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__""N OCEABLU-06
<br />144 41W a0' FDATE(MM/DD/YYYY)
<br />CERTIFICATE OF LIABILITY INSURANCE 7/11/2019
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER License # 0757776 NTACT Andrew Shutak
<br />-t9AM�
<br />San Diego, CA - Mira Sorrento - HUB International Insurance Services Inc. PHONE E:t : 858 373-6953 I FAXN
<br />9855 Scranton Road, Suite 100
<br />San Diego, CA 92121uj°ss: andrew.shutak§hubinternational.com
<br />17370
<br />INSURED INSURER B . Great D
<br />Ocean Blue Environmental Services, Inc. wSURERC:
<br />925 West Esther Street INSURER D
<br />Long Beach, CA 90813 ,,,,,,,,,__
<br />INSURER F :
<br />'OVERAGESCERTIFICATE NUMBER. REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_,
<br />4SR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br />A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000
<br />CLAIMS -MADE � OCCUR X ECP2018650-13 7/1/2019 7/1/2020 DAMAGE TO RENTED 100,000
<br />MED Ea onePerson)5,000
<br />PERSONAL & ADV LRJURY 1,000,000
<br />,AGG 2,000,000
<br />GEOLAGG LIMIT AP ES PER: GENERAL AGGREGATE 2,000,000
<br />LOCPOLICY�PEF TS - COMPIOP
<br />n;-FR•SIR: $20,000X
<br />$
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />Po ubo0 &
<br />X
<br />X
<br />X
<br />A
<br />UMBRELLA LIAB
<br />I EXCESS LIAR
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />X
<br />_ _i DED i RETENTION $
<br />B WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? Y N / A
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />A 'Pollution Liability
<br />A Professional Liab.
<br />8652-13
<br />8651-13
<br />18653-13
<br />8650-13
<br />7/1 /2019 1 7/1/2020
<br />7/1 /2019 1 7/1/2020
<br />7/1 /2019 1 7/1/2020
<br />COMBINED
<br />1,000
<br />BODILY INJURY P arson
<br />BODILY INJURY (Per ecc de
<br />PROPERTY DAMAGE
<br />Per acc'dent
<br />Hazardous Waste
<br />5,000
<br />EACH OCCURRENCE
<br />$ 9,000
<br />AGGREGATE
<br />$ 9,000
<br />v I PER I v I OTH-
<br />7/1/2019 7/1/2020 'Each Occh
<br />7/1/2019 7/1/2020 Aggregate
<br />1,000,000
<br />1,000,000
<br />1,000,000
<br />1,000,000
<br />2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: RFP# 16-144
<br />With respects to General Liability: City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant to
<br />written contract agreement, or memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance carried by
<br />City shall be excess and noncontributory.
<br />4
<br />E WAD BY:
<br />CERTIFICATE HOLLDER C CAN E lON
<br />Risk Man gemenf fvlslOn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Risk Management Division
<br />20 Civic Center Plaza —
<br />Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE
<br />_ 1) ni
<br />i
<br />ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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