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Insurance - Orkin, LLC - 2021-12-22"'yam Page 1 of 2 DATE (MM/DDNWY) CERTIFICATE OF LIABILITY INSURANCE 12/22/2021 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 CONTACT Willis Towers Watson Certificate Center NAME: Willis Towers Watson Southeast, Inc. -- --- - Five Concourse Corporate Center, 18th Floor tAlCNNo. Ext): 1-877-945-7378 _ q( AC, No 1-888-467-2378 Atlanta, GA 30328 A DRIESS: certificates@willis.com INSURED Orkin, LLC Orkin Services of California, Inc. Orkin Pest Control / Orkin Commercial Services 2170 Piedmont Road Atlanta, GA 30324 INSURER(S) AFFORDING COVERAGE %_ NAIC # INSURER A: Old Republic Insurance Company 7- 24147 INSURER B : ACE Property & Casualty Insurance Compan� ' 20699 INSURER C : Indemnity Insurance Company of Nort Ameri 43575 INSURER D : ACE American Insurance Company 22667 INSURER E INSURER F : COVERAGES CFRTIFICATF NIIMRFR• W23285847 RFVISIr1N 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 ADDLSUBR TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER - - --- - - - - ------ POLICY EFF POLICY EXP MM/DD/YYYY MM/DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 3,000,000 - - CLAIMS -MADE X : OCCUR DAMAGPREMISES (Ea occurrences E TO RENTED ;S 3,000,000 A X ' Pesticide/Herbicide Coverage MED EXP (Any one person) S X Pest Control Professional Y MWZY 312034-22 01/01/2022 01/Ol/2023, PERSONAL& ADV INJURY S 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE y $ 3,000,000 POLICY:X PRO- X LOC - - - - -- JECT PRODUCTS - COMP/OP AGG S 3,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 3,000,000 _(Ea accident) X ANY AUTO BODILY INJURY (Per person) S A ^ X OWNED SCHEDULED Y MWTB 312033-22 01/01/2022 01/01/2023 BODILY INJURY (Per accident); S _ AUTOS ONLY __- AUTOS HIRED NON -OWNED X-� PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY der accidents__ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 5,000,000 EXCESS LIAB CLAIMS -MADE! XEU G27927683 007 O1/Ol/2022 01/01/2023 AGGREGATE $ 5,000,000 -$ -- - - DED X 1 RETENTION $ 50,000 WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY Y / N _STATUTE 1 ER C . ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? No ;N/A WLR C68909843 01/01/2022 01/01/2023 - - ---- ---- (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below -- -- Y -- -- E.L. DISEASE -POLICY LIMIT S 2,000,000 D ,Excess Workers Comp WCU C68929714 01/01/2022 01/01/2023'E.L. Each Accident $2,000,000 E.L. Disease -EA Emp $2,000,000 E.L. Disease- Pol Lim $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Branch# 45010 Branch Name: BDD PC DBA Hydrex of California Re: All operations. Division: Pacific. ('_FRTIFIC:ATF I-ICII nFR ('_AKIrP[ i ATInKI 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 Sanitary District AUTHORIZED REPRESENTATIVE 290 Paularino Avenue 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: 21979532 BATCH: 2349017 AGENCY CUSTOMER ID: LOC #: a�o,Rn ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Willis Towers Watson Southeast, Inc. Orkin, LLC Orkin Services of California, Inc. Orkin Pest Control / Orkin Commercial Services POLICY NUMBER See Page 1 2170 Piedmont Road Atlanta, GA 30324 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS ITHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, I FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Costa Mesa Sanitary District, their elected and appointed officials, agents, officers, volunteers and employees are included as Additional Insureds as respects to General Liability and Auto Liability, as required by written contract. 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. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 21979532 BATCH: 2349017 CERT: W23285847 Rollins, Inc. et al. Policy Term: 1/1/2022 to 1/1/2023 Workers' Compensation and Employers Liability Policy Addendum Covera a Policy Number Carrier WC Coveracie EL Limits Work Comp/EL WLR C68909843 Indemnity Insurance Company of North Statutory $2,000,000 Bodily Injury by Accident - America: Each Accident/$2,000,000 Each Employee covers states of Bodily Injury by Disease/$2,000,000 Policy AL,AR,AZ,CA,CO,CT,DC,DE,HI,IA,ID,IL, Limit Bodily Injury by Disease IN,KS,KY,LA,MD,ME,MI,MN,MO,MS,MT, NC,NE,NH,NJ,NM,NV,NY,OK,PA,SC,SD, TN,TX,UT,VA,VT,WV - This policy also provides Stop Gap coverage for ND, OH, WA, WY Work Comp/EL WLR C68929751 ACE American Insurance Company: Statutory $2,000,000 Bodily Injury by Accident - covers state of MA & OR Each Accident/$2,000,000 Each Employee Bodily Injury by Disease/$2,000,000 Policy Limit Bodily Injury by Disease Work Comp/EL SCF C68929799 ACE Fire Underwriters Insurance Statutory $2,000,000 Bodily Injury by Accident - Company: Each Accident/$2,000,000 Each Employee covers state of WI