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Insurance - National Plant Services - 2015-11-06A`oRD® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11106/2015 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(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 MARSH USA INC. 540 W. MADISON CONTACT NAME' 1611�_110 Ext). PHONE A1C Hall: MAIL ADDRESS CHICAGO, IL 60661 Attn: chicago.CenRequest@mamh.wnn M AUTHORIZED REPRESENTATIVE INSURERS AFFORDING COVERAGE NAIC If INSURER A : Zurich American Insurance Company 16535 NPS INSURED INSURER B; American Zurich Insurance Company 40142 NATIONAL PLANT SERVICES, INC. tCCOUMERCIALGENERALLIABILITY CLAIMS -MADE IJOCCUR 1461 HARBOR AVENUE INSURER C INSURER 0: LONG BEACH, CA 90613-2741 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: CHI -005784463-10 REVISION NUMBER:6 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 TR rypE OF INSURANCE J=ADDL MD SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS A M AUTHORIZED REPRESENTATIVE GLD 9377201-12 10/31/2015 10/31/2016 EACH OCCURRENCE $ 1,000,000 Manashi Mukherjee _Mauao�nu.de,c tCCOUMERCIALGENERALLIABILITY CLAIMS -MADE IJOCCUR DAMAGES( RENTED P MAGE Eacccunence $ 1,000,000 MED EXP (Any one person) $ 10,000 INCLUDED PERSONAL B ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L POLICY PRO- JECT FILOC _ PRODUCTS -COMP/OPAGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY BAP 9377199-12 10/31/2015 10/31/2016 COMBINED SINGLE LIMIT $ 2,000,000 E no BODILY INJURY (Per person) $ X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident)$ PROPERTY DAMAGE $ Peraccident) NON -OWNED HIREDAUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTIONS $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNEWEXECUTIVE Y OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA WC 9377202-12 10/31/2015 10131/2016 X PER O7H- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 H es, dascdbe under DE SCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: PREQUALIFICATION FOR MAINTENANCE PROJECTS UNDER 125,000. COSTA MESA SANITARY DISTRICT, ITS DIRECTORS, OFFICERS, ENGINEERS, EMPLOYEES AND AUTHORIZED AGENTS ARE ADDITIONAL INSUREDS UNDER GENERAL LIABILITY AND AUTOMOBILE LIABILITY, BUT ONLY TO THE EXTENT REQUIRED BY THEIR WRITTEN CONTRACT WITH THE NAMED INSURED FOR OPERATIONS PERFORMED BY THE NAMED INSURED. A WAIVER OF SUBROGATION IS INCLUDED IN FAVOR OF THE ADDITIONAL INSURED WITH RESPECT TO THE GENERAL LIABILITY, AUTOMOBILE LIABILITY AND WORKERS COMPENSATION COVERAGES, BUT ONLY TO THE EXTENT REQUIRED BY THEIR WRITTEN CONTRACT WITH THE NAMED INSURED. CERTIFICATE HOLDER CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD COSTA MESA SANITARY DISTRICT ` SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 628 W. 19TH STREET I�p `�'J THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN COSTA MESA, CA 92627 r! ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _Mauao�nu.de,c ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 227309 _ LOC #: Chicago ACC>Rb® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY MARSH USA INC. NAMED INSURED NATIONAL PLANT SERVICES, INC. 1461 HARBOR AVENUE LONG BEACH, CA 96813-2741 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance THE INSURANCE AFFORDED TO THE ADDITIONAL INSUREDS IS PRIMARY INSURANCE OVER ANY OTHER VALID OR COLLECTIBLE INSURANCE THAT THE ADDITIONAL INSUREDS MAY HAVE WITH RESPECT TO LOSS UNDER THIS POLICY. OTHER INSURANCE OF ANY ADDITIONAL INSUREDS APPLICABLE TO LOSS IS IN EXCESS OVER THIS ENDORSEMENT AND THE AMOUNT OF THE COMPANYS LIABILITY UNDER THIS POLICY SHALL NOT BE REDUCED BY THE EXISTENCE OF SUCH OTHER INSURANCE, PROVIDED, HOWEVER, THAT THIS PARAGRAPH DOES NOT APPLY (i) TO LOSS CAUSED SOLELY BY THE NEGLIGENCE OF SUCH ADDITIONAL INSUREDS, OR (ii) TO LIABIUTY OF THE ARCHITECT, ENGINEER OR SURVEYOR ARISING OUT OF (1) PREPARING, APPROVING OR FAILING TO PREPARE OR APPROVE MAPS, SHOP DRAWINGS, OPINIONS, REPORTS, SURVEYS, FIELD ORDERS, CHANGE ORDERS OR DRAWINGS AND SPECIFICATIONS, OR (2) GIVING DIRECTIONS OR INSTRUCTIONS, OR FAILING TO GIVE THEM, IF THAT IS THE PRIMARY CAUSE OF THE INJURY OR DAMAGE, THE INSURANCE PROVIDED UNDER THIS ENDORSEMENT WILL BE PRIMARY AND NON- CONTRIBUTORY ONLY IF A WRITTEN CONTRACT REQUIRES IT. THE INCLUSION OF MORE THAN ONE CORPORATION, PERSON, ORGANIZATION, FIRM OR ENTITY AS A NAMED INSURED OR ADDITIONAL INSURED UNDER THE POLICY SHALL NOT AFFECT THE RIGHTS OF SUCH CORPORATION, PERSON, ORGANIZATION, FIRM OR ENTITY AS RESPECTS ANY CLAIM, DEMAND, SUIT OR JUDGMENT MADE, BROUGHT OR RECOVERED, BY OR IN FAVOR OF ANY EMPLOYEE OF SUCH OTHER NAMED INSURED OR ADDITIONAL INSURED. THE POLICY PROTECTS EACH CORPORATION,PERSON,ORGANIZATION, FIRM OR ENTITY IN THE SAME MANNER AS THOUGH A SEPARATE POLICY HAD BEEN ISSUED TO EACH. HOWEVER, NOTHING IN THIS ENDORSEMENT SHALL INCREASE THE AMOUNTS OF LIABILITY BEYOND THE AMOUNT FOR WHICH THE COMPANY WOULD HAVE BEEN LIABLE HAD ONLY ONE PERSON OR INTEREST BEEN NAMED AS A NAMED INSURED, INSURED OR ADDITIONAL INSURED. