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Insurance - Professional Pipe Services 2021-11-23 (2)ACOR" CERTIFICATE OF LIABILITY INSURANCE 164.� 8/1/2022 DATE (MM/DD/YYYY) 11/23/2021 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Insurance Brokers,LLC NAME:CONTACT NAME: CA License #OF15767 777 S. Figueroa Street, 52nd fl. Los Angeles CA 90017 PHONEFAX A/C No Ext): A/C No E-MAIL ADDRESS: Y 213-689-0065 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Executive Risk Indemnit Inc. 35181 8/l/2022 i INSURED pro -Pipe. Inc., 1429322 Branch #63 INSURER B : Federal Insurance Com an 20281 INSURER C: INSURER D: 47 Discovery #250 Irvine, CA 92618 INSURER E INSURER F: COVERAGES HSWHO01 CERTIFICATE NUMBER: 173363.5R REVISION NUMBER: XXXXXXX 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/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE }{ OCCUR Y N 54310144 3/31 /2021 8/l/2022 i EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence)$ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4 000 000 POLICY JERCOT �f LOC PRODUCTS - COMP/OP AGG $ 4,000,000 $ OTHER: i B AUTOMOBILE LIABILITY Y N 54309479 3/31/2021 8/l/2022 COMBINED SINGLE LIMIT $ Ea accident 2,000,000 I BODILY INJURY (Per person) $ XXXXXXX X ANY AUTO { i ! OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ XXXXXXX X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY r i ( C PROPERTY DAMAGE Per accident)$ XXXXXXX $XXXXXXX UMBRELLA LIAB OCCUR j NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXX}{ EXCESS LIABI CLAIMS -MADE, DED RETENTION $ $ XXXXXXx B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVEj OFFICER/MEMBER EXCLUDED? NN (Mandatory In NH) / A j N 54309480 $/1/2021 8/1/2022 STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below { E.L. DISEASE - POLICY LIMIT $ 1,000,000 l � I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERNI(S) REFERENCED RE: All operations. Costa Mesa Sanitary District, their 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. Notice of Cancellation applies per the attached endorsement or policy language. CERTIFICATE HOLDER CANCELLATION See Attachments 17336358 Costa Mesa Sanitary District-,—�n / /� 290 Paularino Avenue 1 iY°� / J Costa Mesa, CA 92626 V 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 r ACORD 25 (2016/03) ©11 88-20lnCMD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Attachment Code: D568466 Master ID: 1429322, Certificate ID: 17336358 Named Insured:Pro-Pipe, 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 17336358 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 Attachment Code: D532712 Certificate ID: 17336358 POLICY NUMBER: 54310144 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 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) Locations Of Covered Operations WHERE REQUIRED BY WRITTEN CONTRACT ALL LOCATIONS WHERE REQUIRED BY RITTEN 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 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 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. 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. CG 20 10 12 19 0 Insurance Services Office, Inc., 2018 Page 1 of 2 Attachment Code: D532712 Certificate ID: 17336358 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 insurance; whichever is less. This endorsement shall applicable limits of insurance. applicable limits of not increase the Page 2 of 2 0 Insurance Services Office, Inc., 2018 CG 20 10 12 19 Attachment Code: D532717 Certificate ID: 17336358 POLICY NUMBER: 54310144 COMMERCIAL GENERAL LIABILITY 10-02-2461 (Ed. 7-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Additional Insured: Location Of Covered Operations: WHERE REQUIRED BY WRITTEN CONTRACT ALL LOCATIONS (If not entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect only to the Additional Insured and at the Location Of Covered Operations shown in the Schedule, the following is added to SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4.Other Insurance and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to the Additional Insured with respect to the Location Of Covered Operations shown in the Schedule under this policy provided that: (1) The Additional Insured is a named insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the Additional Insured. 