CA CALTRANS & SCRRA 1 - 2005 - Laserfiche WebLink

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" " EXHIBIT "B" CERTIFICATE OF INSURANCE ISSUE DATE (MM/DD/YY) Southern California Regional Rail Authority (SCRRA) PRODUCER THIS CERTIFICATE OF INSURANCE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND. EXTEND OR ALTER THIS COVERAGE AFFORDED BY THE POLICY BELOW COMPANIES AFFORDING COVERAGE COMPANY A LEITER COMPANY B LEITER INSURED COMPANY C LEITER COMPANY D LEITER COMPANY E LEHER COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED NAMED ABOVE FOR TIfE POlley PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENTS. TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE rSSUEDOR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN [S SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlO CLAIMS CD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MM/DDNY) DATE (MMIDDNY) GENERAL LIABILITY GENERAL AGGREGATE $ o COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ o CLAIMS MADE 0 OCCUR PERSONAL &: ADV. INJeRY $ DOWNER'S &: CONTRACTOR'S PROT EACH OCCURRENCE $ FJRE DAMAGE (Anyone fire) $ DOTHER - MED. EXPENSE $ (Any one person) AUTOMOBILE LIABILITY COMBINED $ o ANY AUTO SINGLE LIMIT o ALL OWNED AUTO BODILY I!"JURY $ o SCHEDULED AUTOS (Per person) o HIRED AUTOS o NON-OWNED AUTOS BODJLYJNJlIRY $ o GARAGE LIABILITY (Per accident) PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ o UMBRELLA mRM o OTIJER THAN UMBRELLA FORM AGGREGATE $ PROPERTY INSURANCE AMOUNT OF INSURANCE $ o COURSE OF CONSTRUCTION WORKER'S COMPENSATION STATUARY LIMITS AND EACH ACCIDENT $ EMPLOYER'S LIABILITY DlSEASE-POLlCY LlMIT $ DISEASE-EACH EMPLOYEE $ ................. .......-..-...- .......-..- .....-..- ....- ....- ...... .............. ................................... ................................................ ........................................ .... ...................w.. ...................w.....w.......... .....w... ....w..w..w...w.w..w..w.....w..w...w_.. DFSCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlSPECIAL ITEMS THE FOLLOWING PROVISIONS APPLY: L None of the above-described policies will be canceled, limited in soope of coverage or nonrenewed until after 30 days' written notice has been given to SCRRA at the address indicaled below. 2, As respects operations of the named insured ~fonned on behalfofSCRRA. the following are added as additional insured on al] liability insurance policies listed above: SCRRA, its Member AgenCies, Operatmg Rmlroads, Its subsldlanes, offiCIals and employees. 3 It is agreed that any insurance of self-insurance maintained by SCRRA will apply in excess of and nOI contribute with. the insurance described above 4 SCRRA is named a loss payee on the property insurance policies described above. ifany. 5 All rights of subrogation under the property insurance policy listed above have been waived against SCRRA. 6 Any failure by the, insured to comply with reporting or other provisions of the policies including breaches of warranties shall nol affect coverage provided to SCRRA. its Member Agencies, tts substdmnes. offiCials and employees 7 The worker's compensalion insurer named ahove. if any. agrees to waive all rights of subrogation against SCRRA for injuries to employees of the insured resulting from work for SCRRA or use of Member Agencies premIses or faCilities CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE Southern California Regiona] Rai] Authority (SCRRA) 700 South F]ower St.. Suite 2600, Los Angeles, CA 900]7-410] SIGNATURE ADDITIONAL INSURED TITLE MTA,OCTA,RCTC,SANBAG,YCTC BNSF, UPRR, AMTRAK PHONE NO. SCRRA FORM NO, 6 Page ]20f12 7/12/2004