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Insurance - BEC Bowls - 2011-02-22 Client#: 310336 BECBOWLS De- 2-/?u/ii ACORD, CERTIFICATE OF LIABILITY INSURANCE tiTE(MM/;IY"") PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Hub International ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HUB Intl Insurance Sery Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 4371 Latham St,Ste#101 Riverside,CA 92501 INSURERS AFFORDING COVERAGE NAIC# INSURED AbnIt7oe' INSURERA Travelers Indemnity Company of 25682 A {- XV BEC Bowls, Inc. 14Pn1171'> INSURER Travelers Property Casualty Co 25674 A} J('/ 333 East Stuart Avenue#B1 INSURER Redlands,CA 92374-4440 INSURER D. INSURER E. COVERAGES THE POLICIES OF WSURANCE 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. Tk R ADD L POLICY EFFECTIVE POLICY EXPIRATION LTR NSILE TYPE OF INSURANCE POLICY NUMBER DATE INNVDDIYYYY) DATE(NWVDDREYYY) LIMITS A GENERAL LIABILITY 4T22C09144M381 TCT1 01/01/2011 01/01/2012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENT ED 1'RFMICFS/Fe OccuITMcel $300,000 CLAIMS MADE © OCCUR MED EXP(Any MR person) $5,000 PERSONAI B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 — GE NI.AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $2,000,000 —I POLICY I n'J T I1 LOC A AUTOMOBILE LIAO BA9144M38111CNS 01/01/2011 01/01/2012 COMBINED SINGLE LIMIT X ANY Atli OI! (E accident) $1,000,000 All OWNED AU OS BODILY INJURY s SCHEDULED AUTOS (Pe"person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) — PROPERTY DAMAGE $ (Per acdderl) GARAGE UABLITY AUTO ONLY-EA ACCIDENT $ R ANY AUTO EA ACC $ OTHER THAN AUTO ONLY. qGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ —1 OCCUR n CLAIMS MADE AGGREGATE $ $ 1 DEDUCTIBLE b RETENTION $ $ B WORKERS COMPENSATION AND 4TJUB9145M02711 01/01/2011 01/01/2012 X I WC IIMIISI IOTR EMPLOYERS'LIABILITY IORYIIMIIS FR ANY PROPRIETOR/PARTNER/EXECUTIVE E L.EACH ACCIDENT $1,000,000 O ICE EMBER EXCLUDED? N NH) EL DISEASE EA EMPLOYED $1,000,000 If yes,dermbe under SPECIAL PROVISIONS barns EL,DISEASE POLICY LIMIT $1,000,000 OTHER DESCRIPTION CF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holders Costa Mesa Sanitary District and its officers,agents, and employees are additional insured with respect to attached endorsement#CGD2460805. Primary/Non Contributory insurance included when required by written contract. CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment 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 10 DAYS WRITTEN 628 West 19th Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Costa Mesa, CA 92627 IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS DR REPRESENTATIVES AUTHORIZED REPRESENTATIVE ACORD 25(2009101) 1 of 2 #S1083264/M1014491 0 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JJ42 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 certcate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance 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(2009101) 2 of 2 #S1083264/M1014491 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1 WHO IS AN INSURED — (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to 'bodily injury' or agree in a "written contract requiring insurance" 'property damage' caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for 'bodily injury" requiring insurance' specifically requires you property damage' or 'personal injury" and to provide such coverage for that additional insured, and then the insurance provided to b) If and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of 'bodily injury' or 'property damage' that oc you or your subcontractor in the performance curs before the end of the period of time tor of 'your work" to which the 'written contract which the 'written contract requiring insur- requiring insurance' applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period whichever is insured with respect to the independent acts earlier or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and I by this endorsement is limited as follows: collectible 'other insurance' whether pnmary a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover under this endorsement. However if the "written contract requiring insurance" the in- 'written contract requiring insurance' specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that 'written contract requiring in- this insurance is primary to 'other insurance' surance' This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III—Limits Of Insurance. for such loss, and we will not share with that b) The insurance provided to the additional in- 'other insurance" But the insurance provided to sured does not apply to "bodily injury' "prop- the excess over insured by this endorsement still i- erty damage" or 'personal injury' arising out excess over the valid and excess, "other for of the rendering of, or failure to render any surance' whether primary available to the a i- professional architectural, engineering or sur- on any insured basis, that is sonio organization tze dds veying services, including: annal insured when tdat nder c "otr ns is additional insured under such "other insur- i. The preparing, approving, or failing to ance' prepare or approve, maps, shop draw- e 4. As a condition of coverage opinions, reports, surveys, field or- 9 provided to the rags, additional insured by this endorsement: ders or change orders, or the preparing, approving, or failing to prepare or ap- a) The additional insured must give us written prove, drawings and specifications; and notice as soon as practicable of an "occur- rence' or an offense which may result in a ii. Supervisory inspection, architectural or engineering activities. claim. To the extent possible, such notice should include: CG D2 46 08 05 ©2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the 'occurrence' any provider of "other insurance' which would or offense took place, cover the additional insured for a loss we ii. The names and addresses of any injured cover under this endorsement. However this persons and witnesses; and condition does not affect whether the insur- ance provided to the additional insured by iii. The nature and location of any injury or this endorsement is primary to 'other insur- damage arising out of the 'occurrence"or ance" available to the additional insured offense which covers that person or organization as a b) If a claim is made or 'suit' is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V i. Immediately record the specifics of the — DEFINITIONS: claim or 'suit" and the date received; and 'Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement under which you are required to include a The additional insured must see to it that we person or organization as an additional in- receive written notice of the claim or"suit" as sured on this Coverage Part, provided that soon as practicable. the 'bodily injury' and 'property damage' oc c) The additional insured must immediately curs and the "personal injury' is caused by an send us copies of all legal papers received in offense committed: connection with the claim or 'suit' cooperate a. After the signing and execution of the with us in the investigation or settlement of contract or agreement by you; the claim or defense against the "suit' and otherwise comply with all policy conditions. b. While that part of the contract or d) The additional insured must tender the de- agreement is in effect; and fense and indemnity of any claim or 'suit' to c. Before the end of the policy period. o= o= 0= N a= = Page 2 of 2 ®2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 007753