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Insurance - Pacific Data Electric Inc. - 06-17-2020 (2)
AC " OOCERTIFICATE 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, 6/17/2020 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). PRODUCERAdamson & McGoldrick Insurance Solutions 1150 E. Orangethor e Ave., Suited Placentia, CA 9287 NAME: Brigid Lopez AHONN o. Ext): 714-257-9644 FAAC Nol: 714-257-9833 E-MAIL ADDRESS: bI0 ez adamsonmc oldrick.com INSURER(S) AFFORDING COVERAGE NAIC # www.adamsonmcgoldrick.com JUN2 (2020 INSURER A: Travelers Property Casualty Co of Amer 25674 INSURED Pacific Data Electric, Inc. dba: PDE Total Energy Solutions COSta .Mesa S.4r^ftar v District 231 Benton Court City of Industry CA 91789 INSURER B: St. Paul Surplus Lines Insurance Company 30481 INSURER C : INSURER D: INSURER E: INSURER F: ✓ COVERAGES CERTIFICATE NUMBER: s6n:179Rs RFVISION NIIMRFR- 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! ADDL SUBR POLICY EFF LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY POLICY EXP - MM/DD/YI LIMITS A �/ COMMERCIAL GENERAL LIABILITY ✓ VTCT2J-CO-9322BO94-TIL-20 7/1/2020 7/1/2021EACH OCCURRENCE , $1,000,000 � OC&P & XCU INCLUDE CLAIMS -MADE L"_J OCCUR I , DAMAGE TO RENTED Pf REMISES {Ea occurrence) $ 3T �O OODO _ ✓ Blanket Cont. L( i MED EXP (Any one person) $ 5,000 E✓ 1 BFPD; Cross Liab PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. j GENERAL AGGREGATE $2,000,000 POLICY I jE �J LOC PRODUCTS - COMP/OP AGG $ 2,000,000 ✓ 1 OTHER: $50,000 deductible I $ A AUTOMOBILE LIABILITY VTJ-CAP-9322B125-TIL-20 1 7/1/2020 17/1/2021 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 ✓ ANY AUTO ' _ BODILY INJURY (Per person) $ OWNED I SCHEDULED ! AUTOS ONLY AUTOS j BODILY INJURY (Per accident) $ j ✓AUTOS HIRED NON -OWNED ONLY ✓ AUTOS ONLY PROPERTY DAMAGE $ Per accident !Deductible = 0 is A �/ UMBRELLA LIAB ✓ OCCUR CUP -8N498906-20-25 7/1/2020 7/1/2021 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE ! _ AGGREGATE $ 5,000,000 DED I RETENTION $ ! $ A WORKERS COMPENSATION ( UB -1 N229746 -20-25-K , 7/1/2020 7/1/2021�/ 11 PER 1 ' OERH AND EMPLOYERS' LIABILITY Y / N STATUTE ANYPROPRIETOR/PARTNER/EXECUTIVE a OFFICER/MEMBER EXCLUDED? NIN/A; E.L. EACH ACCIDENT $ 1,000,000 --- — + (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE$ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT ' $1,000,000 A Leased or Rented Equipment IQT6302G406387TIL 7/1/2020 7/1/2021 $250,000 per item / Ded = $5,000 B Professional Liability (ZCD-71N23281 1/21/2020 11/21/2021 $5,000,000 Per Claim / $150,000 ded. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) GL Blanket Additional Insured applies per attached, only if required by written contract/agreement. Job: Operations of the Named Insured. Additional Insured(s): Costa Mesa Sanitary District and its officers, agents and employees. —I � I ww�.� �.HIV�.CLLA I IVry Operations of the Named Insured District SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Costa Mesa Sanitary /� a�� 10 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 290 Paularino Avenue l ACCORDANCE WITH THE POLICY PROVISIONS. Costa Mesa CA 92626 AUTHORIZED REPRESENTATIVE Brian McGoldrick U 19BB-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 56037985 1 MORRO-1 1 20/21 Pacific Data Electric (PDE) *20/21 PL* I Brigid Lopez 1 6/17/2020 12:39:10 PM (PD:) I Page 1 of 3 This certificate cancels and supersedes ALL previously issued certificates. VTCT2J-C0-93228094-TI L-20 6/17/2020 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION 11— WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury" or "property damage" that occurs, or for "personal injury' caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect; and b. If, and only to the extent that, such injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the written contract or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section 111 — Limits Of Insurance. (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury' or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against insured does not apply to: the additional insured: CG D2 46 0419 © 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 56037985 1 MORR0-1 1 20/21 Pacific Data Electric (PDE) *20/21 PL* I Brigid Lopez 1 6/17/2020 12:34:10 PM (PD'-) I Page 2 of 3 This certificate cancels and supersedes ALL previously issued certificates. COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit' as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. Page 2 of 2 (4) Tender the defense and indemnity of any claim or "suit' to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. © 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19 56037985 I MORRO-1 120/21 Pacific Data Electric (PDE) *20/21 PL* I Brigid Lopez 16/17/2020 12:34:10 PM (PD_) I Page 3 of 3 This certificate cancels and supersedes ALL previously issued certificates.