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Insurance - Environmental Engineering & Contracting - 2015-10-28ACo20® CERTIFICATE OF LIABILITY INSURANCE ll./ DATE(MMIDD/YYYY) 1 10/28/2015 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 such endomement(s). PRODUCER Garrett/Mosier/Griffith/Sistrunk Risk Management & Insurance Services 12 Truman Irvine, CA 92620 CONT Jas nn Rowe -NI PHONE o. Ex 949-559-3700 pc No: 949-559-6703 E-MAIL ADDRESS: "asl nnr m s.com INSURER(S) AFFORDING COVERAGE NAIC p INSURER A: Great Divide Insurance Company 25224 www.gmgs.com OB84519 INEEC Environmental INSURER B: Peerless Insurance Company/ 24198 $ 5,000,000 dba Enviromental Engineering Contracting Inc., One City Boulevard West, Suite 1800 INSURER C: INSURER D: Nautilus Insurance Company/ 17370 Orange CA 92868 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 27097735 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 R TYPE OF INSURANCE ADSL$ _BRVD_ POLICY NUMBER POLICY EFF POLICY EXP LIMITS A COMMERCIAL GENERAL LIABILITY GLP2006942-13 10/31/2015 10/31/2016RENCE $ 5,000,000 CLAIMS -MADE OCCUR DAMAGE TO gccurence $ 100,000 one person) $ 5,000 MAGGREGATE ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIM IT APPLI ES PER: GREGATE $ 5,000,000 POLICY ❑✓ JERCOT � LOC COMPIOPAGG $ 5,000,000 $ OTHER. B AUTOMOBILE LIABILITY CBP8977390 10/31/2015 10/31/2016 CEOMaBIdEED SINGLE LIMIT ent)$ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTNONO-OWNED HIRED AUTOS ✓ AUTOS PROPERTY DAMAGE $ Per accicanl UMBRELLA LIAROCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UAB CLAIMS -MADE DED RETENTION$ I $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y❑ WCA2008815-12 5/24/2015 5/24/2016 �/ SPER TATUTE OERH E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH)) NIA E. L. DISEASE - EA EMPLOYE $ 1,000,000 EL.DISEASE - POLICY LIMIT $ 1,000,000 If yes, descnbe under DESCRIPTION OF OPERATIONS beim D Pollution Liability CCP2006941-13 10/31/2015 10/31/2016 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, may be 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. l9a[/1Ila 109G\Ii MMURI Gr Costa Mesa Sanitary District 628 W. 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 ©1 The ACORD name and logo are registered marks of ACORD 27097735 1 15-16 G/A/UIm/P0LL/E60/WC I Jaelynn Rowe 1 10/28/2015 4:33:36 PH (PDT) I Page 1 of 3 GLP2006942-13 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 1 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 liability 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. 2006 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 27090435 1 15-16 G/A/OMB/P0LL/E60/WC I daslynn Rowe 1 30/28/2015 4:33:36 Re (POT) I Page 2 of 3 EEC Environmental 10/28/2015 dba Enviromental Engineering Contracting Inc., POLICY NUMBER: GLP2006942-13 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 PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Ornanization: Bianketwhere required by written contract or agreement. Such written Contract or agreement must be in effect 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 "produets,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 2%09-7135 1 15-16 c/A/UMn/e0LL/e6o/we I Jaslynn Rowe 1 10/28/2015 4 3 36 PM 1eo19 I Page 3 of 3 Page t of 1