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Insurance - Kilbride - 2010-02-19 02'.19/2010 15 23 9495481616 KILBRIDE PAGE D1 RECEIVED 02, 19.2Ele 15.18 9a 95CE1616 KILNIDE /� p T, aCr Aa Sac' TO. 42- :1' Or or 0:2 ACORD Dtoviq oio CERTIFICATE OF LIABILITY INSURANCE ovlRantn THI0 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION M.L.ADAMS INSURANCE SERVICES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 42.280 BEACON HILL,SUITED-7 HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR PALM DESERT CA 822113668 A ho-i1.1.1R•W ;7201. FC•( .t .Y 11[-OLIrICF r. OW Lin D6• 7��8"' 34.2 4 INSURERSAFFORDING COVERAGE NAMCIt INSURED INSURER A Conlin(Insurance Co ,9,i- YV MIKE KILSRIDE,LTD. INSURER 8 P.O.BOX 3341 Lt JRERC NEWPORT BEACH CA 92659 INSURER 0: INSURER E. COVERAGES TH=aot ICI-- :F INSURA:CE 15?'C iELOw Er:V- a=5: or-ufC TO Tr 'N5I.1 3 N'A'rEO AROFE 'OR THE PCL'"Y F •pD INCIr,TED VGIMM:JAN^IV" .L'0 :wrT 100'. CF A. ,IFIFC1 OR Cr. OCCf'PaPP !FRC VFC TOL CEO 'TE wrAr EEI.E OR wY TA:, ik 4'SE :OED V n@ PC" DESCRIEED ,U5)ECT -1.^TME 'I'f HS EVCJJSICV .0 :ONDIT -UL, FCC _ FCC ECATEL ..ON w, Re '0 Cr.VI "FF 1"--DP TYPE OF IN URANCE POLICY NUMBER rout errecrME MC t riming LINO, DATE MM WOO P4TM9 GENERALLNBLITY VCGP01-693 20/30/09 10/30110 El,p COCUPaE'°,.- 11 1,000000 X G' Rv_LAEILITY Du'-E Mar It/ 9 50,000 Curl vf.e_© OC ,ED EAP(Ary n) 3 5.000, A PERSONS a AD.OAF! ; 1,000,000 6_ cRJt GA'_ 5 2 000.000 2-NR.-;RE DATE CV-APPLIE FIEF. FCOTE-COM;j oc- 2,000,000 —1 TL. FI . FILL,: 1 RUT LIAR LOT _Yv AN AfrO (ES EEC'C ' .■EC(,IimOS 'JD L %JUGT E D _ ,— HICED ALTOS 5 uF( f .O('NED 005 00m3 pcv 1 I -0000? GARAGE LABILDF :..TO OVLV-EA.CCIC`IC 4 J E .: 3 P TO ONL :CC i BFELLALIA81L11V EF 4OD _PP 1 0L, pi-, IMn',ADE °GFP- ATE S 5 R TrED[TIPE 3 PF!FNiIR: 3 i WORNE COMPENSATION AYD rcLAUTa I 10 n- EMPLO LOT EL -C7 ACCIDENT Y EA4 WOVE UNFREE P Riot a ercL eEn EL O(EnK:s EtBl. 3 II.r•IADVU near - E' D'SEAS POLY 3 - OTHER DESCRIPTION OF OPERATIONSILOCATION SNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS TEN DAY NOTICE OF CANCELLATION WILL BE GIVEN FOR NON PAYMENT OF PREMIUM CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED PER FORM CG 20 10 10 01 ATTACHED. CERTIFICATE HOLDER CANCELLATION 5 Of R k A?,.vE CR IEED RN SE NGELLED SEE 4E)'-E EXPIRATION ATE. r'EFEC TH' 0550 NSL L 054.2 51L Da vpITTEV ND] E TO THE =RnfICL HCI DER rAL'ED TO -E LEF E. .DEETD COSTA MESA SANITATION DISTRICT AND ITS OFFICERS,AGENTS 0D SC So SE DELC'TIO.'DR LILE Ur, ANY RAC PO'. ,E AND EFIPLOYEES fRS PFE5E'.Al( 628 W.19TH STREET A'i111URIoz,4E`RESeNT.9r'E /] COSTA MESA CA 92627-2716 J alt ,tom An.'Won Me: Del ( I ) Adams ACOAD 25(1001/08) Certificate A 15720 ®ACORD CORPORATION 1988 FEB-19-2 010 lb 23 9495461b16 96, P 01 02 19/2010 15 2' 9495481616 KILBRIDE PAGE 02 RECEIVED 02/19 2810 15.18 94954E1616 KILBRIDE 2`19/ FPO` 11. Ad ann. TO: -LS .8- 6L ?ACE: .01 CF '-0: Policy Number: VCCP017893 CC 2010 10 01 Insured Name:MIKE KILERIDE LTD Number. 24 Effective Duta•10/30/200 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ fl'CAREFULLY. ADDITIONAL INSURED—OWNERS, LESSEES OR CONTRACTORS-SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSiCOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Person Or Organization: AS REQUIRED BY WRITTEN CONTRACT,COMMERCIAL PROJECTS ONLA INCLUDING APARTMENTS (If no entry appears above,information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II-Who is An Insured is amended to iriclude as an insured the person or organization shown lathe Schedule.butonly with respect to liability-arising out ofyour ongoing operations performed fdrtltat insured B. With respect to the insurance afforded to these additional insureds,the following exclusion is added: 2. Exclusions 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 site of the covered operations hay 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 2010 10 01 Page t of I FEB-19-2010 16 23 9495461b16 95% P 02 02'19/2610 15 23 949548161E KILSRIDE PAGE 03 RECEIVED 82/19/2616 12: 38 9495481615 KILSRIDE 02'19/2010 11 08 FAd 919'702084 KELLY BRENNAN