Insurance - Discovery Science Center of Orange County 2018-07-24271069
acol2,0® CERTIFICATE OF LIABILITY INSURANCE
DA 7/24/2018 TE YI
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
Commercial Lines - 213-253-6700
USI Insurance Services National, Inc. - CA Lic#: OD08408
CONTACT
NAME: Norah.Jacobo
PHONE FAX
A/ o Ez : AIC No:
_
E-MAULADDREs: Norah.Jacobo@usi.com
INSURER(S) AFFORDING COVERAGE NAICN
777 South Figueora St, Ste 2100
INSURERA: Philadelphia Indemnity Insurance Company f 18058
Los Angeles, CA 90017
INSURED
INSURER S: Travelers Properly Casualty Co of America 25674
Discovery Science Center of Orange County
INSURERC:
INSURER o:
dba Discovery Cube Orange County
INSURERE:
2500 N. Main Street
1 INSURER F:
Santa Ana, CA 92705
COVERAGES CERTIFICATE NUMBER: 13312424 REVISION NUMBER: See below
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 .DOL SU a POUCYNUMBER POLICY EFF
LTR MMI DIMY LIMITS
A
X COMMERCIALGENERALLUBRITY
CLAIMS -MADE X OCCUR
X
PHPK1843692
7/1/2016
7/1/2019
EACHOCCURRENCE S 1,000.000
DAMAGE TO RENTED
PREMISES Ea omurrence S 100,000
MED EXP (My one person) S 5,000
PERSONAL B ADV INJURY 5 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $ 2,000,000
X POLICY 11 PRO- LOC
JECT
PRODUCTS - COMPIOP AGG $ 2,000,000
Sexual Abuse/Molestation $ Included
OTHER
A
AUTOMOBILE LIABILITY
PHPK1843692
7/1/2018
7/1/2019
COMBINE SINGLE LIMIT Ea cc $ 1,000,000
aident
BODILY INJURY (Per person) $
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLYAUTOS
BODILY INJURY(Pereccidenl) S
PROPERTY DAMAGE S
Peraccident
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
$
UMBRELLALIABOCCUR
EACHOCCURRENCE S
_
AGGREGATE S _
EXCESS LIAB
CL,:MADE
DED I
I RETENTIONS
$
B
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN
ANYPROPRIETORMARTNERIEXECUTNE
OFFICERIMEMBEC
(Mandatory In NH)
NIA
UB003K35535418
04/01/18
04/01/19
X STATUTE OERH
E L EACH ACCIDENT $REXCLUDEO? 1,000,000
E.L. DISEASE - EA EMPLOYEE S 1,000.00
EL.DISEASE - POLICY LIMIT S 1,000,000
K yes, describe under
DESCRIPTION OF OPERATIONS Was
7
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The Costa Mesa Sanitary District, its elected and appointed officials, agents, officers, volunteers and employees are named as additional insured as it
relates to general liability in accordance with the terms and conditions of the policy. The above coverage is primary and noncontributory where required by
written contract. Certificate holder is provided 30 days notice of cancellation in accordance with the terms and conditions of the general liability policy.
Costa Mesa Sanitary District .................
HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
290 Paularino Ave I ACCORDANCE WITH THE POLICY PROVISIONS.
Costa Mesa, CA 92626
AUTHORIZED REPRESENTATIVE
rhe ACORD name and logo are registered marks of ACORD V 1988-2015 ACOKU COKPUKAIION. All rights reserved.
ACORD 25 (2016/03)
,1-6Nfio,e 1p09i951ssee rn 11.. 1.)
Policy Number: PHPK1843692
PI-CANXAICH-002 (05/11)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CANCELLATION NOTICE TO SCHEDULED ADDITIONAL INSURED OR
CERTIFICATE HOLDER
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROFESSIONAL LIABILITY COVERAGE PART
COMMERCIAL CRIME COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
SCHEDULE OF ADDITIONAL INSUREDS OR CERTIFICATE HOLDERS
Al or CH Additional Insured or Certificate Holder Address
Blanket where required by written contract.
The following is added to A. CANCELLATION of the Common Policy Conditions of the above applicable
coverage part:
A. In the event we cancel the policy in accordance with the policy's terms and conditions, we will
endeavor to mail written notice of cancellation to Additional Insureds or Certificate Holders,
shown in the above SCHEDULE within the time frame listed below. However, failure to mail
such notice shall impose no obligation of any kind upon us, our agents or representatives.
1. 30 days before the effective date of cancellation if we cancel for any reason other than for
non - payment of premium.
As respects Additional Insureds, the above cancellation provision applies only when the
Additional Insured shown in the above SCHEDULE is added to the policy by a separate
additional insured endorsement as the CANCELLATION NOTICE TO ADDITIONAL INSURED
OR CERTIFICATE HOLDER does not provide additional insured coverage.
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Policy Number: PHPK1843692
PI -GL -005 (07/12)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
PRIMARY AND NON-CONTRIBUTORY INSURANCE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Effective Date: 07/01/2018
Name of Person or Organization (Additional Insured):
Blanket where required by written contract.
SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or
organization(s) shown in the endorsement Schedule, but only with respect to liability for "bodily injury,"
"property damage" or "personal and advertising injury' arising out of or relating to your negligence in the
performance of "your work" for such person(s) or organization(s) that occurs on or after the effective date
shown in the endorsement Schedule.
This insurance is primary to and non-contributory with any other insurance maintained by the person or
organization (Additional Insured), except for loss resulting from the sole negligence of that person or
organization.
This condition applies even if other valid and collectible insurance is available to the Additional Insured
for a loss or "occurrence" we cover for this Additional Insured.
The Additional Insured's limits of insurance do not increase our limits of insurance, as described in
SECTION III — LIMITS OF INSURANCE.
All other terms, conditions, and exclusions under the policy are applicable to this endorsement and
remain unchanged.
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Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Policy Number: PHPK1843692
COMMERCIAL GENERAL LIABILITY
CG 20 26 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
Blanket where required by written contract.
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", "property
damage" or "personal and advertising injury"
caused, in whole or in part, by your acts or
omissions or the acts or omissions of those acting
on your behalf:
1. In the performance of your ongoing operations;
or
2. In connection with your premises owned by or
rented to you.
However:
i. 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 26 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 12