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Insurance - CR&R - 2006-08-25 CR&RINC-03 ERTH ACORDTM CERTIFICATE OF LIABILITY INSURANCE °Asiia/zoos) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Solid Waste Insurance Managers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 115 N. El Molino Ave RECEIVED HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 7072 Pasadena,CA 91101 AUG 2 5 2006 INSURERS AFFORDING COVERAGE NAIC# INSURED CR&R Incorporated y SpNIThit DISTRICT INSURER A Greenwich Ins. Co. Haulaway Storage Conte INSURER B RSUI Indemnity Company 11292 Western Avenue I INSURER C Stanton, CA 90680- INSURER D INSURER E COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR'ADD'L POLICY EFFECTIVE POLICY EXPIRATION DTI INSRD TYPE OF INSURANCE POLICY NUMBER DATE IMM/DDWYI PATE(MUMMY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X X COMMERCIAL GENERAL LIABILITY GEC0019325 9/3/2005 9/3/2006 'U. • • il PDREMISES(Ea occurence) $ 100,000 CLAIMS MADE X 1 OCCUR MED EXP(Any pe n) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG $ 2,000,000 X POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A X ANY AUTO AEC0019323 9/3/2005 9/3/2006 (Ea cadent) ALL OWNED AUTOS BODILY INJURY Pe pe nI $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Pe cadent) $ PROPERTY DAMAGE $ (Per cident) GARAGE LIABIUTY bf4ENDED CERTIFICATE AUTO ONLY EA ACCIDENT $ ANY AUTO al IdGilMli'1'1.t95 i. OTHERTHAN EA ACC $ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 4,000,000 B OCCUR CLAIMS MADE NHA214812 9/3/2005 9/3/2006 AGGREGATE $ 4,000,000 $ DEDUCTIBLE $ RETENTION $ $ WC STATU- 0TH- WORKERS COMPENSA11ON AND TORY LIMITS ER EMPLOYERS'LIABILITY E L EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EL DISEASE EA EMPLOYEE $ If yes de cube under SPECIAL PROVISIONS below E L DISEASE POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Re:All Operations The certificate holder is included as Additional Insured per attached CG20100704 endorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Costa Mesa Sanitary District DATE THEREOF THE ISSUING INSURER WILLX EXJSXX)MAIL 30 DAYS WRITTEN 628 W 19th Street Costa Mesa,CA 92627 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BX04XXXXXYISX%AI)X XL X/XX*XXISAOLXi fcXXXXIXd4YrM)fXXXX)ld4NtX#6)6X/M MJtBOKIMXXXXXX XfiFXtit;XXXXVOC AUTHORIZED REPRESENTATIVE -^.%+�/) ' Se/ piljea\C" y%1�D•T�(li�C�l- J ACORD 25(2001/08) ©ACORD CORPORATION 1988 CR&RINC-03 ERTH IMPORTANT If the certificate holder is an ADDITIONAL INSURED the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer and the certificate holder nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon ACORD 25(2001/08) POLICY NUMBER GEC0019325 COMMERCIAL GENERAL LIABILITY CG20100704 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 Re: All Operations 628 W 19th Street Costa Mesa, CA 92627 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 This insurance does not apply to 'bodily injury or include as an additional insured the person(s) or 'property damage' occurring after organization(s) shown in the Schedule, but only 1 All work, including materials, parts or equip- with respect to liability for 'bodily injury' 'property ment furnished in connection with such work, damage' or 'personal and advertising injury' on the project (other than service, mainte- caused, in whole or in part, by nance or repairs) to be performed by or on 1 Your acts or omissions; or behalf of the additional insured(s) at the loca- l. The acts or omissions of those acting on your tion of the covered operations has been com- behalf; pleted; or in the performance of your ongoing operations for 2. That portion of 'your work' out of which the the additional insured(s) at the location(s) desig- injury or damage arises has been put to its Hated above. intended use by any person or organization other than another contractor or subcontractor B. With respect to the insurance afforded to these engaged in performing operations for a additional insureds, the following additional exclu- principal as a part of the same project. sions apply CG 20 10 07 04 Copyright, ISO Properties, Inc 2004 Page 1 of 1 UNIFORM