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ZIMIND11.1-01 JTAII
<br />DATE (MMI
<br />CERTIFICATE OF LIA1311LITY INSURANCE, 101912019
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY A114D CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EX"11'119ND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREII AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the iwllcy, certain policies may require an endorsement. A statement on
<br />this certificate does, not confer rights to the certificate holder Mn lieu of such eindorsernent(s).
<br />PRODUCER "1,11'kACT Tracy Dolan
<br />_U&,
<br />Alliant Insurance Services, Inc, PHONE
<br />2355 Gold Meadow Way Ste 250
<br />Al(, 114o, Ext): (916) 210 -0317
<br />E
<br />Gold River, CA 95670 AM,',SS; tracy.dolan@aili-,
<br />INSURED NSU IERB:G
<br />Zim Industries, Inc.; Bakersfield Well & Pump Co. IN SU IER C
<br />4532 E. Jefferson Ave, ER D
<br />Fresno, CA 93725
<br />COVERAGES
<br />CERTIFICATE NUMBER:
<br />Insu
<br />REVISION NUMBER:
<br />210-0343
<br />THIS
<br />IS TO CERTIFY THAT THE POLICIES
<br />OF
<br />INSURANCE
<br />LISTED BILLOW HAVE BEEN
<br />ISSUED
<br />TO THE INSURED
<br />NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED.
<br />NOTWITHSTANDING ANY REQUIREMENT,
<br />TERM OR CONDITION OF ANY
<br />CONTRACT
<br />OR OTHER
<br />DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE
<br />MAY BE ISSUED OR MAY
<br />PERTAIN,
<br />THE INSURANCE AFFORDED II
<br />THE POLICIES
<br />DESCRIBED
<br />HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS
<br />AND CONDITIONS OF SUCH
<br />POLICIES,
<br />LIMITS SHOWN MAY HAVE BEEN
<br />REDUCED BY
<br />PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />IINSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />Mmmm=1
<br />POLICY EXP
<br />MIDDMYY$
<br />LIMITS
<br />A
<br />COMMERCIAL GENERAL LIABILITY
<br />. .. .............
<br />I .. 01 . 00, .. 0
<br />EACH OCCURRENCE 0 0 ..
<br />_3AMI
<br />CLAIMS -MADE
<br />L��J OCCUR
<br />x
<br />GLO�8311662-15
<br />31112�O 19
<br />31112020
<br />TO RENTED
<br />100,000
<br />X Employee Benefits Li
<br />PREMISES �Ea occurreno)
<br />10,000
<br />MEDEXP(Any2ne elE2nJ
<br />7
<br />PERSONAL &AQV�NJURY
<br />S 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />—1
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />V] POLICY PRI? LOC
<br />I J,,
<br />PRODUCTS - COMPIOP A G
<br />$ 2,000,000
<br />THER:
<br />A
<br />AUTOMOBILE LIABILITY
<br />COMBINdent)ED SINGLE LIMIT
<br />1,0100,000
<br />x ANY AUTO
<br />x
<br />BAP8311663-1 6
<br />3/112019
<br />31112020
<br />(Ea accI
<br />BOPILY INJURY Per berson��
<br />5
<br />OWNED SCHEDULED
<br />I
<br />— AUTOS ONLY AUTOS
<br />BODILY INJURY Per a=dent
<br />�O��Ient
<br />$
<br />HIRED NQN-
<br />— AUTOS ONLY AUTO, ONLY
<br />AUTOS
<br />I
<br />PROPERTY�AMAGE t
<br />Per acgden
<br />........ ........ .
<br />B
<br />IUM13RELLA IJAIS EXOCCUR
<br />EACH OCCURRENCE
<br />S 16,000,0010
<br />CLAIMS-
<br />)(E,xCESS LIAB CLAiMS-IADE
<br />TUIJ 3022945 00
<br />311/2019
<br />31112020
<br />AGGREGATE
<br />$ 16,000,000
<br />D:E:D:Dx7RE1E1111ON1 10,060
<br />A
<br />WORKERS COMPENSATION
<br />XIT—A
<br />AND EMPLOYERS'LIABILITY
<br />YIN
<br />ANY PROPMETORTARTNER�EXECUTIVE
<br />WC8311661 -15
<br />3/112019
<br />31112020
<br />T
<br />r= EACH ACCIDENT
<br />110061--o-00
<br />(16ERWEMWHR� EXCLUDED'
<br />-F-'Zory in
<br />NPA
<br />L
<br />E.L. DISEASE - EA EMPLOYEE
<br />S 1,000,000
<br />If es, describe under
<br />E L. DISEASE - POLICY LIMIT
<br />S 1,000,
<br />SCRIPT' N OF OPERATIONS below
<br />E u I PM eon Floater
<br />IMAC95D519
<br />/,112019
<br />112020
<br />Inst./Builders Risk
<br />1'000'-000
<br />C
<br />7
<br />Equipment Floater
<br />rq
<br />IMAC96DS19
<br />311120,9
<br />31112020
<br />RBL $100,000 ; Schad
<br />21,380,,150
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
<br />Re: A-2016-311
<br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers, and representatives are named as
<br />additional insureds on the General Liability and Auto Liability per the attached forms Coverage is primary and non-contributory and 30 days notice of
<br />cancellation applies, 10 days notice for nonpayment of premium in accordance with the policy provisions.
<br />N
<br />&AR 4'04-
<br />. ... ..................
<br />CERTIFICATE HOLDER 1%1 P
<br />Fhf P, A14CELLATION
<br />7
<br />2019
<br />SFIOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />11,111'z EXPIRATION DATE THEREOF,
<br />City of Santa Ana
<br />NOTICE WILL BE DELIVERED IN
<br />Risk Management Division
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />201 Civic Center Plaza, 4th
<br />,
<br />Santa Ana, CA 9270�2 NM4 11A M. LAM BERF
<br />AUTHORIZED REPRESENTATIVE
<br />. . . ...... .
<br />.........
<br />ACORD 25 (2016103) C31988-2015 ACO'RD CORPORATION, All rights reserved.
<br />The ACORD name and logo are regIistered marks of ACORD
<br />
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