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Insurance - Sancon - 1999-01-25 ACORD„ CERTIFICATE OF °LIABILITY INSURANCE, UAT1(25 01/25/99/99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CONFERS ONLY AND Eastman & Company Ins Brokers R.E C E I V E D HOLDER. TH SCERT FICATE DOES OTO CERTIFICATE AM ND, EXTEND OR 2550 N Hollywood Way Suite 201 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Burbank,CA 91505-1055 JAN 2 6 1999 COMPANIES AFFORDING COVERAGE 7} ) OMPANY I I II : tIO .11 C; T A Valley Forge Ins Co 1,_ INSURED COMPANY Sancon Engineering II,Inc. B Transportation Insurance c^ ,.• 5841 Engineer Drive COMPANY Huntington Beach,CA 92649 C Continental Casualty t . COMPANY 1 YS D CgVERAG�B 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 ®', POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MFFECTIY) DATE(MMIDD/VY) GENERAL LIABILITY 98)C01029147116 08/01/98 08/01/99 GENERAL AGGREGATE $ 2 000 000 © COMMERCIAL GENERAL LIABILITY PRODUCTS COMP/OP AGO $ 1 000 000 s ■ CLAIMS MADE X OCCUR PERSONAL&ADV INJURY $ 1 000 000 1.1 OWNER'S&CONTRACTOR'5 PROT EACH OCCURRENCE $ 1 ■ FIRE DAMAGE Any one lire) $ 50000 MED EXP(Any one person) $ 5 000 I AUTOMOBILE LIABILITY © ANY AUTO ■ ALL OWNED AUTOS III SCHEDULED AUTOS © HIRED AUTOS 98BUA1029144748 08/01/98 08/01/99 COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY $ Porn) BODILY INJURY $ EllNON-OWNED AUTOS (Pe aside I) PROPERTY DAMAGE $ AUTO ONLY EA ACCIDENT $ ■ OTHER THAN AUTO ONLY IIIIIIIIIIIIII EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY r iY © EACH OCCURRENCE $ 4000000 UMBRELLA FORM 98CUP1036526482 08/01/98 08/01/99 AGGREGATE $ 4000 000 OTHER THAN UMBRELLA FORM $ I WORKERS COMPENSATOR AND ©TORY (MIT- ■ - EMPLOYERS'LIABILITY WC155939922 I0/01/98 10/01/99 EL EACH ACCIDENT $ 1 000 000 THE PROPRIETOR/ I. EL DISEASE POLICY LIMIT $ 1 000 000 PARTNERS/EXECUTIVE OFFICERS ARE. © E%CL EL DISEASE EA EMPLOYEE $ 1 000 000 DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS Costa Mesa Sanitary District is named Additional Insured as respects to General Liability.Fax#714-432 1436 cERTFICATI'Haan." CANCELLATION Ten Day Notke tur Non.PaymeM OPrenliL@n. .. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Costa Mesa Sanitary District EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ®BA2On(fD MAIL Attn: Dawn 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 77 Fair Drive IIlVexz>BEVYDaMlmSIIEN NnTY®caIIIII flDOxammLIIIDx®cx XIMMIN Costa Mesa,CA 92626-6520 D EXX LNVX X&NIXXRDDYXTHEXXX1111RAIIY(XX 0:XXSI nl9:CERXIIEPiEffiIIWlIEEI' UTHO;IZED REPRESENTATIVE ACOft[?2§S j1i95j A; :"9 AGORD t1RP0RATIDN'1988 CNA c <' G-17957-c Sancon Engineering II Inc (Ed 04/97) 98)001029147116 08-01-98/99 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. WHO IS AN INSURED (Section 11) is amended to a. `Bodily injury or property damage occurring include as an insured any person or organization after (called additional insured) whom you are required to add as an additional insured on this policy under (1) All work on the project (other than service maintenance or repairs) to be performed by 1 A written contract or agreement; or or on behalf of the additional insured at the 2. An oral contract or agreement where a site of the covered operations has been certificate of insurance showing that person or completed; or organization as an additional insured has been (2) That portion of'your work out of which the= issued; but injury or damage arises has been put to its the written or oral contract or agreement must f intended use by any person or organization other than another contractor or 1 Currently in effect or becoming effective during subcontractor engaged in performing the term of this policy- and operations for a principal as part of the 2. Executed prior to the 'bodily injury' 'property same project_ damage personal injury or 'adveitising 5. 'Bodily injury' or-property damage'arising out of injury' acts or omissions of the additional Insured other than in connection with the general B. The insurance provided to the additional insured is supervision of'your work" limited as follows: 4. The insurance provided to the additzonal insured 1. That person or organization is_ .only ..an 'oes not apply to `bodily injury' `property damage additional insured with respect to liaility ansing personal injury' or adverting injury' arising out out of: of an architect's, engineer's,or surveyor's rendering a. Your premises; of or failure to render any professional services including: b. `Your work for that additional insured; or a. The preparing, approving, or failing to prepare c. Ads or omissions of the additional insured or approve maps, drawings, opinions. reports, in connection with the general supervision surveys, change orders, design or of yourwcric specifications; and 2. The Limits of Insurance applicable to the b. Supervisory inspection, or engineering additional insure-' are those specified in the services. written contract or agreement or in the Declarations for this pc cy whichever is le 5. Any coverage provided under this endorsement to These Limits of Insurance are inclusive and not an additional insured shall be excess over any n addition to the Limits of tesurance shown .n other valid arid collectible insurance available to he Declarations. the additional insured whether primary, excess. contingent c, .,❑ any other oasis unless a contract 3 Except when required by contract or agreement, specifically requires that this insurance be primary the coverage provided to the additional insured by this endorsement does not apply to: on..otnf1