Bodily Injury by Disease/$2,000,000 Policy Limit Bodily Injury by Disease Excess Work WCU C68929714 ACE American Insurance Company: Statutory $2,000,000 Bodily Injury by Accident - Comp/EL coverage applies to the qualified self Each Accident/$2,000,000 Each Employee insured states of FL, GA & OH Bodily Injury by Disease/$2,000,000 Policy Limit Bodily Injury by Disease 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 I G27927683 007 01 /01 /2022 to 01 /01 /2023 01 /01 /2022 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 is the policy. subseauent to the nrenaratinn of 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 Workers' Compensation and Ern0overs' Liabilitv Policv Named Insured Endorsement Number ROLLINS, INC. 2170 PIEDMONT ROAD NE Policy Number ATLANTA GA 30324 Symbol:WLR Number:C68909843 Policy Period Effective Date of Endorsement 01-01-2022 TO 01-01-2023 01-01-2022 Issued By (Name of Insurance Company) INDEMNITY INS. CO. OF NORTH AMERICA 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. EARLIER NOTICE OF CANCELLATION AND NON -RENEWAL ENDORSEMENT Paragraphs A. and B. below apply to all States shown in item 3.A. of the Information Page except as indicated below. A. EARLIER NOTICE OF CANCELLATION For any statutorily permitted reason, other than nonpayment of premium, the minimum number of days required for notice of cancellation as provided in either the Cancellation Condition of the policy or as amended by any applicable state cancellation endorsement is increased to 90 days. If the state cancellation endorsement provides for more than the number of days notice of cancellation shown above, this provision does not apply. B. EARLIER NOTICE OF NON -RENEWAL If we decide not to renew this policy for any reason other than non payment of premium, the minimum number of days for notice of non -renewal as provided by any applicable state non -renewal endorsement is increased to 90 days. If the state non -renewal endorsement provides for more than the number of days notice of non -renewal shown above, this provision does not apply. State Exceptions ARIZONA Not applicable - Paragraph A NEW JERSEY Not applicable WISCONSIN Not applicable Authorized Agent CKE-10290 (3/01) Ptd. in U.S.A. WC 99 06 97 IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM SCHEDULE Name of Person(s) or Organization(s): All persons or organizations where required by written contract. With respect to COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured is changed with the addition of the following: Each person or organization shown in the Schedule for whom you are doing work is an "insured". But only for "bodily injury" or "property damage" that results from the ownership, maintenance or use of a covered "auto" by: 1. You; 2. an "employee" of yours; or 3. anyone who drives a covered "auto" with your permission or with the permission of one of your "employees". However, the insurance afforded to the person or organization shown in the Schedule shall not exceed the scope of coverage and/or limits of this policy. Not withstanding the foregoing sentence, in no event shall the insurance provided by this policy exceed the scope of coverage and/or limits required by the contract or agreement. PCA 001 10 13 MWTB 312033-22 Rollins, Inc. 01/01/2022 - 01/01/2023 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. PIL0291010 POLICY NUMBER: 111'Te312033 Rollins, Inc. POLICY PERIOD: oi;01 2022-01 01 2023 POLICY NUMBER: MWZY 312034-22 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 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 as required by written contract as required by written contract 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. CG20101219 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 312034-22 Rollins, Inc. 01/01/2022 - 01/01/2023 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 312034-22 Rollins, Inc. 01/01/2022 - 01/01/2023 POLICY NUMBER: MWZY 312034-22 COMMERCIAL GENERAL LIABILITY CG20371219 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 as required by written contract as required by written contract 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 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 MWZY 312034-22 Rollins, Inc. 01/01/2022 - 01/01/2023 POLICY NUMBER: MWZY 312034-22 PIL 029 10 10 POLICY PERIOD: 01/01/2022-01/01/2023 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. POLICY NUMBER: MWZY 312034-22 POLICY PERIOD: 01/01/2022-01/01/2023 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • • • •' •I MM 1A43 Ma I k, 601111 'k"T ' 0 to q 4 Me] 0 1 Q I 1 • This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek 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 (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 Rollins, Inc.