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Insurance - California Barricade Rentals Inc. 2021-06-16ACORN' CERTIFICATE OF LIABILITY INSURANCE DATE (M 06/16//202202YYY) 1 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 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 Phone: (714) 973-1436 Fax: (714) 973-0811 ECC - t- ELMCO INSURANCE, INC. 1905 N. MAIN STREET SANTA ANA CA 92706-2779 JUN 2 8 2021 CONTACT ELMCO INSURANCE, INC. PHONEFAx 714 973-0811 o Ext): (714) 973-1436 A/c No)7 ( ) A/c No, E-MAIL contact@Elmcoinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # X Agency Lic#: 0509747 INSURER SCOTTSDALE INSURANCE COMPANY 41297 INSURED�osta Mesit Ssanitar�; ;)istrici CALIFORNIA BARRICADE RENTALS IN INSURER INFINITY SELECT INSURANCE COMPANY 20260 1550 E. SAINT GERTRUDE PLACE INSURER c TRISURA SPECIALTY INSURANCE COMPANY 16188 SANTA ANA CA 92705 INSURER D: STATE COMPENSATION INSURANCE FUND 5076 INSURER E : WESTCHESTER SURPLUS LINES INSURANCEZ0 10172 INSURER F HISCOX INSURANCE COMPANY INC 10200 COVERAGES CERTIFICATE NUMBER: 68230 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X BCS0039359 07/01/21 07/01/22 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED $ 1 OO,000 PREMISES (Ea occurence) MED. EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: EMPLOYEE BENEFITS $ 1,000,000 B AUTOMOBILE LIABILITY 504-61015-8309-001 06/20/21 06/20/22 COMBINED SINGLE LIMIT (Ea1,000,000 000 000 (Ea accident) $ , r X ANY AUTO BODILY INJURY (Per person) $ X ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (per accident) $ C UMBRELLA LIAR X OCCUR TXS0001452-02 07/01/21 07/01/22 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAR I CLAIMS -MADE AGGREGATE $ 5,000,000 DED I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) � N / A 9063608-21 07/01/21 07/01/22 XSTATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under D DESCRIPTION OF OPERATIONS below E POLLUTION LIABILITY G73540124001 07/01/21 07/01/22 Each Pollution Condition $1,000,000 F PROFESSIONAL LIABILITY MPL1863490.21 07/01/21 07/01/22 Each Claim $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: As Per Contract or Agreement on File with Insured. The Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers, and employees are included as an additional insured (primary and non-contributory) includes completed operations on General Liability policy per the attached endorsements (to follow), if required. CERTIFICATE HOLDER CANCELLATION Costa Mesa Sanitary District 290 Paularino Avenue Costa Mesa, CA 92626 Attention: 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 ACORD 25 (2014/01) U 19BU-2014 AGORD GORPORATION. All rights rese The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BCS0039359 COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 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 ALL LOCATIONS WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT, EXECUTED PRIOR TO THE OCCURRENCE TO WHICH THIS INSURANCE APPLIES, THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY. 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. CG 20 37 12 19 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. © Insurance Services Office, Inc., 2018 Insured Copy Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 Insured Copy