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AOUAT-H OP lD; BMz.{. -----tACORD CERTIFICATE OF LIABILITY INSURANCE 09/11/2019
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENO, EXTENO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETI',/EEN THE ISSUING INSURER(S), AUTHORIzEO
<br />REPRESETiTATIVE OR PROOUCER, ANO THE CERTIFICATE HOLOER.
<br />IMPORTANTT lf th€ ceniticatr holdo. is an ADOITIONAL I SURED, the pollcy(ies) mlJ3t bB endo.sed. It SUBROGATION lS WAIVED, rubiect to
<br />ths lormE and condltlona of the pollcy. certain policies may r.qulre an endoE6ment. A statoment on this certilicat€ do6! not conlor right! to the
<br />c€rtificate holdor in liou ot such andoE€ment(s).
<br />PROOUCER
<br />Cro3bv lnsurance
<br />8181 E- Kaiser Blvd
<br />Anaheim Hills, CA 9280E
<br />INSUREO Hart Brothers Construction lnc
<br />dba: Aquatic Technologies
<br />32232 Paseo Adelanto #A
<br />San Juan Capistrano, CA 92675-3600
<br />7 11.22',1-5200 7 11-221-52',10
<br />5 AfFORDIXG COVERAGE
<br />rNs{rRER
<br />^
<br />: colony lnsurance company 39993
<br />INSUR€R E: AMERICAN ZURICH INS.CO.10112
<br />rNsuRERc: Navigators specialty lns co 35056
<br />rilsuRER o:zurich American lns. co.16535
<br />rNsuREA E rOhio Security 21082
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSUMNCE LISTED SELOW HAVE BEEN ISSUED TO THE INSURED NAT'EO ABOVE FOR THE POLICY PERIOD
<br />INOICATEO. NOTWITHSTANOING ANY REOUIREMENT TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN HE INSURANCE AFFORDED 8Y THE POLICIES OESCRIAEO HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS ANO CONDITIONS OF SUCII POLICIES. LIMITS SHOWN lvtAY HAVE EEEN REoUCEO BY PAID CIAIMS-
<br />1,000,000SEACN OCCURRENCE
<br />PREMISES (Ea.a!rs.csl 100,000I
<br />MED EXP (Any oE peBon)
<br />PERSONAL A AOV LNJURY
<br />t
<br />I
<br />5,000
<br />1,000,000
<br />GENENAACGREGATE 2,000,000s
<br />PROOUCIS. COMP/OP AGG 2,000,000I
<br />COMMERCIAL GEN€RIL LlAAIL'TY
<br />6EIT,L AGGR€CNqTA UMI] APPLI€S P€R
<br />x
<br />x
<br />x
<br />tl LOC
<br />CLAIMS MAOE occ!R
<br />.JECI
<br />1,000,000,
<br />103G10010241 05 10/01/20'19 10101t2020
<br />Emp Ben,
<br />'1,000,000s
<br />SOOILY INJURY {P{ pmon)5
<br />5EOOrlY INJUFY (Per acc6€.r)
<br />5
<br />B x
<br />AIJTOMOBILE IIA6II.ITY
<br />HIRED AUTOS
<br />SCHEDULED
<br />AUTOS
<br />NON OWNEO
<br />AUIOS
<br />ALL OII/NEO
<br />AUTOS
<br />8AP4s03537-07 10/01/2019 't 0t0't 12020
<br />s
<br />x EACI] OCCURR€NCE 2,000,000g
<br />x
<br />UXBRELLA UAA
<br />EXCESS UAB
<br />OCCUR
<br />ctalMs{r oE AG6REGAIE 2,000,000,c
<br />RETErrl ON t
<br />sE18EXC846938rC 10to,v2019 10t0112020
<br />s
<br />x STATT,]TE ER
<br />E,L EACh ACCIOENT 1,000,000
<br />r.000,000$EL OISEASE EA€MPLOYEE
<br />o
<br />vrrotl(Eill coxPlt{sanox
<br />AXO EUPIOY€RS' LIASILITY
<br />AI.iY PROPRIEIOR/PARTNER/EX€CUT VE
<br />OFFIoEAATEMBER E'(CLUOEO'
<br />DtSCRIP-rlON OF OPERAiIONS d e
<br />10/01/2019 10101t2020
<br />E.I DISEASE , POL]CY LIMIT 1,000,0005
<br />E L6assdrRented
<br />Equipment
<br />BKS(20)5676't546 '10i 01/2019 1010112020 Limit
<br />Oed
<br />100,000
<br />500
<br />DE5C&PiION OF OPERAIIO|S / LOCA TOI{S / VExrC LEg (ACORO l0l, ddldor.l R.m.fi! S.h.duLi Ey !. .nrcn.6 lr hor. .p.c. i. ..quhdl
<br />'Ten days notice of cancsllation will bo given for non-paymont of premium.
<br />RE: Operations usual to the named inauiad p€rlormed undgr written contract.
<br />SHOULO ANY OF THE ABOVE OESCR|aEO POLICIES BE CANCELLEO AEFORE
<br />THE EXPIRAI1ON OATE THEREOF, NOTICE WILL BE DEUVERED IN
<br />ACCORDANCE WTH THE POUCY PROVISIONS,
<br />PROOFIN
<br />Proof of lnsurancs
<br />I
<br />G"LILU\1,^,?
<br />O 19E8.2014 ACORD CORPORATION. All rightr to!.wed.
<br />The ACORO namo.nd logo.rs .egirb6d marts ofACORDacoRD 25 (2014/01)
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<br />AUTHORIZEO REPRESENIA'IVE
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