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Insurance - TTS Engineering Inc. - 2020-02-24ALCOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODNYYY) `„^. 02/24/2020 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(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 Carrie Stubblefield CISR NAME: James G Parker Insurance Associates RECEIVED f=D PHONE Ext1, (559) 222-7722 1 (FZ NO: (559) 222-1724 License #0554959 E- 'vL CarrieStubblefield@jgparker.com A n tn1 ADDRESS: P O Box 3947 H� $ 2UZU o INSURERS AFFORDING COVERAG NAIC # Fresno o ���' INSURERA: Evanston Insurance Company 35378 INSURED C,3 INSURER Insurance Company V 41297 a Mesa Sancta District INSURER B : P Yof T T S Engineerinil INSURER C: Travelers Property Casualty Co of America"V 25674 D B Equipment LLC INSURER D: 10731 Chestnut Ave INSURER E: Stanton CA 90680 INSURER F: rnVFRAnFS r_FRTIFir ATF mi liuRFR• 20-21 GL IM UMB ocinelrW Lu uNlzco. 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 MAYBE 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 ADDLUUBKI INSD WVD POLICY NUMBER POLICY EFF MMIDDIYYYY) POLICY (MMIDDNM LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ©OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE TO RERTM5- PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ Excluded ` PERSONAL & ADV INJURY $ 1,000,000 A Y MKLV5PBC001554 02/26/2020 02/26/2021 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY © PEC LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMPIOPAGG $ 2,000,000 Per Project Aggregate $ 5,000,000 OTHER: AUTOMOBILE LIABILITY GOMBiNED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ Per accident UMBRELLA LIABOCCUR EACH OCCURRENCE $ 5.000,000 B X EXCESS LIAB CLAIMS -MADE XLS0113204 02/26/2020 02/26/2021 AGGREGATE $ 5,000,000 DED F I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' Y ! N LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? NIA I PEROTH- STATUTE ER E.L.EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below C RenteDeductible Equipment Scheduled Equipment Scheduled Equipment QT6601798N365TIL20 02/26/2020 02/26/2021 $1,000 $250,000 Deductible $1,000 Per Schedule 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 Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers and employees are included as Additional Insured as perform CG2012 0413 attached. Said policy shall not terminate, nor shall it be canceled nor the cocverage reduced, until thirty (30) days after written notice is given to the District as per form MEIL1241 0714. Any other insurance maintanced by the Costa Mesa Sanitary District shall be excess and non contributing CFRTIF11r'1kTF Wrll EIFR /`AK111CI 1 ATIAAI 91988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) 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 Ave a� C AUTHORIZED REPRESENTATIVE 111 Costa Mesa CA 92626 91988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: MKLVSPBC001554 COMMERCIAL GENERAL LIABILITY CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION -- PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Costa Mesa Sanitary District, their elected and appointed officals, agents, officers, volunteers and employees 290 Paularino Ave Costa Mesa CA 92626 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 as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the 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. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". 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 the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 2012 0413 O Insurance Services Office, Inc., 2012 Page 1 of 1 INTERLIN E POLICY NUMBER: MKLV5PBC001554 mAwr ESSEX INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. AMENDMENT OF CANCELLATION PROVISIONS All Coverage Parts included in this policy are subject to the following conditions. SCHEDULE Name: Costa Mesa Sanitary District, their elected & appointed officials, agents, officers, volunteers & employees Address: 290 Paularino Ave, Costa Mesa, CA 92626 Number of days advance notice: 30 In the event of cancellation by us, we agree to mail advance written notice of cancellation to the person or organization described in the Schedule above. All other terms and conditions remain unchanged. MEIL 1241 0714 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission