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Insurance - Tecta America Southern California, Inc - 2020-03-23�..w.-' CERTIFICATE OF LIABILITY INSURANCE UA/ttMMlUU/TTTTI 3/23/2020 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(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 ' E this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). j ;PRODUCER HUB International Midwest Limited 1419 Opus Place, Suite 450 Downers Grove IL 60515ADDRESS: CONTACT NAME: PHONE -468-5600 FAX — _ (A/C. No): E-MAIL CSUConstruction@hubinternational.com -- INSURERS AFFORD G COVERAGE NAIC # i ' INSURER A : LM Insurance Corp :PRODUCTS -COMP/OP AGG ; $ 4,000.00ri INSURED—� TECTAME-01 i Tecta America Southern California, Inc. East Wakeham Avenue Santa Ana CA 92705 oe INSURER B: Liberty Mutual Fire Insurance Company__� 23035 a INSURER C: Navigators Specialty Insurance Cam 360_561217 INSURER D: American Guarantee & Liability Insurance Company 26247 INSURER E: Tokio Marine Specialty insurance Company -' 23850 i -- 3/3112020 3/31/2021 COMBINED SINGLE LIMIT i $ 2,000,000 INSURER F, X ANY AUTO UUVtKAcsts GEKTIFIGATE NUMBER: 611838336 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. TYPE OF INSURANCE B _XV COMMERCIAL GENERAL LIABILITY EB2-C41-435487-430 3/31/2020 1 3/31/2021 ;EACH OCCURRENCE $2,000,000 3/31/2020 I _ CLAIMS -MADE X OCCUR DAMAGE TO RENTED — PREMISES 00.000aoccurrencet. --� WA7-C4D-435487-400 (MA) MED EXP (Any one person) $10,000 —_ -- `—STATUTE _1 PERSONAL&ADV INJURY $2,OOQ000 ---- — - i -- _ __A i GEN" AGGREGATE LIMIT APPLIES PER. - GENERAL AGGREGATE $ 4,00O,OOC S E.L. EACH ACCIDENT I $ 12000,000 POLICY .-X JECOT- LOC :PRODUCTS -COMP/OP AGG ; $ 4,000.00ri - iMandato ' ( ry in NH ) �B AUTOMOBILE LIABILITY EU2-C41-435487420 3/3112020 3/31/2021 COMBINED SINGLE LIMIT i $ 2,000,000 i X ANY AUTO :BODILY INJURY (Per person) ! $ OWNED - 'T SCHEDULED ii _- AUTOS ONLY _ AUTOS BODILY INJURY (Per accident) i $ J X HIREDPROPERTY I X DAMAGE-- _7 --- - - $ - '-- _ I _ AUTOS ONLY ' AUTOS ONLY p asci i $ i C UMBRELLA LIAB X : OCCUR LA20EXCZ040521C 3131/2020 3/31/2021 ;EACH OCCURRENCE $13,000,000 - ' - ; AEC 9242436-08 3/31/2020 3/31/2021 --- --- X EXCESS LIAB CLAIMS-MADEAGGREGATE $13,000,000 DED RETENTION S c $ { A WORKERS COMPENSATIONWA5-C4D-435487-390 (AOS) 3/31/2020 3131/2021 X PER OTH- B :AND EMPLOYERS' LIABILITY YIN WA7-C4D-435487-400 (MA) 3/31/2020 3/31/2021 -- `—STATUTE _1 ANY?ROPRIETOR/PARTNERIEXECUTIVE N WCS C41-435487-410 (WI & MN) 3/31/2020 3/31/2021 S E.L. EACH ACCIDENT I $ 12000,000 OFFICER/MEMBEREXCLUDED? iMandato ' ( ry in NH ) s E.L.DISEASE -EAEMPLOYEE $1,000,000 1 — it yes. describe under DESCRIPTION OF OPERATIONS below ! — — __ E.L. DISEASE -POLICY LIMIT i $1,OOO,000 E ' Pollution & Professional Liab 13254866 ' 3/31/20203/31/2021 I Limit/Aggregate $5,000,000 I I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Roofing services provided under under agreement dated 1-25-18 for CMSD Headquarters, Costa Mesa Sanitary District, 290 Paularino Avenue, Costa Mesa, CA 92626. DISTRICT, its directors, officials, officers, employees, agents and volunteers with respect to the work performed by or on behalf of CONTRACTOR are Additional Insured(s) as per the attached endorsement or policy language. Insurance provided to Additional Insured(s) is primary and non-contributory as per the attached endorsements or policy language. Waiver of subrogation applies as per the attached endorsements or policy language. CERTIFICATE HOLDER CANCELLATION -'J ^ Costa Mesa Sanitary District �j LA 14 NV Attn: David Griffin Costa Mesa CA 92626 Amon 1r, 17A IFlnzt 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 4 4 fist ©1988-2015 ACORD CORPORATION. All rights reserved. Thn Action namo anri Inns are r4oniati►rs>r1 martrc %f Arnon Policy Number EB2-C41-435487-430 Issued by THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE AMENDMENT — SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Person or Organization: Any person or organization for whom you have agreed in a written contract or agreement prior to loss. If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person or organization shown in the Schedule of this endorsement that qualifies as an additional insured on this policy, this policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV - Conditions will not apply. If the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4. Other Insurance of Section IV - Conditions will govern. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same 'occurrence", claim or "suit". LC 24 20 02 13 O 2013 Liberty Mutual Insurance. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: EB2-C41-435487-430 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 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 Any person or organization for whom you have agreed in a written contract or agreement prior to loss. All locations where required by written contract or agreement. 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" 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 shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. t%tw- 7A 17 nA 41 0Ina+, trnnnn (lf-rinn Inn Onl > O.a ern 4 r s 4 POLICY NUMBER: EB2-C41-435487-430 COMMERCIAL GENERAL LIABILITY CG 20 10 0413 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 or organization for whom you have All locations where required by written contract or agreed in a written contract or agreement prior agreement. to loss. 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. 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. rr; In 4n nA V1 (rl Inn-jiranr.= Coneinoe lift- Inn 'X117 Dann 4 of 1 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 shown in the Declarations; whichever is less. This endorsement applicable Limits of Declarations. shall not increase the Insurance shown in the D-Irrn'9 nf') n Inc, or -no— Canrinoc nfFinn Inn ')n40 l`l2 9n In nA 44 POLICY NUMBER: EB2-C41-435487-430 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Where required by written contract or agreement prior to loss. Information required to complete this Schedule. if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: 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. �T 7A AA nC nA nF Mn++.nnnn Cnniii+nc+ nfFinn 1"^ 'nnsi Dn..e% 4 .%f 4 i1