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Insurance - Re-Pipe - 2011-11-14 CERTIFICATE OF'''LIABILIITY INSURANCE(. iy)jnj, `'+1 `IT i " ISSUE DATE November 14,2011 v�•..'. + n Ila 'm,. 'II: nI .Ln lk.1 ,stn, Alp. -ass —sit,. H)Ji; ti it ii di !. IS PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE Alliant Insurance Services Houston LLC DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 5847 San Felipe,Suite 2750 POLICIES BELOW Houston,TX 77057 832-485-4000 Fax: 713-470-4124 COMPANIES AFFORDING COVERAGE INSURED INSURERA Liberty Mutual Fire Insurance Company 23035 RePipe California LP INSURER B Starr Indemnity&Liability Company 38318 5525 East Gibraltar Street INSURER C Ontario,CA 91764 INSURERD I INSURER E. COVERAGES , ,,, ! 44 .'rV "i, n nfib (Iii nPV n' ! 'I.1 I I `fi �i .4 Ir iilil;.t ‘.I ;N 't' ,,;.il' L .. '!.'I�'Ji! :9. II ;i!I if `` II-,, I ;':r., �,C 4��§ �,iL,ii II,. dl�l � ^'i, i ^Ilj� '.n r �to t �h,,. THIS IS TO CERTIFY THAT THE POLICIES 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 CO TYPE OF INSURANCE POLICY POLICY POLICY EFFECIIVE EXPIRATION DATE LIMITS LTR NUMBER (MM/D D/AY) (MM MDD/YY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 2,000,000 A tiq I CLAIMS MADE © OCCUR TB2-66013 66037- 04101/11 04101/12 PERSONAL&ADV INJURY_ $ 1,000,00( GENERAL AGGREGATE $ 2,000,000 GENERAL AGGREGATE LIMIT APPLIES PER FIRE DAMAGE(Any one fire) $ 100,000 I POLICY I X PROJECTI I LOC MED EXPENSE(Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,00C X ANY AUTO (Each accident) _ ALL OWNED AUTOS BODILY INJURY $ A SCHEDULED AUTOS AS2-661-066037- (Per person) — HIRED AUTOS 021 04101/11 04/01/12 BODILY INJURY $ NON-OWNED AUTOS (Per accident) GARAGE LIABILITY PROPERTY DAMAGE $ OTHER _ GARAGE LIABILITY AUTO ONLY—EA ACCIDENT $ —1 ANYAUTO Other Than EAACC $ Auto Only AGGREGATE $ EXCESS(LIABILITY EACH OCCURRENCE _ $ 10,000,000 B cwMSMADE © SISCCCL000151 OCCUR 11 04/01111 04/01112 AGGREGATE $ 10,000,000 RETENTION illll! .,,i•'LL IiII., !l.,tiDail"I 4li:titM9■'i!...... WORKERS COMPENSATION AND X WC Statutory Oth EMPLOYERS'LIABILITY WA2.66O Limits er A 066037-011 04101/11 04/01/12 EL Each Acadent $ 1,000,000 EL Disease—EA Employee $ 1,000,000 EL Disease—Policy Limit $ 1,000,000 Other Each Loss $ Aggregate $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS. this certificate cancels and replaces previously issued certificate 10/28/11 Sewer System Rehabilitation Contractor Costa Mesa Sanitary District is included as Additional Insureds for General Liability and Auto Liability and only as required by written contract but limited to the operations of the named insured excluding Workers Compensation and subject to the policy terms,conditions, limitations and exclusions for job:Costa Mesa Sanitary District Bnstol Street Sewer Replacement-Phase II. Waiver of Subrogation is provided(continued on attached) i!: I' " ill, r I' ii r I t r,,. ,,.y CERTIFICATE'HOLDER•�, ��.. ;r,l. Tin. I i�l�(IIp ,IVjja._.W .CANCELLATIC`�N�I�I�I' �M �ilU: ":'�r,yE, 4�41� w�li;, �-6j��,:IS,,.'.P.'µu$I2.`;'1:°'Ir ':' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED,NON- Costa Mesa Sanitary District RENEWED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING COMPANY N^ WILL ENDEAVOR-TO MAIL 301DAYS WRITTEN NOTICE TO THE CERTIFICATE 628 W.19th Street HOLDER NAMED TO THE LEFT ?. Costa Mesa,CA 92627 _ _ OCapt�C,�c,�ca-9wawcv,.,rnwcc _ •. 4I At AUTHORIZED REPRESENTATIVE .�// - too• IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer nghts 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 Certcate 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 for alter the coverage afforded by the policies listed thereon. v 1" r ; r{ups. , "i" I. AIL. �ilry Ipr np vy 1 .1 � ul i�1 411:h {r i,_ .Il, A 'i' ir�i I p„ r n II ' i1'HI 1,II�!! •�I�I", 'I;i�B ri l:; � Iu' ri 7, !I!, ii, d DDITIONAL INFORMATION` ':ir'r ,I�, ! ,l' .„1∎114r !'' ; ;�I I;'1 a,�; �;;� dr a; ISSUE DATE November 14,2011 ;� I1. II ,Pb j� . Ti �"Illl `ii i !„ ii: il" l' �' Ikl �h `! v7ll. {!!rG Vlllo. 'fL ',1.1."' ilmt!' a��' .II„ ari,r. ,li.. {i PAGE 2 INSURED: RePipe California LP 5525 East Gibraltar Street Ontario,CA 91764 CERTIFICATE HOLDER: Costa Mesa Sanitary District 626 W 19th Street Costa Mesa,CA 92627 for Workers Compensation as required by written contract but limited to operations of the named insured and subject to the policy terms,conditions, limitations and exclusions Coverage is Pnmary and Non-Contnbutory as respects General Liability as required by written contract and subject to policy terms,conditions, limitations and exclusions *10 days for premium non-payment. 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 for alter the coverage afforded by the policies listed thereon.