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Insurance - Curbside - 2009-08-21 rpm Risk Strategies Company 9492510347 06/18/2010 15 04 #813 P 001 /002 I -----1 m , ACORD CERTIFICATE OF LIABILITY INSURANCE DATE 09' PRODUCER (999)851 8800 FAX (949) 851 8802 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GSM Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR Lic #0D15612 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 30 Corporate Park #307 Irvine CA 92606 INSURERS AFFORDING COVERAGE , # INSURED NSURER Nautilus ins Co q/' 4_ Gist/ Curbside Inc INSURER B Great Divide Ins Co f AMA/t 0 500 S Jefferson INSURERC INSURER D Placentia CA 92870 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 10 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. I SF ADD L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF I $ :_. POLICY NUMBER DATE IMWDDIYYYYI DATE IMI$/DDTYYYYI LIMITS GENERAL LIABILITY CPCII OCCURRENCE $ 1,000 000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES(Ea ecc eoce) S 100 000 A CLAIMS MADE X OCCUR ECPO 0200181 1. 8/23/2009 8/23/2010 MEDEXP(Any D pa n) $ 5 000 ERSONAL AUV II, URY s 1,000 000 GENERAL AGGREGATE ■ 2,000 000 GENE AGGREGATE LIMN APPLIES PER PRODUCTS-COMROP AGG $ 2,000 000 X POLICY PRO LOC FCT AUTOMOBILE LIABILITY COMBWED SINGLE LIMIT X ANY AUTO IEe °dent) 1,000 000 . B ALL OWNED AUTOS BAP0200182 12 8/23/2009 0/23/2010 BOOILYINJURY SCHEDULED AUTOS (Pe Pe son) $ X HIRED AUTOS BODII INJURY $ (Pm Oda X NON-OWNED AUTOS . Comp & Coll Ded. FROPERTY DAMAGE 2,000 (Par ed $ ac GARAGE LIABILITY AUTO OT LY-EA ACCIDENT $ ANY AOTO OTHER THAN EA ACC 5 _ AUTO ONLY AGE S EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE S OCCUR ,CLAIMS MADE AGGREGATE $ S _ DEDUCTIBLE $ RETENTION $ S TH- B WORKERS COMPENSATION X WC STATU- OER AND EMPLOYERS'LIABILITY JY PROP TOWPARTNEP/EXECUTI IY-1 E I EACH ACCIDENT $ ,/,000 000 FFICERI AEL BER EXCLUDED? (Manna ory In NH) WCA1S12397 10 8/23/2009 8/23/2010 EL DISEASE EA EMPLOYEES 1 000 000 yes. Pies ndo SPECIAL PROVISIOIO ve NS Del . E L DISEASE POLICY LIMIT $ 1,000,000 S A OTHER Contractors ECPO 0200181 12 8/23/2009 8/23/2010 Each Oc enc $ 1,000 000 Pollution Aggrege $ 2 000 000 1 DESCRIPTION Of OPERATIONS 1 LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Costa Me Sanitary Distr ct, its oafr agents and employe eluded additional sured with regard to work performed by or on behalf of the named Insured whe requ ed by written contr. ct pe the attached form SEC-P10091006 except to 10 days note of can ellatr fo non-payment of premium. CERTIFICATE HOLDER . CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Costa Mesa Sanitary District DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Attn. Torn Fauth NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SD SHALL 628 W 19th Street Costa Mesa, CA 92627 IMPOSE NO OBUGATIDN OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE ` Joy Folse/JLF —/° ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. 'RS02512009011 The ACORD name and logo are registered marks of ACORD n nn, , n-, n.n-TV no An CA P P1 From Risk Strategies Company 9492510347 06/18/2010 15 05 #813 P 002/002 Policy#ECPO 0200181 12 Effective Date 08/23/09 Named Insured: Curbside, Inc. ENDORSEMENT This endorsement forms a part of the policy to which It is attached.Please read it carefully. �l', tirar;ry`�, a�yfl K;.1.1.•ea. 11'1 i C• ') I ‘C. i11,ri 'l / 5 �` y i,a:> 2..d4k SitYF4st ' 'H. a e � ��... f�5,.may#. •:.d' :.[ aA.�.�1 2:E• S. .s'(r;?. `t.� , This endorsement modifies Insurance provided under the following: ENVIRONMENTAL COMBINED POLICY Section III—Who is an Insured is amended to Include as an insured,with respect to Coverage A and B,any person(s)or organization{s)when you and such person(s)or orgenizaton(s)have agreed In a written contract or written agreement that such person(s)or organizations)be added as an additional insured on your policy.Such written contract or written agreement must be In effect prior to the occurrence giving rise to the claim or suit for which the person(s)or organization(s)seeks coverage. Such additional Insured status applies only 1. With respect to your work performed for such person(s)or organization(s)In the performance of your ongoing operations for the additional Insured;or 2. With respect to your work performed for such person(s)or organizations(s)and Included In the products. completed operations hazard,only when required by the written contract or written agreement. With respect to damages caused by your work,as described above,the coverage provided hereunder shall be primary and not contributing with any other Insurance available to those person(s)or organizatlon(s)with which you have so agreed In a written contract or written agreement. 02000 by hereby epatlany Undarw04r,c Ma age LLC. stellate 0l Na Num insurance Company and treat Divato Iowa a Company,all rights mad. 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