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Insurance - Technology - 2006-09-21 To: Costa Ilesa Sanitary District From: Robin Derrrch 9-21-06 8 50am p 2 of 1 ACORD CERTIFICATE OF LIABILITY INSURANCE Dde(rm'dd5 ) L ... .. • . __ 9/21/2006 Produrct Robl We ch /HIS CFRI II IC'IF IS ISSUED AS A MAI TER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER Garrett/Mosier Insurance Services, Inc THIS CERTIFICATE DOES NOT AMEND EX FEND OR ALTER THE 2 Truman COVERAGE AFFORDED BY THE POLICIES BELOW Irvine CA 92620 INSURERS A ORDING COVERAGE 949-559-6700 INSURER Scottsdale Insurance Company wrvew garrett-mosier corn A OB84519 INSURER St Paul Travelers B Insured SURER Hartford Insurance Co Technology Resource Center Inc C 2101 E 4th Street INSURER Suite 130A D Santa Ana, CA 92705 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 SUBJEC`TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAO HAVE BEEN REDUCED BY PAID CLAIMS. POL ICY POI ICY INSP EFFECTIVE EXPIRATION TYPE OF INSURANCE POI ICY NUMBER DATE DATE I IMITS LTR MM'DDIYY MM/ODIYY GENERAL LIABIL IT Y _ EACH OCCURRENCE s 1,UOu.000 A 7COMMERDAL GENERAL UAB BCSO012531 3/20/2006 3/20/200/ IRE DAMAGE Any one iIrn) 5 50,000 I CLAIMS ADC ODCCUR YID LAP Any one Person/ 5 0 PERSONAL h ADV INJURY 5 1 000 DOO GENERAL ACCRECATE 5 2 ODD COO I-GI�IJ 14CG IIMIT APPI II S PER PRUUUC IS-CUMP'DP ACC 5 2000,000 �PUIL, FPItG.IECTf LOC A I OMOBII 1 11501111 Y B 7A AUTO 6303W167-06 3/20/2006 3/20/2007 COMBINED SINGIrLIMIT 5 1,000,000 All U&NID AU US BODILY INJURY SCHEDULED AUTOS (Pe perscq 5 7 HIRED AUTOS BOUII Y INJURY 7 NON OIANUJ U DS ( en) 5 PROPERTY DAMAGE (Pe Went) 5 GARAGE L'ABII ITV AUIV UNL. EA ACCIDENT S R ANY AUTO OTHER THAN FA ACC: AUTO ONLY AGGS EXCESS LIABII IIY EACH OCCURRENCE s OCCUR fl Li IM5 MADE AGGRFCATE 5 5 _DEDUCT ICU 5 RETI NTION 1 ` WORKERS'COMPENSATION& VISTATUIDRY LIMIT I }OTHER , ,. . EMPLOYERS'LIABILITY El EACH ACCIDENT s 1,000 000 C 44WEOD306108 10.1/2005 10/1/2006 EIUI„IASE EAIWWPIDYII s 1070000 EL DISEASE POLICY LIMIT s 1 000 C00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED NY ENDORSEMENT/SPECIAL PROVISIONS At operations of the named Insured subject to the terms and conditions of the policies Costa Mesa Sanitary District is added as Additional Insured per CG20 33 07/D4, as required by written contract with respect to work performed for them by Technology Resource Center Inc under General Liability coverage CERTIFICATE HOLDER"','; • CANCELLATION: . All Op era Lions SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Costa Mesa Sanitary District EXPIRATION DATE THEREOF THE ISSUING COMPANS WILL ENDEAVOR TO MAIL _ _ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Attn Thomas Fauth LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGAT ION OR LIABILITY Of ANY KIND UPON THE COMPANY ITS AGENTS OR REPRE 623 W 19th Street SENTATIVES 10 Days to No -Payment of Pr Costa Mesa CA 92627 AUTHORIZE) REPRESENTATIVE E.....- Gnff Griffith ACORD.25.S.(7/97). .0 ACORD CORPORATION'A 9,88 =in_-01_nnr ,n.cr O r}^ To. Costa Mesa Sanitary Distract From: Robin ldeirich 9-21-06 B 50am p. 3 of 4 IMPORTANT If th with ate holder ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of uch endorsement(s). It SUBROGATION IS WAIVED. uhlect to the terms nd mon of the policy. erta poll may equ re ndo ment. A statement thi rtdl ate do of rife fights to the certificate holde li of such en ement(s). DISCLAIMER The C roll ate of In the ide of thi form do statute ntr et between the ny r(s), utho ed epresentati produ nd th roll ate holdr, do it dllirmab ely negate ely amend, xte id alte the ayt afforded by the pot listed the ACORD 25 (2001/08) ated at%MN .eCertsONLINE, om cFP-71-7172C. '1P c1 X71 P PT. To: Costa Mesa Sanitary District From: Robin Ifeirrch 9-21-06 8 SOam p, 4 of 4 Policy No. BCS0012531 COMMERCIAL GENERAL LIABILITY Technology Resource Center Inc CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or or additional insureds, the following additional exclu- ganization for whom you are performing opera- sions apply Lions when you and such person or organization This insurance does not apply to have agreed in writing in a contract or agreement that such person or organization be added as an 1 'Bodily injury' 'property damage' or 'personal additional insured on your policy Such person or ana advertising injury arising out of the ren- organization is an acditional insured only with re denng of, or the failure to render any profes- spect to liability for 'bodily injury' 'property dam- sional architectural, engineering or surveying age' or 'personal and advertising injury' caused, services, including' in whole or in part, by a. The preparing, approving, or failing to pre- 1 Your acts or omissions, or pare or approve maps, shop drawings, opinions reports, surveys, field orders, 2. The acts or omissions of those acting on your change orders or drawings and specifica- behaif tions or in the performance of your ongoing operations for b. Supervisory inspection, architectural or the additional insured engineering actwities A person's or organization's status as an adds- 2. 'Bodily injur/ or 'property damage' occurring ticnal insured under this endorsement ends when after your operations for that additional insured are completed a. All work, including materials parts ur equipment furnished in connection with such work, on the project iother than ser vice maintenance or repairs) to be per formed by or on behalf of the additional in- sured(s) at the location of the covered operations has been completed, or b. That portion of your work out of which the injury cr damage arises has been put to its intended use by any person or organization other than another contractor or subcon- tractor engaged in performing operations for a principal as a part of the same project Costa Mesa Sanitary District CG 20 33 07 04 ©ISO Properties Inc 2004 Page 1 of 1 ❑ cFP-21-200„ kP'Si 11 P Pad