured on this policy by written contract in effect during the policy period and executed prior to the "occurrence" of the "bodily injury" or "property damage", but only for the vicarious liability imposed on the Additional Insured provided that such liability is caused by the sole negligent conduct of the Named Insured and is proximately caused by "your work" or "your product" for the Additional Insured. B. The insurance provided to the Additional Insured under this endorsement is limited as follows: 1. In the event the written contract requires limits of insurance in excess of the Limits of Insurance provided by this policy, the Limits of Insurance provided by this policy shall apply and not the limits required by the written contract. This endorsement shall not increase the Limits of Insurance stated in the Declarations of this policy. 2. This insurance does not apply to "bodily injury" or "property damage" arising out. of "your work" or "your product" included in the "products -completed operations hazard" unless you are required to provide such coverage by written contract. If such insurance is required by written contract, the insurance provided to the Additional Insured is limited to the alleged or actual vicarious liability imposed on the Additional Insured as a result of the alleged or actual negligent conduct of the Named Insured as a result of liability solely caused by "your work" or "your product" for the Additional Insured. 3. Any insurance provided by this endorsement to an Additional Insured shall be excess with respect to any other valid and collectible insurance available to the Additional Insured unless the written contract specifically requires that this insurance apply on a primary and non-contributory basis, in which case this insurance shall be primary and non-contributory. 4. Where there is no duty to defend the Named Insured, there is no duty to defend the Additional Insured. Where there is no duty to indemnify the Named Insured, there is no duty to indemnify the Additional Insured. 5. This insurance does not apply to "bodily injury" or "property damage," arising out of the sole negligence of the Additional Insured or any employees of the Additional Insured. C. Duties of the Additional Insured in the event of "occurrence", claim or "suit": 1. The Additional Insured must promptly give notice of an "occurrence", a claim which is made or a "suit", to any other insurer which has insurance for a loss to which this insurance may apply. 2. The Additional Insured must promptly tender the defense of any claim made or "suit" to any other insurer which also issued insurance to the Additional Insured as a Named Insured or to which the Additional Insured may qualify as an Additional Insured for a loss to which this insurance may apply. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CAS5010 0717 54237756 I OCELE 1 19/20 GL/EX(Aug)/BA (Oct) I Jon Kimbrell 1 2/24/2020 8:39:52 AM (PST) I Page 2 of 2 Page 1 of 1