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OCEABLU-06
<br />CERTIFICATE OF LIABILITY INSURANCE DAM
<br />(MMIDO20 )
<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 endorsemen a .
<br />PRODUCER License # 0757776 1IpCT Andrew Shutak
<br />San Diego, CA - Mira Sorrento - HUB International Insurance Services Inc. P,VC N., EM: (858 373-6953 jAACX.
<br />9855 Scranton Road
<br />Suite 100 N .andrew.shutak hubinternational.com
<br />Suite
<br />San Diego, CA 92121 ..' ... 1 e.1.
<br />INSURED
<br />Ocean Blue Environmental Services, Inc.
<br />925 West Esther Street
<br />Long Beach, CA 90813
<br />rnvcnerncc rooTlolrATIP MI IURFR• RFVISInN NIIMRFR-
<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 />INBR
<br />TYPE OF INSURANCE
<br />ADD
<br />9UBR
<br />POLICY NUMBED
<br />POLICY EFP
<br />MAMDOIYYYYI
<br />POLICY UP
<br />IIWTS
<br />A
<br />X
<br />COMMERCIALGENERALDAB0.h1'
<br />CLAIMS -MADE ❑X OCCUR
<br />X
<br />EC3001568
<br />7/1/2020
<br />711/2021
<br />EACHOCCURRENCE
<br />S 1,000.000
<br />OAMAGETORENTED
<br />100,000
<br />S 5,000
<br />_
<br />.MEoEXP(MY"fxrNpl
<br />PERSONAL a ADVINJURY
<br />6 1,000,000
<br />GEMLAOGREGATE
<br />NX
<br />POLICY
<br />pLIRM�T. IAPPLIES PER
<br />❑ ❑ LOC
<br />JECT
<br />GENERAL AGGREGATE
<br />2,000.00 0
<br />PRODUCTS -COMP,IIP AGG
<br />Z,000,000
<br />11
<br />X
<br />OTHER,
<br />DED: $5,000
<br />B
<br />AUTOMOBILE
<br />LIABILMY
<br />COMBINED SINGLE LIMIT
<br />1 1�gggmg
<br />sCaILnwuRv Per
<br />X
<br />ANY AUTO E00056991 71112020
<br />71112021
<br />_ i
<br />A OSONLY AAUTOSSDWUIEDp
<br />BODILY INJURY Per awtla,l
<br />ectidTMenl DE
<br />X
<br />X
<br />_.
<br />AUTOS ONLY l X J AUTOS ONLY -
<br />MCSaD Palubm
<br />Hazardous Waste
<br />51000,000
<br />C
<br />X UMBRELLA LIAR X 'OCCUR
<br />EACH OCCURRENCE
<br />S 9.000,000
<br />EXCESS LIAB CLUMs-rAwe. ;UEC0056992 71112020
<br />71112021
<br />AGGREGATE
<br />91000,000
<br />DED I X 1 RETENTIONS 10,000
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY IN
<br />AqWF �pP��ROWRIPMMREIETORIPARTNERIEXECUTNE
<br />(M.F.ICE yUlM�W EXCLUDED?
<br />N yes desalt. under
<br />DESCRIPTION OF OPERATIONS Cahn
<br />NIA
<br />EC3001567 ! 711/2020
<br />.
<br />L.
<br />TIV2021
<br />X PER OmH
<br />EL EACH ACCIDENT
<br />1,000,000
<br />EL DISEASE -EA EMRO
<br />1,000,000
<br />E.L DISEASE -POLICY LIMO
<br />1,000,000
<br />C
<br />;Pollution
<br />PECO057033 7/112020
<br />71112021
<br />Each OoclAggregate
<br />5,000,000
<br />C
<br />?Professional Liab.
<br />PECDO57033 71112020
<br />71112021
<br />Each Occ/Aggregate
<br />1 5,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addd..l R.m.A. Schwf M. may A. attach" If m..1. H 1aXulr n
<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 carded by
<br />City shall be excess and noncontributory.
<br />REVIEWED & APPROVED
<br />By Risk MANAC(FMENT DIVISION
<br />r Conch ATC un1 MCo . B 11 U Pill MR rAMrn I Annu
<br />MUL
<br />City of Santa Ana F A E - ( AL
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />CCORDAN E WITH THE POLICY PROVISIONSION DATE THEREOF, CE WILL BE DELIVERED IN
<br />Risk Management Division
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92702
<br />ACORD 25 (2016103) ©1988.2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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