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Insurance - California Barricade - 2015-07-01CALIFB7 OP ID: MP CERTIFICATE OF LIABILITY INSURANCE COVERAGES CERTIFICATF NI IMRFR• DDlnernM all usDDD. 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. DATE 1 /2 01 6 07/01/2075 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 Elkins Jones Insurance Agency Inc 12100 Wilshire Blvd., #300C / � Los Angeles, CA 90025 ` S` l® Walt Storch ` CONTACT Walt Storch PHONE Pax ac Ne Eae:310-207-9796 ac Ne: 310-207-5337 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC If INSURER A: IronshoreSpecialty Ins Co./ INSURED California Barricade Rentals 1550 East St. Gertrude COSTA V[ ,� Santa Ana, CA 92705 INSURERS: Allied Group' 42579 INSURER C: National Union Fire Ins. Co./19445 INsuRERD:State Compensation Ins. Fund INSURERE: _ INSURER F: A COVERAGES CERTIFICATF NI IMRFR• DDlnernM all usDDD. 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. /N RILTR TYPE OF INSURANCE UBR POLICY NUMBER MM OI D/rYYVY MMI,,YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXIOCCUR X X AGS0047502 07/01/2015 07/0112016 PREMISES Ea Occurrence $ 50,000 MED EXP (Any one person) $ 5,00 PERSONAL S ADV INJURY $ 1,000,000 X Agg per project GENERAL AGGREGATE $ 2,000,00( GENT AGGREGATE X POLICY LIMIT APPLIES PER: RO LOC PIFCT PRODUCTS-COMP/OP AGG $ 2,000,00( Emp Ben. s 1,000,00 B AUTOMOBILE X LIABILITYO ANY AUTO ACPBA3006735836 0710112015 0710112016 BINE tSINGLELIMIT $ 1,000,00 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ -PROPERTY-DAMAGE HIRED AUTOS NON -OWNED AUTOS PER ACCIDENT $ X UMBRELLALIAB OCCUR EACH OCCURRENCE $ 5,()00,000 CX EXCLIAB CLAIMS -MADE BE047721473 0710112015 U7/01/2016 AGGREGATE $ 5,000,00( DEDESS X I RETENTION$ nil $ D WORKERS COMPENSATIONWCSTAI'U- AND EMPLOYERS' LUIBIUTY YIN ANY PROPRIETORIPARTNERIEXECUTIVEX OFFICERIMEMBER EXCLUDED? ❑ N/A 906360815 07/01/2015 07/0112016 0TH. XI' E.L. EACH ACCIDENT $ 1,000,0( E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: Operations of the named insured Certificate Holder are named as Additional insureds per CG20370413 (primary) Automobile Al: ACOS 01 03 01. Waiver subrogation per CG24000509 COSTAM1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Costa Mesa SanitaryTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN may, District, its employees 8 I ACCORDANCE WITH THE POLICY PROVISIONS. 'S^/���I`jjj,,11 agents (CI111`A, �� AUTHORIZED REPRESENTATIVE 628 ta 19th Street Costa Mesa, CA 92627 ©1988-2010 ACORD CORPORATION_ All rinhtc rn.. u.H ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: AGS0047502 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) As required by written contract. If required by your Location And Description Of Complete Operations The insurance afforded by this policy for the benefit of written contract or written agreement with such the additional insured does not apply to Additional Insured, this insurance is primary and non- 'property damage' to any building, structure or contributory. appurtenant structure intended to be occupied as If anyone, other than the Additional Insured, provides a 'private residence'. The term "private residence" includes single family homes or residences, similar insurance for the Additional Insured, then this insurance will apply as multi -family homes or residences. Apartments are not outlined in SECTION IV — COMMERICAL LIABILITY CONDITIONS, paragraph considered "private residences." 4. Other Insurance, subparagraph c. Method of Sharing. The inclusion of one or more Insured(s) under the terms of this endorsement does not increase our limits of liability. All other terns and conditions remain unchanged. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © ISO Properties, inc., 2004 CG 20 37 07 04 POLICY NUMBER: AGS0047502 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 LIABILITY COVERAGE PART SCHEDULE Or Whereas Required by Written Contract Information required to complete the 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 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 0 POLICY NUMBER: AGS0047502 COMMERCIAL GENERAL LIABILITY CG 25 03 03 97 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Pro 1,,11W .,,,.,y a.rq... 1- ...... . .....................y.....,.. ... ...,. as applicable to this endorsement.) A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits'. as 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. CG 25 03 03 97 Copyright, Insurance Services Office, Inc., 1996 Page 1 of 2 0 C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or 'property damage' included in the 'products -completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Limits Of Insurance (SECTION 111) not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, Insurance Services Office, Inc., 1996 CG 25 03 03 97 ❑ C loll When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, Insurance Services Office, Inc., 1996 CG 25 03 03 97 0 � e