STATE FARM 2001 CERTIFICAT'IE OF INSURAt This certifies That Si® AT:FARM FIRE AND CASUALTY COMPANY Bloomington,Illinois ❑ Si ATE=FARM GENERAL INSURAN'_,, COMPANY E;!oontington, Illinois insures the fonowng p)licyholder For tie coverages indicated below Name of pat yholder MIKE KILRRIDE LTC DBA COAST WATER & POWER Address of pc licyholder P•O- BOX 3341 NEWPORT BEACH, CA 92659 _ Location of operations Description o operation The soliCies listed bel Are have b.en issued to the policyholder older Tor Inc policy perio•s shorn.The insurance described in these policies Is subject to all the tern evyusionl and conditions of those .1,icie.The limits of habit- shown ma have been reduced • an •aid claims. POLICY PO LICY PERIOD LIMITS OF UABILITY OLICY NUMBER TYT E OF INSURANCE Effective[)its E: ration Irate atbo.Innln, of •old •-riod Corn gehansive BODILY INJURY AND Bush ass Liab& _ PROPERTY DAMAGE Thi insurance'nclude, ❑ P adti is Completed Operations ❑ C)ntractual Liability ❑ U)derground Hazard Coverage Each Occurrence $ ❑ P msenal Injury ❑A Iverisinp Injury General Aggregate $ ❑ E.plosion Hazard Coverage Products Completed ❑C',Magee Hazard Coverage Operations Aggregate $ Q G eneral Aggregate Limit applies to Brach project 0 ❑ _ POI ICY PERIOD BODILY INJURY AND PROPERTY DAMAGE E:CESS LIABILITY Effective Date Er iration I:ate (Combined Single Limit) ❑U nbrella Each Occurrence $ ■ O her AEI9Male >E Part 1 STATUTORY Part 2 BODILY INJURY Won are'Compensation and I mp!oyers❑ability Each Accident $ Disease Each Employee $ _ Disease re i Limit $ POLICY NUMBER TYff E OF INSURANCE •1,[ICY PERIOD LIMITS OF LIABILITY Effective Mote ••/radon!:ate (at tlnnin• of•otie • iod 87• --A 01 - IAUYDMO. • 1 'l ) 7 10 e If ally of the described policies are cancaled before its KF.LY C.BREP vAN,AGENT CPCU,Ixu OTT alien date,State Farm will try to mail a written notice to `^ •O the certikate Colder 30 days betory cancellation. If. id'vg C.BRE l a end AGEN T CPCU,4 UC-M E 091e;is hovl?ver,we fail to mail such notice,no obligation or liability Zit 00':xIRISAr TA Da SUITE 150 will be im posed on State Farm or its agents or MI;SION VIGIL CA°zel realLsentatives Fri)NE 94&771-S100 FX 9.9.770-20 F4 ked fieketytbrer neneen Nam and Addre ss of:ertihcala iolder Costa Mesa S€in tat on District F�✓1 62E W 19th S_reet sign.) N unz dRepn:,entabw Costa Mesa (:A 926: 9 _ Talc SSe4•-4 a 2A0 Filmed U. - l� �� Oat FEB-19-2010 16-23 9495481b1b 96. P 9� 02!19/2010 15 23 9495461616 KILBRIDE PAGE 04 POLICYHOLDER COPY SG STATE PO. BOX 420807 SAN FRANCISCO,CA 94142-0807 COMPENSATION INSURANCE FU N D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 02-19-2010 CROUP 000238 POLICY NUMBER: 0012920-2009 CERTIFICATE ID: 163 CERTIFICATE EXPIRES: 10-01 2010 10-01-2009/10-01 2010 THIS CERTIFICATE SUPERSEDES AND CORRECTS CERTIFICATE F 14 DATED tO-01 2009 COSTA MESA SANITATION DISTRICT SG 028 W 19TH ST COSTA MESA CA 92627 2718 Tm Is to certify that we have issued a valid Workers Compensation insurance policy :n form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy not subject to ellati by the Fund except upon 30 days advance written notice to the employer We will also give yo. 30 days advance notice should this policy be cancelled prior to its normal expI ation. This cerificate of insurance not rice policy and does not amend, extend or alter the coverage affordec by the policy listed herein. Notwithstanding any requirement. term or condition of any contract or other document with espied to which this certificate of Insurance may be issued or to which it may pertain, the insurance afforded by the policy described here, is subject to all the terms, exclusions. and condition of such policy JTHORIZED RECRESENTATIl PRESIDENT EMPLOYER S LIABILITY LIMIT INCLUDING DEFENSE COSTS 51 000 000 PER OCCURRENCE ENDORSEMENT 62065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-22 2009 IS ATTACHED TO AND FORMS A PART OF THIS POLICY EMPLOYER MIKE KILBRIDE LTD DBA. COAST WATER AND POWER PO BOX 3341 NEWPORT BEACH CA 92659 [SA5,CS] WEV 2-061 PRINTED 02-19-2010 FEB-19-2010 16-23 949548161b 9b: P 134