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Project 181 - Insurance - Nikola - 2007-03-13 ACORD, CERTIFICATE OF LIABILITY INSURANCE 3 3 0 I 0 /1 /2 PRODUCER (714)524-4949 FAX (714)524-4940 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Commercial Associates Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4226E La Palma Avenue HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Anaheim, CA 92807 INSURERS AFFORDING COVERAGE NAIC# INSURED Nikola Construction Corporation INSURERA Netherlands Insurance Company 18012 Cowan #290 INSURER B Irvine CA 92614 INSURERC INSURER D INSURER E 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR IN RP DATE IMM DD/YYI DATE IMM/DD/YYI GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PRFvISFS(Fa nc.irncel CLAIMS MADE OCCUR MED EXP(Any pe n) $ PERSONAL 8 AOV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG $ —1 POLICY n jE 0 n LOC AUTOMOBILE LIABILITY BA8096362 12/19/2006 12/19/2007 COMBINED SINGLE LIMIT ANY AUTO (Eaacadenl) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY A X SCHEDULED AUTOS (Per per n) X HIRED AUTOS THIS CERTIFICATE SUPERSEDES BODILY INJURY X NON-OWNED AUTOS ALL PREVIOLS CERTIFICATES (Peracadent) PROPERTY DAMAGE (Pe accident) GARAGE LIABILITY AUTO ONLY EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY. AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TOR I IMIT S OTH- EMPLOYERS'LIABILITY ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED' E L DISEASE EA EMPLOYEE $ If ye describe under SPECIAL IAL PROVISIONS below E L DISEASE POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re Operations usual to the named insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL Costa Mesa Sanitary District 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Joan Revak Board Secretary/Program Manager/ Clerk of the District BUT FAILURE TO IL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 628 W 19th Street OF ANY KIND UPON• - • S -ER,ITS AGENTS OR REPRESENTATIVES. Costa Mesa CA 92627 AUTHORIZED REP: � N h I ACORD 25(2001/08) < ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED the policyhes) 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 The Certificate of Insurance on the reverse side of this form 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(2001/08)