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Insurance - American Integrated Services, Inc. 2020-08-27ACOR" CERTIFICATE OF LIABILITY INSURANCE L....-� 12/27/2020 DATE (MM/DDmnrY) 8/27/2020 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 Lockton Insurance Brokers LLC , 777 S. Figueroa Street, 52nd Fl. CA License #OF15767 Los Angeles CA 90017 CONTACT NAME: PHONE FAx Ext : A/C No E-MAILo ADDRESS: 1000066049191 (213) 689-0065 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Starr Surplus Lines Insurance Company 1360 DAMAGE TO PREMISES Ea occurrence) $ 1,000,000 INSURED American Integrated Services, Inc. 1319084 1502 E. Opp Street INSURER B: Starr Indemnity & Liability Company 3831 INSURER C: Hartford Fire Insurance Company 19682 Wilmington CA 90744-3927 INSURER D: INSURER E: $ INSURER F: AUTOMOBILE X X X COVERAGES AMEIN05 CERTIFICATE NUMBER: 15596464 RFVISI0N Nl1MRFR• SIyylvyyy 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/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X Poll./Prof Liab. Y N 1000066049191 12/27/2019 12/27/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO PREMISES Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 100,000 X I Ded: $10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYFX] PECOT- 7 LOC OTHER: GENERAL AGGREGATE $ 2 000 000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X X X LIABILITY ANY AUTO AUTOSOWNED ONLY AUTODULED HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY Comp/Coll D d: 5K y N SISIPCA08222819 12/27/2019 12/27/2020 CMINED Ea accidentSINGLE LIMIT $ 1,000,000 000000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident) $ XXXXXXX PROPERTY DAMAGE Per accident $ XXXXXXX $ XXXXXXX A • UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N 1000336805191 12/27/2019 12/27/2020 EACH OCCURRENCE $ 20,000,000 AGGREGATE $ 20,000,000 X DED 7 RETENTION $ Deductible $ 0 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? F_y] (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N 1000002942 9/l/2020 9/l/2021 X SPER TATUTE EORH EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Contractor's Pollution and Professional Liability is included in the GL policy: $1 MM Ea Occ, $2MM Agg, with $10,000 Ded. RE: All Operations. The Costa Mesa Sanitary District, its elected and appointed officials, agents, officers, volunteers and employees are Additional Insured(s) as per the attached endorsement or policy language. Insurance provided to Additional Insured(s) is primary and non-contributory as per the attached endorsements or policy language. CERTIFICATE HOLDER CANCFI I ATION CeP Attnnhmentc 15596464 Costa Mesa Sanitary District 290 Paularino Avenue�% jaoa Costa Mesa CA 92626 � SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR t ACORD 25 (2016/03) ©1688-201nCGRD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Attachment Code: D568466 Master ID: 1319084, Certificate ID: 15596464 Named Insured:American Integrated Services, Inc. Costa Mesa Sanitary District 290 Paularino Avenue Costa Mesa, CA 92626 To whom it may concern: In our continuing effort to provide timely certificate delivery, Lockton Companies is transitioning to paperless deliveryof Certificates of Insurance, thus this is your final hard -copy delivery. To ensure electronic delivery for future renewals of this certificate, we need your email address. Please contact us via one of the methods below, referencing Certificate ID 15596464 • Email: LACertseDelivery@lockton.com • Phone: (213) 334- 4669 If you received this certificate through an internet link where the current certificate is viewable, we have your email and no further action is needed. In the event your mailing address has changed, will change in the future, or you no longer require this certificate, please let us know using one of the methods above. The above inbox and phone number is for automating electronic delivery of certificates only. Please do NOT send future certificate requests to this inbox or contact the phone number below with email updates. Thank you for your cooperation and willingness in reducing our environmental footprint. Lockton Companies Lockton Companies 777 South Figueroa Street Los Angeles, CA 90017 POLICY NUMBER: 1000066049191 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 Political Subdivision: Where Required By Written Contract (Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - 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: 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 1. This insurance applies only with respect to operations b. "Bodily injury" or "property damage" included within performed by you or on your behalf for which the state or the "products -completed operations hazard". governmental agency or subdivision or political subdivision has issued a permit or authorization. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - However: Limits Of Insurance: a. The insurance afforded to such additional insured only If coverage provided to the additional insured is required applies to the extent permitted by law; and by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of b. If coverage provided to the additional insured is insurance: 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 12 04 13 Attachment Code: D517373 Certificate ID: 15596464 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. © Insurance Services Office, Inc., 2012 Page 1 of 1 Attachment Code: D501438 Certificate ID: 15596464 Starr Surplus Lines Insurance Company Chicago, IL 1-646-227-6300 Primary and Non-contributory Condition Policy Number: 1000066049191 Effective Date: 12/27/2019 Named Insured: American Integrated Services, Inc.; AIS-TN&A; Azetca LB1, Inc.; Azetca LB2, Inc. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Form A. SECTION IV - CONDITIONS, condition 4. Other Insurance is amended as follows: 1. The following is added to paragraph 4.a. of the Other Insurance condition: This insurance is primary insurance as respects our coverage to the additional insured, where the written contract or written agreement requires that this insurance be primary and non-contributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured is a Named Insured. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. SL - 707 (04/11) Page 1 of 1 Copyright © C. V. Starr & Company and Starr Surplus Lines Insurance Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. Attachment Code: D472048 Certificate ID: 15596464 Starr indemnity & Liability Company Dallas, TX 1-866-519-2522 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy Number: SISIPCA08222819 Effective Date: 12/27/2019 at 12:01 AM Named Insured: American Integrated Services, Inc. ADDITIONAL INSURED - Where Required Under Contract or Agreement (Additional Insured Schedule) This policy is amended as follows: BUSINESS AUTO COVERAGE FORM ADDITIONAL INSURED: I. SECTION II — LIABILITY COVERAGE A. Coverage, 1. Who is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. Signed for STARR INDEMNITY & LIABILITY COMPANY Steve Blakey, Presidentand Nehemiah E. Ginsburg, General Counsel Chief Executive Officer SICA 1024 (04/12) Page 1 of 1 Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. Starr Indemnity & Liability Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS Policy Number: SISIPCA08222819 Effective Date: 12/27/2019 Named Insured: American Integrated Services, Inc.; AIS-TN&A; Azetca LB1, Inc.; Azetca L132, Inc. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This policy is amended as follows: BUSINESS AUTO COVERAGE FORM Section IV - Business Auto Conditions, B., General Conditions, 5., Other Insurance, c., is amended by the addition of the following sentence: The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional insured where so required under an agreement executed prior to the date of accident. We will not ask any insurer that has issued other insurance to such additional insured to contribute to the settlement of loss arising out of such accident. All other terms and conditions remain unchanged. SICA 1017 (02/12) Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Page 1 of 1 Includes copyrighted material of ISO Properties, Inc., used with its permission. Attachment Code: D507015 Certificate [D: 15596464