Insurance - Discovery Science Center 2019-07-02DISCOSCI
1
A 'p® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
7/2/2019
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).
PRODUCER CONTACT Norah.Jacobo
Commercial Lines - 213-253-6700 PHONE FAX
USI Insurance Services LLC - CA Lic#: OD08408 MA"� Ext): AIC No
777 South Figueora St, Ste 2100
ADDRESS: Norah.Jacobo@usi.com
INSURERS) AFFORDING COVERAGE NAIC #
Los Angeles, CA 90017 INSURER A: Philadelphia Indemnity Insurance Company / 18058
INSURED
Discovery Science Center of Orange County INSURER B
dba Discovery Cube Orange County INSURER C
2500 N. Main Street INSURER D:
Santa Ana, CA 92705 INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER: 14405643 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 ADDL SUBR
LTR TYPE OF INSURANCE IN D POLICY NUMBER MM/DID�YY MM/LDCD/YYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY X PHPK2006438 EACH OCCURRENCE S 1,000,000
7/1/2019 7/1/2020
CLAIMS -MADE � OCCUR DAMAGE TO RENTED
PREMISES Ea occurrence $ 1,000,000
MED EXP (Any one person) $ 20,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY PRO- ❑
E]PRO-LOC
PRODUCTS -COMP/OP AGG $ 2,000,000
OTHER:
A AUTOMOBILE LIABILITY Sexual Abuse/Molestation $ Included
PHPK2006438 7/1/2019 7/1/2020 COMBINED SINGLE LIMIT $ 1,000,000
X ANY AUTO Ea accident
OWNED SCHEDULED BODILY INJURY (Per person) $
AUTOS ONLY AUTOS BODILY INJURY (Per accident) S
X HIRED X NON -OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY Per accident)$
UMBRELLA LIAR _ OCCUR EACH OCCURRENCE S
EXCESS LIAB CLAIMS -MADE AGGREGATE
S
DED 'RETENTION $ $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N STATUTE EERH
ANYP ROPRI ETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?❑
( un
If yes, describe under N / A E.L. EACH ACCIDENT $
Mandatory in E.L. DISEASE - EA EMPLOYEE S
I
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / 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.
CERTIFICATE H01_nFR DiVA-irn-&.___ .,.........._._..
Costa Mesa Sanitary District SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
290 Paularino Ave JUL `0 8 2019 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Costa Mesa, CA 92626
ACCORDANCE WITH THE POLICY PROVISIONS.
Costa A4esa Sanitary .District AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD @ 1988-2015 ACORD CORPORATION. All rights reserved.
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POLICY NUMBER: PHPK2006438
COMMERCIAL GENERAL LIABILITY
CG 20 26 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
• • •
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.
I 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:
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 is added to
Section 111 — 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.
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' CYB01 A03/000538/03/05/0/0/0/0'
Policy # PHPK2006438
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 CERTIFICATF Nni nFRc
All 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.
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 # PHPK2006438
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 111— 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.
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