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Insurance - Municipal Maintenance Equipment - 2021-09-27CC U DATE (MM/DD/YYYY) ,/ CERTIFICATE OF GARAGE INSURANCE 09/27/2021 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 Sentry Insurance 1800 North Point Drive CONTACT Sentry Customer Service NAME: PHONE 800-473-6879 FAX 800-514-7191 A/C No Ext): A/C No): Stevens Pant, WI 54481 EMAIL ADDRESS: businessproducts_direct@senty.com INSURER(S) AFFORDING COVERA NAIC # INSURER A: Sentry Select Insurance Company 21180 A0163992001 INSURED INSURER 8: Municipal Maintenance Equipment Inc 4634 Mayhew Rd INSURER C INSURER D: Sacramento, CA 95827-9700 INSURER E: INSURER F: COVERAGES PROD/ CUSTOMER ID: CERTIFICATE #: 2020788 REVISION #: 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 INSRD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS '4 GARAGE LIABILITY HIRED AUTOS X ANY AUTO ONLY Ll NON -OWNED OWNED AUTOS USED AUTOS ONLY IN GARAGE BUSINESS A0163992001 12/15/2021 12/15/2022 AUTO ONLY (Ea accident) $ 500,000 OTHER THAN AUTO ONLY ACCIDENT $500,000 AGGREGATE $ 2,500,000 GARAGE KEEPERS LIABILITY X OTG P / LOC 1 $ 3,000,000 A LEGAL LIABILITY DIRECT BASIS A0163992001 12/15/2021 12/15/2022 SPECSIED LOC $ X COLLISION LOC 1 $ 3,000,000 PRIMARY EXCESS LOC $ X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 500,000 CLAIMS -MADE E OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 A X A0163992006 12/15/2021 12/15/2022 PERSONAL & ADV INJURY $ 500,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,500,000 X POLICYa PRO' JEGT [:]LOC PRODUCTS - COMP/OP AGG $ 1,500,000 OTHER $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 3,000,000 A X EXCESS LIAB CLAIMS -MADE A0163992007 12/15/2021 12/15/2022 AGGREGATE $ 9,000,000 DED RETENTION $ PRODUCTS - COMP/OP AGG$ 9,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY STATUTE ERTT H E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y / N N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) (—j If yes, describe under —J E.L. DISEASE - POLICY LIMIT $ REMARKS below REMARKS (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Refer to attached CERTIFICATE HOLDER CANCFLI_ATInN Costa Mesa Sanitary District 290 Paularino Ave Costa Mesa, CA 92626-3314 vf� ��7 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUT RIZ +��y IE_SENTA N/�" (/ OWT! ACORD 30 (2016/03) 's A0163992 Sentry Select Insurance Company 3 00003 0000000847 21270 N A 0 Page 1 of 2 O 2010-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 09/27/2021 3B9B96E5-21CC-4BFI-AFA1-A4812201DFOC 0027020044362462878992626331490 AC" 1161 - - AGENCY CUSTOMER ID: MOM3697 LOC #: ADDITIONAI RFMARKS SP.t4FDI11 F Page 2 of 2 AGENCY Brittany Beaumonte NAMED INSURED Municipal Maintenance Equipment Inc POLICY NUMBER A0163992001 CARRIER Sentry Select Insurance Company NAI C CODE 21180 EFFECTIVE DATE: 12/15/2021 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: AGORD 30 FORM TITLE: Certificate Of Garage Insurance General Liability COSTA MESA SANITARY DISTRICT, THEIR ELECTED AND APPOINTED OFFICIALS, AGENTS, OFFICERS, VOLUNTEERS, AND EMPLOYEES AS ADDITIONAL INSURED- PERSUANT TO ATTACHED ENDORSEMENT.ANY OTHER INSURANCE MAINTAINED BY THE COSTA MESA SANITARY DISTRICT SHALL BE EXCESS & NON-CONTRIBUTORING WITH THE INSURANCE PROVIDED BY THIS POLICY. UMBRELLA IS EXCESS OVER GENERAL LIABILITY AND AUTO LIABILITY POLICIES. Garagekeepers Liability Location # State Basis Collision Limit 2 CA Natural Disasters Legal $ 2,000,000 Liability 6 CA Natural Disasters Legal $ 1,250,000 Liability 7 NV Natural Disasters Legal $ 60,000 Liability 8 CA Natural Disasters Legal $ 1,250,000 Liability ACORD 101 (2008/01) A0163992 Sentry Select Insurance Company Comp/OTC/Specified Perils Limit $ 2,000,000 $ 1,250,000 $ 60,000 $ 1,250,040 O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 09/27/2021 POLICY NUMBER: A0163992006 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 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) Location(s) Of Covered Operations Costa Mesa Sanitary District All Locations. Description: All Jobs. 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. CG 20 10 0413 A0163992 Sentry Select Insurance Company 5 00003 0000000847 21270 N A 0 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. 0 Insurance Services Office, Inc., 2012 9CCF643 F-3 FF2-4484-855 8-A25A52 E88605 0027020044362462812792626331490 Page 1 of 2 09/27/2021 C. With respect to the insurance afforded to these additional insureds, the following is added to Section 111 - 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. 0 Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 A0163992 09/27/2021 Sentry Select Insurance Company