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Insurance - Environmental Engineering & Contracting - 2015-05-22ACORN® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 5/22/2015 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 sl --.h endorsement(s). PRODUCER Garrett/Mosier/Griffith/Sistrunk Risk Management & Insurance Services 12 Truman Irvine, CA 92620 CONTACT PHONE (949 )559-6700 AX No: (949)559-6703 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC If INSURER A: Great Divide Insurance Company 25224 www.gmgS.Com OB84519 INSURED EEC Environmental INSURER B: Peerless Insurance Company 24198 EACH OCCURRENCE $ 5,000,000 One City Boulevard West, Suite 1800 Orange CA 92868 INSURER C: INSURER D: Nautilus Insurance Company 17370 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 947A17" 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. (NSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER EFF MM IDDIYYYY CY EXP MM/D DIYYYY LIMITS A GENERAL LIABILITY GLP2006942-12 10/3112014 10/31/2015 EACH OCCURRENCE $ 5,000,000 TCOMMERCIAL CLAIMS -MADE F✓ OCCUR DAMAGE TO RENTE PREMISESEa occurrence $ 100,000 MED EXP (Any we person) $ 5.000 PERSONAL& ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 5,000,000 POLICY F PRO F—]LOGPRODUCTS-COMPIOPAGG $ 5,000,000 $ OTHER: B AUTOMOBILE LIABILITY CBP8977390 10/31/2014 10/31/2015 COMBINED tSINGLE LIMIT $ 1000,000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUT NON OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE $ Peraccidenl $. UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTIONS $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN WCA2008815-12 5/24/2015 5/24/2016 PERO STATUTE ERH- E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA EL. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describo under DESO IPTION OF OPERATIONS below D Pollution Liability CCP2006941-12 10/31/2014 10/31/2015 Each Poll Occurrence $5,000,000 Professional Liability Each Prof Liab Claim $5,000,000 General Aggregate: $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) Certificate Holder is added as Additional Insured and this insurance is primary per ENV2154AO906 attached. As respects General Liability coverage, a Waiver of Subrogation is hereby included per CG24040509 attached. L"EI c411 u a 1s!N1I a IN Lae is Iu Costa Mesa Sanitary District 628 a 19th Street Costa Mesa CA 92627 ACORD 25 (2014101) 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 The ACORD name and logo are registered marks of ACORD 24191795 114-15 G/A/UMB/POLL/Dan; 15-16 WC I Mariana Romo 15/22/2015 9:29:24 AM (PDT) I Page 1 of 3 GLP2006942-12 EEC Environmental ENDORSEMENT This endorsement forms a part of the policy to which it is attached. Please read it carefully. ADDITIONAL INSURED - BLANKET - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Who is An Insured (Section II) is amended to include as an insured any person(s) or organizations, for whom you are performing operations under a written contract or agreement, which is in effect prior to the performance of your work which is the subject of such written contract or agreement, that such person(s) or organization(s) be added as an additional insured on your policy, but Only with respect to liahility for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by: 1. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured; or 2. Your work performed for such person(s) or organizations(s) and included in the products -completed operations hazard, only when required by the written contract or written agreement. With respect to damages caused by your work, as described above, the coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above, but only when required by written contract or agreement. 02006 by Berkley Specialty Underwriting Managers LLC, an affiliate of Nautilus Insurance Company and Great Divide Insurance Company. All rights reserved. © 1985-2006 by Insurance Services Office, Inc., material used by permission. ENV 2154 A 09 06 Page 1 of 1 24791795 1 14-15 G/A/V B/POLL/E60, 15-16 WC I Marissa Roma 1 5/22/2015 9:28:24 AM (POT) I Page 2 of EEC Environmental POLICY NUMBER: GLP2006942-12 5/22/2015 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LtABILITY COVERAGE PART SCHEDULE Name Of Person Or Ornanization: Blanket where required by written contract or agreement. Such written contract or agreement must be in affect prior to the performance of your work which is the subject of such written contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 D4 05 09 ® insurance Services Office, Inc., 2008 29191/95 1 19-15 G/A/UM9/POLL/ECO; 15-16 WC I M—.... R— 1 5/22/2015 9:28:29 AM (PU'f) I Page 3 Of Page 1 of 1