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Insurance - Municipal Maintenance Equipment - 2020-12-11,/' CCM" CERTIFICATE OF GARAGE INSURANCE DATE (MM/DD/YYYY) 12111/2020 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 Sentry Insurance 1800 Nath Point Drive CONTACT Sentry Customer Service NAME: AF/C No Ext): 800-473-6879 AX. No : 800-514-7191 Stevens Point, WI 54481 EMAIL ADDRESS: businessproducts_direct@sentry.com INSURER(S) AFFORDING COVERAGE NAIC # GARAGE LIABILITY HIRED AUTOS X ANY AUTO ONLY -OWNED OWNED AUTOS USED AUTOS ONLY IN GARAGE BUSINESS INSURER A: Sentry Select Insurance Company 21180 INSURED INSURER B: Municipal Maintenance Equipment Inc 4634 Mayhew Rd INSURER C: INSURER D: Sacramento, CA 95827-9700 AGGREGATE $ 2,500,000 INSURER E: INSURER F: COVERAGES PROD /CUSTOMER ID: CERTIFICATE #: 2020788 REVISION #: 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 RTYPE LTR(MM/DD/YYYY) OF INSURANCE NSRD ADDL SUBR WVD POLICY NUMBER POLICY EFF POLICY EXP (MM/DDNYYY) LIMITS ANON GARAGE LIABILITY HIRED AUTOS X ANY AUTO ONLY -OWNED OWNED AUTOS USED AUTOS ONLY IN GARAGE BUSINESS A0163992001 12/15/2020 12/15/2021 AUTO ONLY (Ea accident) $ 500,000 OTHER THAN AUTO ONLY EA ACCIDENT $ 500,000 AGGREGATE $ 2,500,000 GARAGE KEEPERS LIABILITYCOMP X / OTC LOC 1 $ 3,000,000 A LEGAL LIABILITY DIRECT BASIS A0163992001 12/15/2020 12/15/2021 SPECIFIED LOC $ X COLLISION LOC 1 $ 3,000,000 PRIMARY EXCESS LOC $ X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 500,000 CLAIMS -MADE E OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 A X A0163992006 12115/2020 12/15/2021 PERSONAL & ADV INJURY $ 500,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,500,000 X POLICY PRO-JECT 0 LOC PRODUCTS - COMP/OP AGG $ 1,500,000 OTHER $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 3,000,000 A X EXCESS LIAR CLAIMS -MADE A0163992007 12/15/2020 12/15/2021 AGGREGATE $ 9,000,000 DED RETENTION $ PRODUCTS - COMP/OP AGGOT{� $ 9,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PER ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y / N N ! A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT S REMARKS below REMARKS (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Refer to attached CERTIFICATE HOLDER CANCELLATION Costa Mesa Sanitary District SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 290 Paularino Ave Costa Mesa, CA 92626-3314 '� THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. RUTH RIZ �r NTAj1Y :=Y ACORD 30 (2016/03) A0163992 Sentry Select Insurance Company ^" 3 00003 0000001402 20348 N A 0 Page 1 of 2 O 2010-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 12/11/2020 7D17B282-3E45-4CE4-9217-4373862AEA52 0027020044358943679192626331490 ACCP AGENCY CUSTOMER ID: X)0000{3697 LOC #: AnnITIONAI RFMARKS SrI141= t l F Page 2 of 2 AGENCY Brittany Beaumonte NAMED INSURED Municipal Maintenance Equipment Inc POLICY NUMBER A0163992001 CARRIER Sentry Select Insurance Company NAIC CODE 21180 EFFECTIVE DATE: 12/15/2020 4DDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 30 FORM TITLE: Certificate Of Garage Insurance General Liability COSTA MESA SANITARY DISTRICT, THEIR ELECTED AND APPOINTED OFFICIALS, AGENTS, OFFICERS, VOLUNTEERS, AND EMPLOYEES AS ADDITIONAL INSURED- PERSUANT TO ATTACHED ENDORSEMENT.ANY OTHER INSURANCE MAINTAINED BY THE COSTA MESA SANITARY DISTRICT SHALL BE EXCESS & NON-CONTRIBUTORING WITH THE INSURANCE PROVIDED BY THIS POLICY. UMBRELLA IS EXCESS OVER GENERAL LIABILITY AND AUTO LIABILITY POLICIES. Garagekeepers Liability Location # State Basis Collision Limit Comp/OTC/Specified Perils Limit 2 CA Natural Disasters Legal $ 2,000,000 $ 2,000,000 Liability 6 CA Natural Disasters Legal $ 1,250,000 $ 1,250,000 Liability ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. A0163992 The ACORD name and logo are registered marks of ACORD 12/11/2020 Sentry Select Insurance Company POLICY NUMBER: A0163992006 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Costa Mesa Sanitary District All Locations. Description: All Jobs. 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 the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those 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 to the extent permitted by law; and 2. 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. Change effective 12/15/2020 Z CG 20 10 0413 A0163992 .r Sentry Select Insurance Company 5 00003 0000001402 20348 N A 0 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, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) 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 a principal as a part of the same project. U Insurance Services Office, Inc., 2012 718B29EC-3BAF-4884-8DC3-B2BB1 DFF1 BCD 0027020044358943638992626331490 Page 1 of 2 12/11/2020 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 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. Change effective 12/15/2020 Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 2010 04 13 A0163992 12/11/2020 Sentry Select Insurance Company