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Insurance - Sancon Technologies, Inc. - 2022-09-27is ACC>R" CERTIFICATE OF LIABILITY INSURANCE 161 DATE(MM/DD/YYYY) 1 " 9/27/2022 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). PRODUCERCONTACT patriot Risk & Insurance Services 2415 Campus Drive, Suite #200 Irvine, CA 92612 NAME: HO No Ext): 949 486-7900 a No E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # EACH OCCURRENCE $1,000,000 INSURER A: Hartford Fire Insurance Company 19682 www.patrisk.com OK07568 INSURED Sancon Technologies Inc. 5841 Engineer Dr. Huntington Beach CA 92649 INSURER B : Hartford Casualty Insurance Company 29424 INSURER C : Navigators Specialty Insurance Company 36056 INSURER D : Scottsdale Insurance Company 41297 INSURER E : 1 $ INSURER F: AUTOMOBILE ✓ COVERAGES CERTIFICATE NUMBER: 7nrn99.m 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 SUER POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A ✓ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑✓ OCCUR $5,000 Deductible 72UEAC14418 10/1/2022 10/1/2023 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ✓Z PE� LOC OTHER: GENERAL AGGREGATE s2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 1 $ A AUTOMOBILE ✓ LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY i ( 11 I72UEAC14419 1 110/1/2022 1 10/1/2023 ( COMBINED tSINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident 1$ B �/ UMBRELLA LIAB�/ EXCESS LIAR OCCUR CLAIMS -MADE 72HHAC13468 10/1/2022 10/1/2023 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED ✓ RETENTION $10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A 72WEAAUOTGJ 10/1/2022 10/1/2023 PER OTH- ✓ STATUTE ER EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1 000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 C D D IPollution Liability Installation Floater Rented/Leased Equipment SF22ECPZOCBLVQN RBS0179062 RBS0179062 10/1/2022 10/1/2022 10/1/2022 10/1/2023 10/1/2023 10/1/2023 $1,000,000 Each Incident/$2,000,000 Agg $250,000 Any one Job Site $100,000 Any one item DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: #328 Ductile Iron Pipe Rehabilitation, Phase II. EVIDENCE OF COVERAGE CERTIFICATE HOLDER CANCELLATION Costa Mesa Sanitary District 290 Paularino Avenue 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 REPRESENTATIVE Dave Jacobson ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 70502251 1 22-23 GL/Auto/Umb/TRC/Poll/IM I Tina Kennedy 1 9/27/2022 10:03:12 AM (PDT) I Page 1 of 1 This certificate cancels and supersedes ALL previously issued certificates.