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Insurance - B.D.D. Pest Control, Inc. - 12-20-2019Page 1 of 2 Ac"R "� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/20/2019 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 Willis Insurance Services of Georgia, Inc. Five Concourse Corporate Center, 18th Floor Atlanta, GA 30328 CONTACT Willis Towers Watson Certificate Center NAME: PHONE 1-877-945-7378 FAX 1-888-467-2378 A/C No Ext): A!C No E-MAIL certificates@willis.com ADDRESS: i INSURER(S) AFFORDING COVERAGE NAIC # MWZY 312034-20 O1/Ol/2020'Ol/Ol/2021 2,000,000 PERSONAL & ADV INJURY $ INSURERA: Old Republic Insurance Company 24147 INSURED B.D.D. Pest Control, Inc. 3073 Long Beach Blvd. INSURER B : ACE Property & Casualty Insurance Company 20699 INSURER C : New Hampshire Insurance Company/,23841 INSURER D : National Union Fire Insurance Company of P' 19445 Long Beach, CA 90807 USA INSURER E: OTHER: INSURER F: AUTOMOBILE LIABILITY COVERAGES CERTIFICATE NUMBER: W14837819 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 j ADDL;SUBR LTR I TYPE OF INSURANCE IN POLICY EFF i POLICY EXP POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X '', COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 j CLAIMS -MADE X j OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 2,000,000 A i X :Pesticide/Herbicide CoverageMED EXP (Any one person) $ 10, 000 X 'Pest Control Professional Y MWZY 312034-20 O1/Ol/2020'Ol/Ol/2021 2,000,000 PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ 2 , 000 , 000 PRO - POLICY X ' JECT I X LOC ;PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ' $ 3,000,000 (Ea accident)_ X i ANY AUTO _ BODILY INJURY (Per person) $ AXOWNED :SCHEDULED Y AUTOS ONLY AUTOS MWTB 312033-20 101/01/2020101/01/2021i BODILY INJURY (Per accident); $ HIRED NON -OWNED X X PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) j 1$ X j UMBRELLA LIAB X B Fa OCCUR j EACH OCCURRENCE $ 5,000,000 EXCESS LIAB 1 , � CLAIMS -MADE; XEU G27927683 005 01/01/2020101/01/2021 � I AGGREGATE $ 5,000,000 X 50,000 DEDif RETENTION $ $ WORKERS COMPENSATIONPER X OTH- ! ' AND EMPLOYERS' LIABILITY Y / N ! STATUTE ER _ C ' ANYPROPRIETOR/PARTNER/EXECUTIVEE.L. EACH ACCIDENT + $ 2 , 000 , 000 OFFICER/MEMBER EXCLUDED? iNo jN/A'! WC 020608757 01/01/2020101/01/2021i (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below 1 E.L. DISEASE - POLICY LIMIT $ 2,000,000 D 'Excess Workers Comp j XWC 6559344 101/01/2020101/01/2021 E.L. Each Accident $2,000,000 E.L. Disease -EA Emp 1$2,000,000 jE.L. Disease- Pol Lix $2,000,000 DESCRIPTION OF OPERATIONS ! LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All operations Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers, and employees are included as Additional Insureds as respects to General Liability, Auto Liability, but solely in regards to work being performed by or on behalf of the Named Insured as required by written contract. CERTIFICATE HOLDER CANCELLATION ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 18999851 BATCH: 1502382 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Costa Mesa Sanitary District Attn: Dyana Bojarski 1i� ,i a ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 290 Paularino Ave. Costa Mesa, CA 92626 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 18999851 BATCH: 1502382 AGENCY CUSTOMER ID: LOC #: ACC>R " ADDITIONAL REMARKS SCHEDULE Imo__.. Page 2 of 2 AGENCY NAMED INSURED Willis Insurance Services of Georgia, Inc. B.D.D. Pest Control, Inc. 3073 Long Beach Blvd. Long Beach, CA 90807 USA POLICY NUMBER See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance General Liability policy shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Additional Insureds, as required by written Contract. B.D.D. Pest Control Inc. dba Hydrex Pest Control Company of California, 3073 Long Beach Blvd., Long Beach, CA 90807. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 18999851 BATCH: 1502382 CERT: W14837819 Rollins, Inc. Policy Term: 1/1/2020 to 1/1/2021 Workers' Compensation and Employers Liability Policies Coverage Policy Number Carrier Work Comp/EL WC 020608757 New Hampshire Ins. Co. - covers states of AL,AR, CO, CT, DC, DE, H I, IA, I D, I N, KS, LA, M D,ME,MI,MN,MO,MS,MT,NE,NH,NM,NV,N Y,OK,OR,RI,SC,SD,TN,TX,WV Work Comp/EL WC 020608754 American Home Assurance Company - covers state of CA Work Comp/EL WC 020608755 New Hampshire Ins. Co. - covers states of MA and WI - This policy also provides Stop Gap coverage for WA, WY Work Comp/EL WC 020608756 New Hampshire Ins. Co. - covers state of AZ, I L, KY, N C, N J, PA, UT, VA, VT Excess Work XWC 6559344 National Union Fire Insurance Company of Comp/EL Pittsburgh, PA and coverage applies to the qualified self insured states: GA & OH Excess Work XWC 6559345 National Union Fire Insurance Company of Comp/EL Pittsburgh, PA and coverage applies to the qualifed self insured state of FL WC Coverage EL Limits Statutory $2,000,000 Bodily Injury by Accident - Each Accident/$2,000,000 Each Employee Bodily Injury by Disease/$2,000,000 Policy Limit Bodily Injury by Disease Statutory $2,000,000 Bodily Injury by Accident - Each Accident/$2,000,000 Each Employee Bodily Injury by Disease/$2,000,000 Policy Limit Bodily Injury by Disease Statutory $2,000,000 Bodily Injury by Accident - Each Accident/$2,000,000 Each Employee Bodily Injury by Disease/$2,000,000 Policy Limit Bodily Injury by Disease Statutory $2,000,000 Bodily Injury by Accident - Each Accident/$2,000,000 Each Employee Bodily Injury by Disease/$2,000,000 Policy Limit Bodily Injury by Disease Statutory $2,000,000 Bodily Injury by Accident - Each Accident/$2,000,000 Each Employee Bodily Injury by Disease/$2,000,000 Policy Limit Bodily Injury by Disease Statutory $2,000,000 Bodily Injury by Accident - Each Accident/$2,000,000 Each Employee Bodily Injury by Disease/$2,000,000 Policy Limit Bodily Injury by Disease POLICY NUMBER: MWZY 312034-20 COMMERCIAL GENERAL LIABILITY CG 20 10 1219 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 R14:1[49111111114 Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations 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: 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 12 19 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., 2018 Page 1 of 2 MWZY 312034-20 Rollins, Inc. 01/01/2020 - 01/01/2021 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 of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 10 12 19 MWZY 312034-20 Rollins, Inc. 01/01/2020 - 01/01/2021 POLICY NUMBER: MVVZY 312034-20 COMMERCIAL GENERAL LIABILITY CG 20 37 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS 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 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. 