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Insurance - Jimni Systems Inc. 2018-04-04SOCPAC-002 14T:75 -Y it '4`� o' CERTIFICATE OF LIABILITY INSURANCE DATE ) 04/04/2018 0 4104/2 01 8 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 have ADDITIONAL INSURED provisions or 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 License it OD79613 C NTACT Lizette Orozco BOwermaster ll. Associates Insurance Agency, Inc. PHONE FAX 10805 Holder Street, Suite 350 Ac, No, Ext : (714) 733-6248 Ac, No): Cypress, CA 90630 A&4jss. forozco@bowermaster.com INSURERS AFFORDING COVERAGE NAC e INSURER A: Admiral Insurance Comp ny 24856 INSURED INSURER a: Security National Insurance Company/ 19879 37257 Jimni Systems, Inc. INSURER C: Praetorian Insurance Company GEN'L 11161 Jeffrey Rd INSURER D : Irvine, CA 92602 AGGREGATE LIMIT APPLIES PER POLICY ❑X JECor LOC OTHER: INSURER E PRODUCTS - COMP/OP AGG 2,000,006 INSURER F: OVERAGES CERTIFICATENUMBER: 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 TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF POLICY EXP 04101/2019 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [X] OCCUR Incl: Pollution Liab X FEIECC2133403 04101/2018 EACH OCCURRENCE $ 1,000,660 DAMAGE TO RENTED $ 50,()00 PREMISES (Ea occumencs)X GEN'L MED EXP (my one arson $ 5,000 PERSONAL S ADV INJURY $ 2,060,000 AGGREGATE LIMIT APPLIES PER POLICY ❑X JECor LOC OTHER: GENERAL AGGREGATE 2,000,006 PRODUCTS - COMP/OP AGG 2,000,006 B AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUU�TN01OS EEpp AUT030NLY AUTO-sgga SPP1539199 0410112018 04101/2019 COMBINED SINGLE LIMIT $ 1,009,000 BODILY INJURY Per Person)$ BODILY INJURY Per accident $ err aCilEe^I AMAGE $ A X UMBRELLA LIABX EXCESS LIAB OCCUR CIAIMS-MADE FEICXS2133503 0410112018 04101/2019 EACH OCCURRENCE 2,069,660 AGGREGATE 2,000,000 DED RETENTION$ C WORKERS COMPENSAnON AND LIAnON YIN ANY PROPRIETOR/PARTNER/EXECLmVE (nlantlatory In NH) EXCLUDED? � a es, describe antler DE CRIPTON OFOPERATI NS bel N/A EQB0102429 0419112018 64101/2079 X PIAT OTH- ER E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE -EA EMPLOYE 7,666.666 E..DI EASE -POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: All Operations Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers, and employees are listed as Additional Insured — Pursuant to attached endorsement CO2010 0413 and CG2037 0704. Any other insurance maintained by the Costa Mesa Sanitary District shall be excess and non-contributing with the insurance provided by this policy per form ECC548 0712. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Costa Mesa Sanitary DistrictTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 290 Paularino Avenue ACCORDANCE WITH THE POLICY PROVISIONS. //,4 Costa Mesa, CA 926261 uV AUTHORIZED REPRESENTATIVE of. 25 (2016/03) @ 1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ,>g,a,e,>t7. Jimni Systems, Inc. Endorsement Number: 20 Additional Insured - Owners, Lessees or Contractors - Completed Operations This endorsement, effective 4/1/18 attaches to and forts apart of Policy Number FEI-ECC-21334-03 This endorsement changes the Policy. Please read it carefully. In consideration of an additional premium of $Applied this endorsement modifies insurance provided under the following: COMMERCIAL GENERAL 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) whom the Named Insured Those project locations where this agrees, in a written contract, to name as an additional insured. endorsement is required by contract However, this status exists only for the project specified in that contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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". CG 20 37 07 04 © ISO Properties, Inc., 2004 Jimni Systems, Inc. Endorsement Number: 13 ABMMN row.. Automatic Primary and Non -Contributory Insurance Endorsement Designated Work Or Project(s) This endorsement, effective 4/1/18 attaches to and forms a part of Policy Number FEI-ECC-21334-03 This endorsement changes the Policy. Please read it carefully. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract. In consideration of an additional premium of SAtmlied and notwithstanding anything contained in this policy to the contrary, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non- contributory to this insurance. ECC -548-0712 Jimni Systems, Inc. naxnUv. �... Endorsement Number: 19 Additional Insured — Owners, Lessees or Contractors — Scheduled Person or Organization This endorsement, effective 4/1/18 attaches to and forms apart of Policy Number FEI-ECC-21334-03 This endorsement changes the Policy. Please read it carefully. In consideration of an additional premium of $Applied, this endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART fsY9Oti>fl111Gy Name Of Additional Insured Person(s) Or Organization(s): Locations Of Covered Operations Any person(s) or organization(s) whom the Named Insured Those project locations where this agrees, in a written contract, to name as an additional insured. endorsement is required by contract However, this status exists only for the project specified in that contract Informationrequired 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", "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(s) at the location(s) designated above. 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 additional exclusions apply: CG 20 10 04 13 0 ISO Properties, Inc. Jimni Systems, Inc. aenrra2-MV- Endorsement Number: 19 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 location 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 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: 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 10 0413 0 ISO Properties, Inc. Jimni Systems, Inc. Endorsement Number: 5 aeeuerne �..... Automatic Waiver of Subrogation Endorsement This endorsement, effective 4/1/18 attaches to and forms apart of Policy Number FEI-ECC-21334-03 This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: CONDAMCLAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person(s) or organization(s) to whom the Named Insured agrees, in a written contract, to provide a waiver of subrogation. However, this status exists only for the project specified in that contract The Company waives any right of recovery it may have against the person or organization shown in the above Schedule because of payments the Company makes for injury or damage arising out of the imured's work done under a contract with that person or organization. The waiver applies only to the person or organization in the above Schedule. Under no circumstances shall this endorsement act to extend the policy period, change the scope of coverage or increase the Aggregate Limits of Insurance shown in the Declarations. ECC -320-0712