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Insurance - CR&R Incorporated 2021-03-31Client#: 569053 C�c7:� c71: C ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY)3/31/2021 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh & McLennan Agency LLC CONTACT Karen Thomas NAME: PHONE949-900-2250 FAX �° A/c, No): 858-452-7530 Marsh & McLennan Ins. Agency LLC E ADDRESS: Karen.Thomas@MarshMMA.com 1 Polaris Way #300 Aliso Viejo, CA 92656 -- INSURER(S) AFFORDING COVERAG NAIC # INSURER A: ACE American Insurance Company 22667 INSURED CR&R Incorporated 11292 Western Avenue INSURER B: - INSURER C PERSONAL & ADV INJURY $ 5,000,000 Stanton, CA 90680 INSURER D: INSURER E : INSURER F: A COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 INSR SUB WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR G71453352 9/03/2020 09/03/2021 EACH OCCURRENCE s5,000,000 DAMAGE TO RENTED PREMISES Ea occurrence} $_100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICYF-1 JECOT LOC OTHER: GENERAL AGGREGATE $ 5,000,000 PRODUCTS - COMP/OP AGG $ 5,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY H25310275 9/03/2020 09/03/2021 Ea acciden eESINGLE LIMIT 3,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE SEE ATTACHED 9/03/2020 09/03/2021 EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATIONWLRC67814861 AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE nY / N OFFICER/MEMBER EXCLUDED? L�J (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4/01/2021 09/03/2021 X SER OTH- E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) *See Attached for Excess Layers* Certificate Holder is included as Additional Insured as respects General Liability and Auto Liability per the attached. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Costa Mesa Sanitary District 290 Paularino Ave. Costa Mesa, CA 92627 ACORD 25 (2016/03) 1 of 2 #S8156806/M8153889 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 REPRESENTATIVE F _ %I -: ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INSURED: CR&R Incorporated POLICY#: SEE ATTACHED POLICY PERIOD: 09/03/2020 TO: 09/03/2021 CR&R Excess Layers Excess General Liability: $3,000,000 Excess of $5,000,000 09/03/2020 - 09/03/2021 Lloyd's of London Policy #8167013073762020 NAIC #AA1127084 Excess Auto Liability: $5,000,000 Excess of $3,000,000 09/03/2020 - 09/03/2021 Interstate Fire & Casualty Company Policy #USZ00031420 NAIC #22829 DESCRIPTIONS (Continued from Page 1) Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers and employees are included as additional insured as respects to Auto Liability per attached endorsement. SAGITTA 25.3 (2016/03) 2 of 2 #S8156806/M8153889 INSURED: CR&R Incorporated POLICY #: G71453352 POLICY PERIOD: 09/03/2020 TO 09/03/2021 COMMERCIAL GENERAL LIABILITY CG 20 26 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A l l • 0 1 A • twei k, Kei' •' • i m±vi• This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization (s): Any person or organization whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I A. Section 11 — 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 26 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 INSURED: CR&R incorporated POLICY#: H25310275 POLICY PERIOD: 09/03/2020 TO: 09/03/2021 ADDITIONAL INSURED — DESIGNATED PERSONS OR ORGANIZATIONS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM EXCESS BUSINESS AUTO COVERAGE FORM Additional Insured(s): Any person or organization whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. A. For a covered "auto," Who Is Insured is amended to include as an "insured," the persons or organizations named in this endorsement. However, these persons or organizations are an "insured" only for "bodily injury" or "property damage" resulting from acts or omissions of: 1. You. 2. Any of your "employees" or agents. 3. Any person operating a covered "auto" with permission from you, any of your "employees" or agents. B. The persons or organizations named in this endorsement are not liable for payment of your premium. DA-9U74c (03/16) Page 1 of 1 MARSH & MCLENNAN AGENCY LLC CO 1 POLARIS WAY STE 300 ALISO VIEJO CA 92656-5358 COSTA MESA SANITARY DISTRICT 290 PAULARINO AVE COSTA MESA CA 92626-3314