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Insurance-Technology Resource Center-2013-09-30A6C °® CERTIFICATE OF LIABILITY INSURANCE OATEIMMIDD YYYYI gni THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. 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). PRODUCER Garrett/Mosier /Griffith /Sistrunk fV i e P IF �\ E /C D Risk Management & Insurance Se 12 Truman Irvine, CA 92620 'j ��',} 4 WWW.gmgs.com OB81519... 0 CONTACT NAME: PHONE AID No E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Scottsdale Insurance Company INSURED Technology Resource Center, Inc. 601 N. Par center Drive, Suite 209 Santa Ana CA 92705 INSURER B : I ce Corporation n Eagle Insuran 3/20/2013 INSURER C: Insuran a Company of the West EACH OCCURRENCE NSURER D: PREMI9ESOEaEONCCTUnenca INSURER E MED EXP (Any one person) INSURER F: PEft$ONALBADV INJURY COVERAGES CERTIFICATE NUMBER: 17904988 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TR TYPE OF INSURANCE im a-BR POLICY NUMBER MWD�nrYYY MMID� YYXYY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR SCS0029832 3/20/2013 3120/2014 EACH OCCURRENCE $ 1,000,000 PREMI9ESOEaEONCCTUnenca $ 100,000 MED EXP (Any one person) $ Excluded PEft$ONALBADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY PRO LOG PRODUCTS - COMPIOP AGO $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS ✓ AUTOS Physical Damage BA8831788 $1,000 Comp Ded. $1,000 Coll Ded. 3/2012013 3120/2014 Ee BINEDISINGLE LIMIT $ 1,000,000 ✓ BODILY INJURY(Perperson) $ BODILY INJURY (Per accident) $ ✓ PROPERTY DAMAGE Per concert $ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ OED RETENTIONS $ $ G WORKERS COMPENSATION YIN EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEREXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WSD500697802 10/1/2013 10/1/2014 WC STATU- "It TORY LIMITS RR F..L. EACH ACCIDENT $ 1,000 000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT I $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AHach ACORD 101, Additional Remarks Schedule, if more space Is required) All operations of the named Insured subject to the terms and conditions of the policies. As respects General Liability coverage, Costa Mesa Sanitary District , its officers, agents, officials, employees and volunteers are added as Additional Insured per CG20330704 attached. CERTIFICATE HOLDER CANCELLATION All Operations Costa Mesa Sanitary District 628 W. 19th Street Costa Mesa CA 92627 /{y/j �II� G`-V SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Griff Griffith Q"✓ © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT NO., 17904988 Marissa Romo 9/30/2813 2:39:30 PM Page 1 of 2 Technology Resource Center, Inc. Policy No. BCS0029832 COMMERCIAL GENERAL LIABILITY 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 include as an additional insured any person or or- ganization for whom you are performing opera- tions when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with re- spect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations for that additional insured are completed. CG 20 33 07 04 B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the ren- dering of, or the failure to render, any profes- sional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other 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 or 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. © ISO Properties, Inc., 2004 CENT NO.: 17909988 Mazisaa komo 9/30/2013 2:39:30 PM Page 2 of 2 Page 1 of 1 ❑