10-02-2461 (Ed. 7-15) Includes copyrighted material o' Insurance Services Office, Inc., with its permission. Attachment Code: 13532720 Certificate ID: 17336358 POLICY NUMBER: 54310144 COMMERCIAL GENERAL LIABILITY 10-02-2494 (Ed. 7-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION OR NON -RENEWAL TO SPECIFIED PERSONS OR ORGANIZATIONS This endorsement modifies the following: COMMON POLICY CONDITIONS SCHEDULE Name(s) and Address(es): ALL PERSONS OR ORGANIZATIONS AS ON FILE WITH US The following Condition is added: Notice Of Cancellation Or Non -Renewal To Specified Persons Or Organizations 1. If we cancel or non -renew this policy for any reason other than non-payment, we will deliver notice of the cancellation or non -renewal to any Person(s) or Organization(s) shown in the Schedule thirty (30) days prior to the effective date of cancellation or non -renewal. 2. If we cancel this policy for non-payment, we will deliver notice of the cancellation to any Person(s) or Organization(s) shown in the Schedule ten (10) days prior to the effective date of cancellation. 3. If notice is mailed, proof of mailing will be sufficient proof of notice. 4. Any failure by us to notify such person(s) or organization(s) will not invalidate such cancellation or non -renewal with respect to any other person(s) or organization(s). 10-02-2494 (Ed.7-15) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Attachment Code: D532741 Certificate ID: 17336358 Policy No:54309479 COMMERCIAL AUTOMOBILE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM This endorsement modifies the Business Auto Coverage Form. D. Persons And Organizations As Insureds Under A Written Insured Contract Paragraph A.1- WHO IS AN INSURED - of SECTION II - LIABILITY COVERAGE is amended to add the following: f. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed under an express provision in a written "insured contract", written agreement or a written permit issued to you by a governmental or public authority to add such person or organization to this policy as an "insured". However, such person or organization is an "insured" only: (1) with respect to the operation, maintenance or use of a covered "auto"; and (2) for "bodily injury" or "property damage" caused by an "accident" which takes place after: (a) You executed the "insured contract" or written agreement; or (b) The permit has been issued to you. Form: 16-02-0292 (Rev. 11-16) "Includes copyrighted material of Insurance Services Office, Inc. with its permission" Attachment Code: D532743 Certificate ID: 17336358 POLICY NUMBER: 54309479 COMMERCIAL AUTO 16-02-0316 Ed.10 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. a Z1 I ►Ti r_1ZYN_11'k, x•7016 L Me]I! r 1110 r=ilj 1101 � _ = ► : _ , This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Pro -Pipe, Inc., Branch #63 Endorsement Effective Date: 3/31/2021 SCHEDULE Name(s) Of Person(s) Or Organization(s): WHERE REQUIRED BY WRITTEN CONTRACT. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Item 5. - "Other Insurance" of Item B. - "General Conditions" under Section IV - "Business Auto Conditions": e. Regardless of the provisions of Paragraph 5.a. through d. above, for any liability arising out of the ownership, maintenance, use, rental, lease, loan, hire or borrowing by an "insured" of a covered "auto" for which an "insured" is contractually obligated to provide primary insurance coverage to a client, this Coverage Form will be primary and non-contributory with respect to the Persons or Organizations in the schedule, regardless of the availability or existence of other collectible insurance under any other Coverage Form or policy that applies on a primary basis. 16-02-0316 Ed.10 14 Page 1 of 1 Attachment Code: D535496 Certificate ID: 17336358 Policy Number: Commercial Auto 54309479 16-02-0322 (Ed. 11-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION OR NON -RENEWAL TO SPECIFIED PERSONS OR ORGANIZATIONS This endorsement modifies the following: COMMON POLICY CONDITIONS SCHEDULE Name(s) and Address(es): ALL PERSONS OR ORGANIZATIONS AS ON FILE WITH US. The following Condition is added: Notice Of Cancellation Or Non -Renewal To Specified Persons Or Organizations 1. If we cancel or non -renew this policy for any reason other than non-payment, we will deliver notice of cancellation or non -renewal to any Person(s) or Organization(s) shown in the Schedule 30 days prior to the effective date of cancellation or non -renewal. 2. If we cancel this policy for non-payment, we will deliver notice of cancellation to any Person(s) or Organization(s) shown in the Schedule 10 days prior to the effective date of cancellation. 3. If notice is mailed, proof of mailing will be sufficient proof of notice. 4. Any failure by us to notify such person(s) or organization(s) will not invalidate such cancellation or non -renewal with respect to any other person(s) organization (s). 16-02-0322 (Ed. 11-15) Included copyrighted material of insurance Services Office, page 1 of 1 Inc., with its permission.