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 37 1219 © Insurance Services Office, Inc., 2018 Page 1 of 1 MWZY 312034-20 Rollins, Inc. 01/01/2020 - 01/01/2021 POLICY NUMBER: MWZY 312034-20 PIL 029 10 10 POLICY PERIOD: 01/01/2020-01/01/2021 IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS This endorsement modifies the notice of cancellation of insurance provided hereunder by adding the following: A. In the event this policy is cancelled for any permissible reason, other than for nonpayment of premium, we shall endeavor to provide advance written notice of cancellation to certificate holders set out in the schedule on file with the Company, after notifying the first Named Insured of such cancellation. Notice of cancellation to certificate holders may be made by any commercially reasonable means, including mail, electronic mail, facsimile transmission or courier service. B. This advance written notification of a cancellation of coverage is intended as a courtesy only. Our failure to provide such advance written notification will not extend the policy cancellation date, nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. Rollins, Inc. IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS This endorsement modifies the notice of cancellation of insurance provided hereunder by adding the following: A. In the event this policy is cancelled for any permissible reason, other than for nonpayment of premium, we shall endeavor to provide advance written notice of cancellation to certificate holders set out in the schedule on file with the Company, after notifying the first Named Insured of such cancellation. Notice of cancellation to certificate holders may be made by any commercially reasonable means, including mail, electronic mail, facsimile transmission or courier service. B. This advance written notification of a cancellation of coverage is intended as a courtesy only. Our failure to provide such advance written notification will not extend the policy cancellation date, nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. PIL 029 10 10 POLICY NUMBER: MwTs 312033-20 Rollins, Inc. POLICY PERIOD: 01/01/2020-01/01/2021 NOTICE TO OTHERS ENDORSEMENT — SCHEDULE NOTICE BY INSURED'S REPRESENTATIVE Named Insured Endorsement Number Rollins, Inc. Policy Symbol Policy Number Policy Period Effective Date of Endorsement XEU G27927683 005 01/01/2020 to 01/0112021 01/01/2020 Issued By (Name of Insurance Company) ACE Property and Casualty Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A. If we cancel the Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium, we will endeavor, as set out in this endorsement, to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the "Schedule") by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. B. The notice referenced in this endorsement as provided by your representative is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use. D. We will only be responsible for sending such notice to your representative, and your representative will in turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. E. This endorsement does not apply in the event that you cancel the Policy. All other terms and conditions of the Policy remain unchanged. Authorized Representative ALL -32686 (01/11) Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ENDORSEMENT This endorsement, effective 12:01 AM forms a part of Policy No. 20608754 Issued To Rollins, Inc. By New Hampshire Insurance Company LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL TO ENTITIES OTHER THAN THE NAMED INSURED (WORKERS' COMPENSATION ONLY) This policy is amended as follows: In the event that the Insurer cancels this policy for any reason other than non-payment of premium, and 1. the cancellation effective date is prior to this policy's expiration date; 2. the Named Insured or, if applicable, any other employers named in Item 1 of the Information Page is under an existing contractual obligation to notify a certificate holder when this policy is canceled (hereinafter, the "Certificate Holder(s)") and the Named Insured has provided to the Insurer, either directly or through its broker of record, the email address of a contact at each such entity; and 3. the Insurer received this information after the Named Insured receives notice of cancellation of this policy and prior to this policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the Insurer, the Insurer will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within 30 days after the Named Insured provides such information to the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the Named Insured provides such information to the Insurer. Proof of the Insurer emailing the Advice, using the information provided by the Named Insured, will serve as proof that the Insurer has fully satisfied its obligations under this endorsement. This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy. The following definitions apply to this endorsement: 1. Named Insured means the first named employer in Item 1 of the Information Page of this policy. 2. Insurer means the insurance company shown in the header on the Information Page of this policy. All other terms, conditions and exclusions shall remain the same. AUTHORIZED REPRESENTATIVE WC990056 (4/11)