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Insurance - Dependable Graham 2023-01-03GE1 ]ED A CURL7� �� CC> RT ICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1/3/2023 THIS CERTIFIC TE IS I Uj OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE D �� R NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS ATE 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(les) 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 Venture Pacific Insurance Services 111 Corporate Drive #200 Ladera Ranch CA 92694 CONTACT NAME: Kelli Orleck PHONEFAX . 949-297-4900 A/C Noll: 949-297-4911 ADDRESS: korleck@vpisrisk.com INSURERS AFFORDING COVERAGE NAIC # X COMMERCIAL GENERAL LIABILITY INSURER A: Valley Fore Insurance Company 20508 Licensek OD10299 INSURED DEPEGRA-01 Dependable Graham Air Conditioning, Inc. 2952 Century Place INSURER B: The Continental Insurance Company 35289 INSURER C INSURER D: Costa Mesa CA 92626 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 615799955 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. lNSR LTR TYPE OF INSURANCE ADDL J= SUER WVQ POLICY NUMBER MM/DD LICY EFF LICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 6075714593 1/1/2023 1/1/2024 EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 15,000 X 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY I A I JERO F—] LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY Y Y 16075714609 1!1/2023 1/1/2024 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ X ANY AUTO OWNEDLY SCHEDULED AUTOS ONAUTOS BODILY INJURY (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ Per accident B X UMBRELLA LIAR X OCCUR Y Y 6075714612 1/1/2023 1/1/2024 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED X I RETENTION $ In nnn $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITYi / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? ❑ N / A PER OTH- _ ER _STATUTE_ E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Rented/Leased Equip. 6075714593 1/1/2023 1/1/2024 LimiUDed. per item $25,000/$500 ded Builder's Risk/Install/ Floater Limit - max $50,000 LimiUDed. per loc $50,000/$1,000 ded DESCRIPTION OF OPERATIONS / LOCATIONS f VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) "POLICY FORMS TO FOLLOW UPON RECEIPT OF POLICY""" Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers and employees is named as additional insured as required by written contract but only insofar as the insureds operations. Coverage Is primary and non-contributory. 30 Days Notice of Cancellation for any reason, 10 Days Notice of Cancellation for non-payment of Premium. CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and !ogo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District ACCORDANCE WITH THE POLICY PROVISIONS. 290 Paularino Ave. Costa Mesa CA 92626. , =. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and !ogo are registered marks of ACORD