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Insurance - American Integrated Services, Inc. 2019-08-23A'C"R& CERTIFICATE OF LIABILITY INSURANCE llkl --' 12/27/2019 DATE(MM/DDNYYY) 8/23/2019 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(les) 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 Lockton Insurance Brokers, LLC 777 S. Figueroa Street, 52nd FI. CA License #OF15767 Los Angeles CA 90017 (213) 689-0065 CONTACT 00i I FAX ac No, Ext): A/c No): E-MAIL LIMITS INSURER A: Starr Surplus Lines Insurance Com an 13604 INSURED American Integrated Services, Inc. 1319084 1502 E. Opp Street Wilmington CA 907443927 INSURER B: Starr Indemnity & Lability Company 38318 INSURER C: Hartford Fire Insurance Com an 19682 JNSURER D: 12/27/2018 INSURER F; rrnvcoAr_Cc Ann a 1lnu►�% r%Cn'r,clrrA rC sit nA0C0- 1 ccoAnAn nr1n01nu .n nAn=n. 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 ADDL SUER POLICY NUMBER POLICY EFF MM/DD POLICY EXPIm (MMIDD/YYM LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE -1 OCCUR Poll./Prof. Liab. X Ded: $10.000 Y N 1000066049181 12/27/2018 12/27/2019 EACH OCCURRENCE 1,000, 000 E TO RENTED n 1,000,000 DAMAPREMGE ES (Ea o MED EXP An one person)5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: NX POLICY RCOT- � LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ $ AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X AIT OS ONLY X NON-OWNED ONLY X Comp/Coll D : $ K Y N SISIPCA08222818 12/27/2018 12/27/2019 COMBINED SINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $����� BODILY INJURY (Per accident $ X)CXy�XX (PROPERTY DAMAGE er accident) $ XXX)CKXX $ XXXX= A UMBRELLA LwB X EXCESS LIAR X IOCCUR CLAIMS -MADE N N 1000336805181 12/27/2018 12/27/2019 EACH OCCURRENCE $ 20,000,000 AGGREGATE $.20,000,000 X DED I I RETENTION $ Deductible $ 0 B WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y/N ANY PROPRIET ER EXRRTNER/ �C�I� Y� OFF(Mandatory in NH) be under DESCRIPTION OF OPERATIONS below N / A N WC 100 0002942 02 9/1/2019 9/1/2020_ X 7-PERTUTE ER E.L. EACH ACCIDENT 1,000,000 E -L DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT Is 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Contractor's Pollution and Professional Liability is included in the GL policy: $1 MM Ea Occ, $2MM Agg, with $10,000 Ded. RE: All Operations. The Costa Mesa Sanitary District, its elected and appointed officials, agents, officers, volunteers and employees are Additional Insured(s) as per the attached endorsement or policy language. Insurance provided to Additional lnsured(s) is primary and non-contributory as per the attached endorsements or policy language. RECEIVED CERTIFICATE HOLDER u t1 V LU IJ CANCELLATION See Attachments Costa Mesa Sanitary District 15596464 -�6C�Vill Costa Mesa Sanitary District 290 Paularino Avenue Costa Mesa CA 92626 ACORD 25 (2016103) 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 ©1 The ACORD name and logo are registered marks of ACORD TION. All rights reserved POLICY NUMBER: 1000066049181 COMMERCIAL GENERAL LIABILITY CG 2012 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State or Political Subdivision: 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 2. This insurance does not apply to: additional insured any state or governmental agency= or subdivision or political subdivision shown in the Schedule, a. "Bodily injury", "property damage" or "personal and subject to the following provisions: advertising injury" arising out of operations performed for the federal government, state or municipality; or 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or b. "Bodily injury" or "property damage" included within the governmental agency or subdivision or political subdivision has "products -completed operations hazard". issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. 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 2012 0413 Attachment Code: D517373 Certificate ID : 15596464 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 Page 1 of 1 Attachment Code: D501438 Certificate ID : 15596464 Starr Surplus Lines Insurance Company Chicago, IL 1-646-227-6300 Primary and Non-contributory Condition Policy Number: 1000066049181 Effective Date: 12/27/2018 Named Insured: American Integrated Services, Inc.; AIS-TN&A; Azetca LB1, Inc.; Azetca LB2, Inc. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Form A. SECTION IV - CONDITIONS, condition 4. Other Insurance is amended as follows: 1. The following is added to paragraph 4.a. of the Other Insurance condition: This insurance is primary insurance as respects our coverage to the additional insured, where the written contract or written agreement requires that this insurance be primary and non-contributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured is a Named Insured. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. SL - 707 (04/11) Page 1 of 1 Copyright © C. V. Starr & Company and Starr Surplus Lines Insurance Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. Starr Indemnity & Liability Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy Number: SISIPCA08222818 Effective Date: 12/27/2018 Named Insured: American Integrated Services, Inc.; AIS-TN&A; Azetca 1-131, Inc.; Azetca 1-132, Inc. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This policy is amended as follows: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATION LIABILITY ARISING OUT OF THE USE OF A COVERED "AUTO" SECTION II - LIABILITY COVERAGE A. Coverage, 1. Who is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of - (1) f (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. SICA 1016 (02/12) Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Page 1 of 1 Includes copyrighted material of ISO Properties, Inc., used with its permission. Attachment Code: D472048 Certificate ID : 15596464 Starr Indemnity & Liability Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS Policy Number: SISIPCA08222818 Effective Date: 12/27/2018 Named Insured: American Integrated Services, Inc.; AIS-TN&A; Azetca 1-131, Inc.; Azetca 1-132, Inc. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This policy is amended as follows: BUSINESS AUTO COVERAGE FORM Section IV - Business Auto Conditions, B., General Conditions, 5., Other Insurance, c., is amended by the addition of the following sentence: The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional insured where so required under an agreement executed prior to the date of accident. We will not ask any insurer that has issued other insurance to such additional insured to contribute to the settlement of loss arising out of such accident. All other terms and conditions remain unchanged. SICA 1017 (02/12) Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Page 1 of 1 Includes copyrighted material of ISO Properties, Inc., used with its permission. Attachment Code: D507015 Certificate ID : 15596464