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Insurance - California Barricade Rentals Inc. 2018-06-20From: 06/26/2018 14:58 #607 P.001/005 ACORo CERTIFICATE OF LIABILITY INSURANCE `� DATE(MMOONYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 6/20/2018 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 endorsament(s). PRODUCER CONTACT Fernando Rivas NAME: ISU Insurance Services - Centinel Agency, LLC PHONE Ex1L (415) 657-2000 uc No, (415)657-2002 LAID No.250 Executive Park Blvd nDDRII fernando®isuca. com Stilt¢ 9800 EACH OCOURRENE $ 11000,000 -INSURER(S) AFFORDING COVERAGEkAICB San Francisco CA 99139 INSURER A:Sco t tadale Insurance Comp97INSURED INSURER B:American Fire and Casualt66 California Barricade Rentals Inc INSURER C:National Union Fire Insur45 1550 E Saint Gertrude PlaceINSURERD:State Compensation Ins. F76 INSURER E:HiscOX InsuInc/ 10200 X Santa Ana CA 92705 _ INSURER F:Xinsale Insurance Company 38920 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. IITM TYPE OF INSURANCE SSL UBR POLICY NUMBER POLICY EFF MMIOD/YVYY POLICY E%P M /YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCOURRENE $ 11000,000 A Cl -MAGE X OCCUR DAMAGE TO REN ED 100,000 PREMISES Ea occurrence $ X EC30037111 7/1/2018 7/1/2019 __ _ MEDEXP(Anyoneperson) $ Excluded _ PERSONAL 6 ADV INJURY S 1, 000, 0 D GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000,000 PRO- X POLICY n PRC- JECT OC PRODUCTS - COMPIOP AGG $ 2,000,000 EmPayee Benallls S 1, 000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 11000,000 Ea acodenl B X ANY AUTO _ BODILY INJURY ((Par person) S ALL OS SCHEDULED AUTOS AUTOS BAA (19) 58 05 63 03 7/1/2018 7/1/2019 BODILY INJURY Per accident $ I ) X HIRED AUTOS X NON -OWNED AUTOS PROPERTYDAMAGE E Per, accident) UMBRELIA LIAR X OCCUR IFACN OCCURRENCE $ C X E%LESS LIAB yCLAIMS-MADE _5,000,000 AGGREGATE E 5,000 /100 OED RETENTION$ _ S BE 014795709 7/1/201B 10/1/1019 WORKERS COMPENSATION 'PER OTH- X STATUTE R ANDEMPLOYERS'LIABILITY YIN E.L. EACH ACCIDENT S 1, 000, 000 ANY PROPRIETOPIPARTNERVEXECUTVE OFFICERIMEMBER EXCLUDED? ❑,NIA __ E. L. DISEASE - EA EMPLOYE $ 1,000,000 - D (Mandatory In NH) 9063608-2018 7/3/2018 7/1/2019 If yes, describe under -- E.L. DISEASE -POLICY LIMIT $ 11000,000 DESCRIPTIONOFOPERATIONSbelow E Professional Liability NPL1863490.18 7/1/2018 7/1/2019 Eaon Claim $1,000,000 P 1Pollution Liability 0100052798-1 7/1/2038 7/1/2019 Each Pollution Condin. $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarb 5chetlule, mey be edechetl 11 mwe space la regWr¢tl) The Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers, and employees are named as additional insured. Additional Insured applies per form CG 20 33 04 13 a CG 20 37 04 13 on the GL policy. Primary s Non-contributory wording included. Those usual to the insured's operations. (714)540-1392 DBojarski®crosdca.gov Costa Mesa Sanitary District 290 Paularino Avenue �I/,6 Costa Mesa, CA 92626 6Ty if 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 Ferenc/FR © 198 ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) _;7� N. All rlahts reserved. 06/26/2018 14.58 #607 P.002/005 POLICY NUMBER: BCS0037139 COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured 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. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. CG 20 33 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 2. "Bodily injury" or 'property damage" occurring after: a. 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 b. 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. 06/26/2018 14:59 #607 P.003/005 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 you have entered into with the additional insured; 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 © Insurance Services Office, Inc., 2012 CG 20 33 04 13 From: POLICY NUMBER: BCS0037139 06/26/2018 14:59 #607 P. 004/005 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 OR ORGANIZATION WHEN YOU AND ALL LOCATIONS SUCH PERSON OR ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT OR AGREEMENT, EXECUTED PRIOR TO THE "OCCURRENCE" TO WHICH THIS INSURANCE APPLIES, THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY 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. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 From 06/26/2018 14:59 #607 P.005/005 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. Page 2 of 2 0 Insurance Services Office, Inc., 2012 CG 20 37 04 13 11