Item 20 - Agreements for On-Call Demolition Services for Abatement

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DATE (MMIDDNYYY) AC"R o CERTIFICATE OF LIABILITY INSURANCE 9/13/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Debbie Williams HUB International Insurance Services Inc. PHONE 916 480-4124 FAX No1916-993-7224 PO Box 255387-I'L�Q�� — - :- - E-MAIL Sacramento CA 95865 ADDRESS: debbie.williaM_�@Aubin.ternational.com INSURED Interior Demolition Inc 23508 Pine Street Newhall CA 91321 INSURER(S) AFFORDING COVERAGE NAIC# # 0757776 INSURER A: Nautilus Insurance Company 17370 INTEOEM-01 INSURERB: Ket Risk Insurance Company _ 10885_ INSURER C : State Compensation Insurance Fund of California 35076 INSURER D : _ - INSURER E rnVrRAr_Fc r`FRTIFIIr"ATF NIIMRFR• 19A.;1'1R77R REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRI iADDL SUER{ POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY ECP2035025-13 6/4/2024 614/2025 EACH OCCURRENCE $ 1.000,000 1 CLAIMS -MADE X OCCUR PAMAGETO RENTED PREMISES Ea occurrenca)_ _ $. 100,000 X $5,0W DedlOccur MEDMED E� a person) $ 5,000 PERSONAL & ADV INJURY_ $ 1,0D0,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000.000 POLICY n PE ti LOC PRODUCTS - COMPIOP A_G_G $ 2,000,000 OTHER $ -E B AUTOMOBILE LIABILITY _ BAR2035024-13 6/412024 6/412026 COMBINED SINGLE LIMIT Ea accident S 1 04p,000 BODILY INJURY (Per person) X ANY AUTO $ J OWNE❑ SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 5 S BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) - $ I A UMSRELLALIAB X OCCUR FFX2035026-13 6/412024 614/2025 EACH OCCURRENCE $5,000,000 $ 5,000,000 X EXCESS LIAR CLAIMS -MADE AGGREGATE $ ❑ED X RETENTION$ 0 1 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPR(7PRIETORIPARTNERJEXECDTIVE YIN 1977624-24 91 I 9/2712025 IX PER OTH- STATUTE _ ER E. L.EACH ACCIDENT $1,000,000 $ 1,000,000 OFFICERIMEMBERFXCLUDFD? ❑ (Mandatory in NH) NIA -- - E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT A Professional Liability Contractors Pollution Liability I ECP2036025-13 61412024 6W2025 Each Claim/Aggregate Each OccurrencelAgg. $1,000.01 $1,000.000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE. Evidence of Insurance Only. CERTIFICATE HOLDER CANCELLATION PROOF OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 00"Jow— (0 1988-2015 ACORD CORPOKA I ION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD