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Insurance - Pacific Data Electric Inc. - 01-15-2020Aca CERTIFICATE OF LIABILITY INSURANCE DATE(MMtDD/YYYY) �... 1/15/2020 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). PRooucERAdamson & McGoldrick Insurance Solutions NAME T Brigid Lopez 1150 E. Orangethor e Ave., Suite 100 PHONE 714-257-9644 FAC No : 714-257-9833 Placentia, CA 9287 E-MAIL ADDRESS: blo ez adamsonmc oldrick.com www.snains.com �ff t1TV1 T_'\-1 INSURED Pacific Data Electric, Inc. dba: PDE Total Energy Solutions JAN 12020 231 Benton Court City of Industry CA 91789 CnVFRAr.FS r.FRTIFIr:ATF NIIMRFR• wza,xizvza INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Property Casualty Co of Amer 25674 INSURER B: St. Paul Surplus Lines Insurance Company 30481 INSURER C : INSURER D: INSURER E: INSURER F: R1=VISI0N NIIMRFR• 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 SUBR I POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A ✓ COMMERCIAL GENERAL LIABILITY ✓ VTCT2J-CO-9322BO94-TIL-19 7/1/2019 7/1/2020 EACH OCCURRENCE $1000,000 CLAIMS -MADE ✓ OCCUR OC&P & XCU INCLUDE _ DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $5,000 ✓ Blanket Cont. L ✓ BFPD; Cross Liab PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY FVI JEC LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ ✓ OTHER: $50,000 deductible A AUTOMOBILE LIABILITY VTJ-CAP-9322B125-TIL-19 7/1/2019 7/1/2020 COM (Ea accdentSINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ ✓ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ accident ✓ HIRED NON -OWNED AUTOS ONLY Iv AUTOS ONLYPer $ Deductible = 0 A ✓ UMBRELLA LIAB �/ OCCUR CUP -8N498906-19-25 7/1/2019 7/1/2020 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5 1 OOO 000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? .. N/A UB -1N229746 -19-25-K 7/1/2019 7/1/2020PER �/ EOH T E STATUTE R — - -- - EACH ACCIDENT $ 1,000,000 - (Mandatory in NH) If as, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE $1.000.000 E.L. DISEASE - POLICY LIMIT $1,000,000 A Leased or Rented Equipment QT6302G406387TIL 7/1/2019 7/1/2020 $250,000 per item / Ded = $5,000 B Professional Liability ZCD-71N23281 1/21/2020 1/21/2021 $5,000,000 Per Claim / $150,000 ded. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) GL Blanket Additional Insured applies per attached, only if required by written contract/agreement. Job: Operations of the Named Insured. Additional Insured(s): Costa Mesa Sanitary District and its officers, agents and employees. �i�3d�13ta�r �3Ri71<IT�: �\�Ti� 31f\i C�7. Operations of the Named Insured Costa Mesa Sanitary District � 290 Paularino Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Costa Mesa CA 92626 AUTHORIZED REPRESENTATIVE Brian McGoldrick U 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 53623336 1 MORRO-1 1 19/20 Pacific Data Electric (PDE) *20/21 PL* I Brigid Lopez 1 1/15/2020 10:35:11 AM (PST) I Page 1 of 3 This certificate cancels and supersedes ALL previously issued certificates. Pacific Data Electric, Inc. VTCT2J-C0-9322B094-TIL-19 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities. CG D2 46 08 05 c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: © 2005 The St. Paul Travelers Companies, Inc. 53623336 ( MORRO-1 1 19/20 Pacific Data Electric (PDE) *20/21 PL* I Brigid Lopez 1 1/15/2020 10:35:11 AM (PST) I Page 2 of 3 This certificate cancels and supersedes ALL previously issued certificates. Page 1 of 2 COMMERCIAL GENERAL LIABILITY L How, when and where the "occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: i. Immediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit' to Page 2 of 2 any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. © 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 53623336 1 MORRO-1 ( 19/20 Pacific Data Electric (PDE) *20/21 PL* Brigid Lopez 1/15/2020 10:35:11 AM (PST) ( Page 3 of 3 This certificate cancels and supersedes ALL previously issued certificates.