Loading...
Insurance Environmental Engineering & Contracting - Workers Comp - 2019-05-23ACORD0 C4 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 5/23/2019 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). GMGS Risk Management & Insurance Services 6201 Oak Can on, Suite 100 Irvine, CA 9268 CONTAPRODUCER NAME: Ashley Brewster PHONE FAX A/c No Ext): 949-559-3377 A/c No): 949-559-6703 E-MAIL ADDRESS: ashleyb@gmgs.com EACH OCCURRENCE $ 5,000,000 INSURER(S) AFFORDING COVERAGE NAIC # i MED EXP (Any one person) $ 5,000 INSURER A: Great Divide Insurance Company 25224 www.gmgs.com OB84519 INSURED EEC Environmental INSURER B: American Fire and Casualty Company 24066 dba Enviromental Engineering Contracting Inc., INSURER C: INSURER D: Nautilus Insurance Company 17370 One City Boulevard West, Suite 1800 Orange CA 92868 INSURER E: INSURER F: GENERAL AGGREGATE $ 5,000,000 COVERAGES CERTIFICATE NUMBER: 48889827 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 LTR TYPE OF INSURANCE IVSD OLICY EFF SWVDUBR POLICY NUMBER MM DD1YYYY POLICY EXP MM DD/YYYY LIMITS A ✓ COMMERCIAL GENERAL LIABILITY CLAIMS-MADEOCCUR GLP2006942-16 10/31/2018 10/31/2019 EACH OCCURRENCE $ 5,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 i MED EXP (Any one person) $ 5,000 _ 1 PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 j PR - POLICY ✓ ECT L____1 LOC ! PRODUCTS - COMP/OP AGG $ 5,000,000 $ OTHER: B AUTOMOBILE LIABILITY BAA(19)58333458 10/31/2018 10/31/2019 E8 a ci EDLIMIT $1,000,000 BODILY INJURY (Per person) $ ✓ ANY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS I BODILY INJURY (Per accident) ! $ ✓ HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAB OCCUR I EACH OCCURRENCE $ AGGREGATE $ EXCESS Ll AB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION 'AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE i OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A WCA200881516 15/24/2019 j 15/24/2020 SPER TATUTE OERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEEI $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1$ 1,000,000 D Pollution Liability CCP2006941-16 10/31/2018 10/31/2019 Each Poll Occurrence $5,000,000 Professional Liability Each Prof Liab Claim $5,000,000 I General Aggregate: $10,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is added as Additional Insured per CG20100413 and CG20370413 attached, and this insurance is primary per CG20010413 attached. As respects General Liability coverage, a Waiver of Subrogation is hereby included per CG24040509 attached. CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 48889827 1 18-19 G/A/UMB/POLL/E&O 19-20 WC I Ashley Brewster 1 5/23/2019 2:45:20 PM (PDT) I Page 1 of 6 Costa Mesa SanitaryDistrict 290 Paularino Ave 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 Grill Griffith ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 48889827 1 18-19 G/A/UMB/POLL/E&O 19-20 WC I Ashley Brewster 1 5/23/2019 2:45:20 PM (PDT) I Page 1 of 6 POLICY NUMBER: GLP2006942-16 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED 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) Locations Of Covered Operations Any person, organization, or project with whom the named insured executes a written contract prior to the start of the project and is shown on a certificate of insurance issued by our authorized representative prior to the start date of the project. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — 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. CG 20 10 04 13 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 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. © Insurance Services Office, Inc., 2012 48889827 1 18-19 G/A/UMB/POLL/E&O 19-20 WC ( Ashley Brewster 1 5/23/2019 2:45:20 PM (PDT) I Page 2 of 6 Page 1 of 2 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 Insurance shown in the Declarations; whichever is less. This endorsement shall not increase applicable Limits of Insurance shown in Declarations. of the the Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 48889827 1 18-19 G/A/UMB/POLL/E&O 19-20 WC I Ashley Brewster 1 5/23/2019 2:45:20 PM (PDT) I Page 3 of 6 POLICY NUMBER: GLP2006942-16 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SII • A 1 • 1 0•' • '� •' • 0•' 'i •IL 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, organization, or project with whom the named insured executes a written contract prior to the start of the project and is shown on a certificate of insurance issued by our authorized representative prior to the start date of the project. 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 0413 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. © Insurance Services Office, Inc., 2012 48889827 1 18-19 G/A/UMB/POLL/E&O 19-20 WC I Ashley Brewster 1 5/23/2019 2:45:20 PM (PDT) I Page 4 of 6 Page 1 of 1 G LP2006942-16 EEC Environmental COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy 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. CG 20 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 48889827 1 18-19 G/A/UMB/POLL/E&O 19-20 WC I Ashley Brewster 1 5/23/2019 2:45:20 PM (PDT) I Page 5 of 6 EEC Environmental 5/23/2019 dba Enviromental Engineering Contracting Inc., POLICY NUMBER: GLP2006942-16 COMMERCIAL GENERAL ILIABILITY CG 24 04 06 09 I"ITER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US IIS.*It*lolgrot&aollvlt:iqal:I*xol;i---ggl�fiumb*.NltfllI 1411-9 Aame Je-i Person Or Ornanization: Blanket where required by written contract or agreement. Such written contract or agreement must be in effed prior to the performance of your work which is the subject of such written contract or agreemenL The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Condftlons: We waive any right of recovery we may have against the person or organization shown In the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard", This waiver applies only to the person or organization shown in the Schedule above. 48889827 1 18-19 G/A/UMB/POLL/E&O 19-20 WC I Ashley Brewster 1 5/23/2019 2:45:20 PM (PDT) I Page 6 of 6