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD Additional Insured — Owners, Lessees Or Contractors — Ongoing Operations — Scheduled 0 ZURICH Policy No. Eft. Date of Pol. Exp. Date of Pol. Eft. Date of End. Producer No. AddT Prem Return Prem. GLO-8377201-12 10/31/2015 10/31/2016 ARE REQUIRED TO ADD AS AN ADDITIONAL INSURED OR PROJECT FOR WHICH INSURANCE IS OTHERWISE NIA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided underthe: Commercial General Liability Coverage Part SCHEDULE Name of Person or Organization: Location and Description of Ongoing Operations: Additional Premium: ANY PERSON OR ORGANIZATION, OTHER THAN AN ANY LOCATION OR PROJECT, OTHER THAN A WRAP-UP ARCHITECT, ENGINEER, OR SURVEYOR, WHOM YOU OR CONSOLIDATED INSURANCE PROGRAM LOCATION ARE REQUIRED TO ADD AS AN ADDITIONAL INSURED OR PROJECT FOR WHICH INSURANCE IS OTHERWISE NIA UNDER THIS POLICY UNDER A WRITTEN CONTRACT OR SEPARATELY PROVIDEDTO YOU BY A WRAP-UP OR WRITTEN AGREEMENT EXECUTED PRIOR TO LOSS, OTHER CONSOLIDATED INSURANCE PROGRAM. EXCEPT WHERE SUCH REQUIREMENT IS PROHIBITED BY LAW. A. Section II — Who Is An Insured is amended to Include as an additional insured any person or organization shown In the Schedule of this endorsement, but only with respect to liability arising out of your ongoing operations performed for that Insured at or from the corresponding Location designated and described in the Schedule. However, 1. The Insurance afforded to such additlonai insured only applies to the extent permitted by law; and 2 If coverage provided to the additlonai Insured Is required by a written contract or written agreement, the Insurance afforded to such additional insured will not be broader than that Which you are required by the written contract or written agreement top rovide for such additional insured. B. With respect to the Insurance afforded to any additional Insured shown in the Schedule of this endorsement, the following additional exclusions apply: This Insurance does not apply to'bodily injury' or"Property damage" occurring after: 1. All work, including materials, parts or equipment furnished In connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or 2 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 subcontractor engaged in performing operations for a principal as a pan of the same project. C. Wth respect to the Insurance afforded to the additional Insureds underthis endorsement, the following Is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a written contract or written agreement, the most we will pay on behalf of the additional insured isthe amount of insurance: Required bythewdtten contract orwritten agreement; or 2 Available underthe applicable UmBs of Insurance shown In the Declarations, whicheveris less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. U -GL -1465•C CW (04113) Page 1 of 1 Includes copyrighted material of Insurance Servces Office, Inc., Wth its pemdsslon. 0 Additional Insured — Owners, Lessees Or Contractors — ZURICH Completed Operations — Scheduled Policy No. I Eft. Date of Pol. I Exp. hate of Pol. I Eff. Date of End. Producer No. Add -1. Prem Return Prem. GLO-9377201- 121 10/31/2015 1 10/31/2016 1 WRAP-UP OR CONSOLIDATED INSURANCE N/A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part SCHEDULE Name of Person or Organization: Location and Description of Completed Operations: Additional Premium: ANY PERSON OR ORGANIZATION, OTHER ANY LOCATION OR PROJECT, OTHER THAN A THAN AN ARCHITECT, ENGINEER, OR WRAP-UP OR CONSOLIDATED INSURANCE SURVEYOR, WHOM YOU ARE REQUIRED TO PROGRAM LOCATION OR PROJECT FOR N/A ADD AS AN ADDITIONAL INSURED UNDER WHICH INSURANCE IS OTHERWISE THIS POLICY UNDER A WRITTEN CONTRACT SEPARATELY PROVIDED TO YOU BYAWRAP- OR WRITTEN AGREEMENT EXECUTED PRIOR UP OR OTHER CONSOLIDATED INSURANCE TO LOSS, EXCEPT WHERE SUCH PROGRAM. REQUIREMENT IS PROHIBITED BY LAW. Section II — Who Is An Insured is amended to include as an insured any person or organization shown in the Schedule of this endorsement, but only with respect to liability arising out of "your work" at or from the corresponding location designated and described in the Schedule performed for that insured and included in the "products -completed operations hazard". However, if you have entered into a construction contract with an additional insured person or organization shown in the Schedule of this endorsement, the insurance afforded to such additional insured only applies to the extent permitted by law. All other terms and conditions of this policy remain unchanged. U-GL-146ED AK (02-14) Page i of 1 Includes copyrighted material of Insurance Services Office, Inc., vrith Its permission.