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Insurance - Golden Bell 2017-01-05AC R CERTIFICATE OF LIABILITY INSURANCE DA 01/05/2017 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 Van Eeurdeu Ina. Serve Inc. - Xingsburg PO Box 67 CT NAME: Jeanette Heinrich® PHONE (559) 897-2975 A/C No:(559) 897-4070 E-MAIL ODRESS: INSURER S AFFORDING COVERAGE NAIC q %ingsburg CA 93631 INSURERA:Evemeton Insurance Company 35378 16PXGWE00826 INSURED 714) 630-3861 INSURER e: INSURER C Golden Bell Products, Inc. INSURER D: P.O. Box 366 INSURER E: Atwood CA 92811 INSURERF: V THIS 13 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 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IL. LIR TYpE OFIN9URANCE OL POLICY NUMBER MSD EFF MMUpYE%P UMIT9 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR 16PXGWE00826 10/25/2016 10/25/2017 EACH OCCURRENCE $ 11000,000 PREMISES Eao D $ 50,000 MED EXP An .ere rem $ 5,000 X CPL X 10, D00 SIR PERSONAL a ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: - GENERALAGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG S 2,000,000 % POLICY jE T FLOC OTHER: AUTOMOBILE UABILITY COMBINED S NG LIMIT Eaeccent $ BODILY IWURY(Per Perem) $ ANY AUTO BODILY INJURY (Per nmol) $ ALLOWNED SCHEDULED AUTOS AUTOS NON OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ Per ¢' $ A UMBRELLA LIAR X OCCUR 163FXWE00390 10/25/2016 10/25/2017 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 11000,000 X EXCESS UAB CLAIMS -MADE DED X ENTION$ 10,000 $ WORKERS COMPENSATION OTH STATUE ER AND EMPLOYERS' LUUIRRY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE r-7 E.L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N/A E.L DISEASE -POLICY LIMIT $ Krd..to undar DESCRIPTION OF OPERATIONS below A Cont. Pollution Liab. 16PKGWE00826 10/25/2016 10/25/2017$25,000 SIR $ 1,000,000 A Environ. Impairment Liab. 16PR(WEOO826 10/25/2016 10/25/2017$25,000 SIR $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 10%AddNmnal Remarks Schedule, may be aftached If mare space is required) Re: Maahole spraying for roaches at various city locations. It is agreed that the Coat& Mean Sanitary District, its elected and appointed officials, officers, agents, and employees are named as additional insureds as respects to General Liability per attached additional insured form only when required by written contract. Costa mesa Sanitary District 290 Paularino Avenue �9 Costa Mesa CA 92626 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 /I�r4 re) 1gRR.2n1d ACORn CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD _f` , I COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 16PKGWE00826 ��Ifi1�AiL®, EVANSTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, BLANKET ADDITIONAL INSURED — PRIMARY AND NON-CONTRIBUTORY — OWNERS, LESSEES OR CONTRACTORS This endorsement modes Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. Section it — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) to whom the insured agrees to provide additional Insured status on a primary and noncontributory basis in a written contract, provided such written contract is signed by loth parties and executed prior to the commencement of operations, 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 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional Insured. However, the insurance afforded to such additional insured; 1. Only applies to the extent permitted by law; and 2. 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 additional exclusions apply: This Insurance does not apply to "bodily injury', "property damage", or "personal and advertising injury" occurring after. 1. All work on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured at the location of the covered operations, including materials, parts or equipment furnished in connection with such work, 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 part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: 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 will not increase the applicable Limits Of Insurance shown In the Declarations. MEGL 1543 05 16 Includes copyrighted material of insurance Services Office, Inc., Page 1 of 2 with its permission. D. With respect to the coverage provided by this endorsement, the following is added to Paragraph 4. Other Insurance under Section IV — commercial General Liability Conditions: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to any person(s) or organizations) ,qualifying as an additional insured by this endorsement provided that: (1) The additional Insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional Insured. All other terms and conditions remain unchanged. MEGL 1543 05 16 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 2 with Its permission. POLICY NUMBER: 16PKGWE00826 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 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) Location And Description Of Completed Operations Any person(s) or organization(s) to whom the insured agrees to provide Additional Insured status in a written contract signed by both parties and executed prior to the commencement of operations Not Applicable 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: 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. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 IIIPOLICY NUMBER: 16PKGWE00826 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 16PKGWE00826 EVANSTON INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name Of Person Or Organization: Any person(s) or organization(s) with whom the Named Insured agrees, in a written contract executed prior to the "occurrence", to waive rights of recovery Additional Premium: $ Included The following is added to Condition 8. Transfer Of Rights Of Recovery Against Others To Us under Section IV — Commercial General Liability Conditions: We waive any right of recovery we may have against any person or organization shown in the Schedule of this endorsement. This waiver applies only to the person or organization shown in the Schedule of this endorsement. All other terms and conditions remain unchanged. MEGL 0241-01 05 16 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission.