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Insurance - TTS Engineering - 2012-09-26A� H Y , J CERTIFICATE OF LIABILITY INSU E DATE (MM DD YY Y) 9/26/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT&PILIFIoU ThEZUMTiFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER ' THE ppprCOVERAGE TAAFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BElvppply1111NRUntffMf ER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 James G Parker Insurance Associates License #0554959 1753 E Fir Ave Fresno CA 93720 NAMeCT Mary Doig PHONE (559)222 -7722 FAX (559)222 -1724 AC No: nOORIEss.MaryDoig @jgparker. com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Praetoria . Insurance Compainy Company 37257 INSURED T T S Engineering Inc DBA T T S Engineering 16835 Algonquin Street #453 ,Huntington Beach CA 92649 INSURER B INSURER C: INSURER D: INSURER E : $ INSURER F: raDy fCATC 6U IMDFD9 2 _ IA AT. Rd Renewal Onlv REVISION NUMBER: V 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. INS. TR TYPE OF INSURANCE POLICY NUMBER MMIDDYEFF MMIOOrY�Y LIMITS GENERAL LIABILITY EACH OCCURRENCE $ -15A–M F P T ED— COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence $ MED EXP(Any one person) $ CLAIM S-MADE D OCCUR PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG S $ POLICY PR0. LOU I I AUTOMOBILE LIABILITY Ea accCdentSINGLE LIMIT $ 1,000,00 BODILY INJURY (Per person) $ X A ANYAUTO ALL OWNED SCHEDULED 01000069304 9/26/2012 9/26/2013 BODILY INJURY (Per accident) $ AUTOS AUTOS NON -OWNED PeOa RTY DAMAGE $ i{ g HIRED AUTOS AUTOS Uninsured motorist combined $ 1,0 0 000 UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMCrMADE DED RETENTION $ WORKERS COMPENSATION WCKI M IT OTH- A7 ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNER /EXECUTIVE❑ EL EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory In Ni E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below A Rented /Leased Equipment MHOI000069304 9/26/2012 9/26/2013 $1,000 Deductible $125,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space Is required) This represents the auto and inland marine coverage renewal only. Costa Mesa Sanitary Districtr,J District Engineering 1/61r Fu {I 628 W 19th Street Costa Mesa, CA 92627 120101051 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 Parker III /MDOIG �—�K` -� 'zs i 0 1988-2010 ACORD CORPORATION. All rights reser INS025 Colons,m The Ar.ni name and lone, are enicf.i mari of Aftf1RD Other Named Insureds im Wilson PTS Engineering Additional Named Insureds Individual, Additional Named Insured Individual, Doing Business As OFAPPINF (02/2007) COPYRIGHT 2007, AIMS SERVICES INC ADDITIONAL COVERAGES Ref # I Description Medical payments Coverage Code MEDPM Form No. Edition Date _imitI 5,000 Limit2 Limit3 Deductible Amount Deductible Type Premium Ref# Description Coverage Code Form No. Edition Date Limit Limit Limit Deductible Amount Deductible Type Premium Ref# Description Coverage Code Form No. Edition Date Limit Limit2 Limit3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code For No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit Limit2 Limit Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date _imit1 Limit Limit Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description I Coverage Code Form No. Edition Date Limit Limit Limit Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 7imit2 Limit Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date .imitl Limit Limit Deductible Amount Deductible Type Premium OFADTLCV Copyright 2001, AMS Services, Inc.