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Insurance - Technology - 2010-06-17 EXHIBIT A r AC RO o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMND/YYyY) L---" 6/1712010 PRODUCER Garrett/Mosier/Griffith/Sistrunk Ins. Services THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 12 Truman ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Irvine, CA 92620 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. OB84519 949 559-6700 www.garrett-mosier corn 949,559-6703 INSURERS AFFORDING COVERAGE NAIC C /\ INSURED Technology Resource Center, Inc. INSURER A Scottsdale Insurance Co. f (/ S Jt 2101 E. 4th Street, Suite 130A INSURER B. Peerless Insurance Company I` /9841/NE- Santa Ana CA 92705 INSURER C Ace Property&Casualty Company j9F INSURER D I INSURERE _ COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION ITR INRYD TYPE OF INSURANCE POLICY NUMBER DATEIMMATD/YYYYI DATE MIDDIYYYYI LIMITS A GENERAL LIABILITY BC50021694 3/20/2010 3/20/2011 EACH OCCURRENCE 3 1,000,000 I COMMERCIAL GENERAL LIABILITY PREMIES aoc 0 DAAGET(EEN nce) S 50,000 CLAIMS MADE I OCCUR MEDEXP(Any one person) 3 0 I Contractual PERSONAL 8ADV INJURY $ 1,000,000 Liab.lncluded GENERAL AGGREGATE $ 2,000,000 GENT_AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY ni JFCT n LOC B AUTOMOBILE LIABILITY BA8751889 3/20/2010 3/20/2011 COMBINED SINGLE LIMIT I ANY AUTO (Eaaoade I) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per Person) ✓ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Pe accident) PROPERTY DAMAGE $ (Pe accident) GARAGEUASIUTY AUTO ONLY EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE _ $ I OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ c WORKERS COMPENSATION C45843907 10/1/2009 10/1/2010 t/ I W'CSTATU- OTH- AND EMPLOYERS'UABILRY Y/N TORYL R _ R MY PROPRIETORNARTNERIEXECUTNE E L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E L.DISEASE-EA EMPLOYEE $ 1,000,000 N yyea,desal%e under SPECIALPROVISIONSbelaw EL-DISEASE POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS All operations of the named insured subject to the terms and conditions of the policies. Costa Mesa Sanitary District its officers,agents,officials,employees and volunteers are added as Additional Insured,per CG20 33 07/04, as required by written contract with respect to work performed for them by Technology Resource Center Inc.under General Liability coverage. CERTIFICATE HOLDER CANCELLATION All Operations SHOULD ANY OE THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEEXPIRATION Costa Mesa Sanitary District DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Attn: Thomas Fauth NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 628 W 19th Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Costa Mesa CA 92627 REPRESENTATIVES. 10 Days for No -Payment of Premium. AUTHORIZED REPRESENTATIVE Grill Griffith 66 ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. NO Phylli 6/17/101 age of IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer and the certificate holder nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25(2009/01) Phylls she 6/17/2 age Technology Resource Center Inc. Policy No. BCS0021694 COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or or- additional insureds, the following additional exclu- ganization for whom you are performing opera- sions apply Lions when you and such person or organization This insurance does not apply to: have agreed in writing in a contract or agreement that such person or organization be added as an 1. 'Bodily injury' 'property damage' or 'personal additional insured on your policy. Such person or and advertising injury' arising out of the ren- organization is an additional insured only with re- Bering of, or the failure to render any profes- spect to liability for 'bodily injury' 'property dam- sional architectural, engineering or surveying age' or 'personal and advertising injury' caused, services, including: in whole or in part, by- a. The preparing, approving, or failing to pre- 1 Your acts or omissions; or pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, 2. The acts or omissions of those acting on your change orders or drawings and specifics- behalf; lions;or in the performance of your ongoing operations for b. Supervisory inspection, architectural or the additional insured. engineering activities. A person's or organization's status as an addi- 2. 'Bodily injury' or 'property damage' occurring tional insured under this endorsement ends when after your operations for that additional insured are completed. a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(s) at the location of the covered operations has been completed; or b. 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 subcon- tractor engaged in performing operations for a principal as a part of the same project. CG 20 33 07 04 © ISO Properties, Inc. 2004 Page 1 of 1 ❑ CE 76052 Phyllis 6/17/2 eye