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Insurance - Norman A Traub & Associates 2019-04-08OP ID: MN CERTIFICATE OF LIABILITY INSURANCE DATE (MM/04/08/22019019 Y) 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 endorsements . PRODUCER Alliance Mgt. & Insurance Sery 355 Via Vera Cruz #7 CONTACT Michelle A Nowell PHONE FAx A/c No Ext1: 760-471-7116 A/C No): 760-471-9378 CA Agent/Broker Lic# 0737966 San Marcos, CA 92078 1 2019 Michelle A. Nowell -MAIL E-MAILADDRESS: mnowell@amiscorp.com PRODUCER TRAU B-2 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Norman A Traub & Costa- esu , nI101'y ' - t Ct INSURER A: Acceptance Casualty Ins Comp 10349 Associates LLC Brock Avery 3225 Grande Vista Drive INSURER B: INSURER C : INSURER D: Newbury Park, CA 91320 INSURER E: 04/07/2019 INSURER F: DAMA PREM E T RENTED PREMISES Ea occurrence $ 100,00 COVERAGES CERTIFICATE Nl1MRFR- RFVICInKI All IMRGD• 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 LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx7 OCCUR CP00962819 04/07/2019 04/07/2020 DAMA PREM E T RENTED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 X Errors & Omission PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 5,000,00 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1.000.00 X POLICY JECT F7] PRO LOC $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (PER ACCIDENT) $ HIRED AUTOS $ NON -OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION WC STATU OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Costa Mesa Sanitary District is named as an additional insured with respect to the work performed by the named insured. Investigation, CA -- CERTIFICATE HOLDER cAKIr.F1 I ATInAI ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Dyana Bojarskl 290 Paularino Ave Costa Mesa CA 92626 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP00962819 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 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) iAutomatic Status Included Where Required by Written Contract. All Where Required by Written Contract. Section II - Who Is An Insured is amended to in- clude 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: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 202607 04 © ISO Properties, Inc., 2004 Page 1 of 1 17