Laserfiche WebLink
A� V CERTIFICATE OF LIABILITY INSURANCE <br />DATE <br />7/30/2014W) <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsoment(s). <br />PRODUCER Garrett/Mosier /Griffith /Sistrunk <br />Risk Management & Insurance Services <br />12 Truman <br />Irvine, CA 92620 <br />CONTACT <br />NAME <br />PHONE gqg 559 -6700 qIC No l: (949)559-6703 <br />AID No Exit <br />E -MAIL <br />ADDRESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC N <br />INSURER A: Great Divide Insurance Company <br />25224 <br />www.gmgs.com OB84519 <br />INSURED <br />Environmental Engineering & Contracting, Inc. <br />501 Parkcenter Drive <br />INSURER B; Peerless Insurance Company <br />24198 <br />INSURER C: <br />CLAIMS -MADE ❑✓ OCCUR <br />INSURER D: Nautilus Insurance Company <br />17370 <br />Santa Ana CA 92705 <br />INSURER E: <br />INSURER F: <br />$ 100,000 <br />COVERAGES CERTIFICATE NUMBER: 21049180 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />A <br />= <br />SU <br />D <br />POLICY NUMBER <br />POLICY <br />MMIDIYYYY <br />MMIDDM' YY <br />LIMITS <br />Grill Griffith <br />COMMERCIAL GENERAL LIABILITY <br />GLP2006942 -11 <br />10/31/2013 <br />10/31/2014 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />CLAIMS -MADE ❑✓ OCCUR <br />AAGE RENTED <br />PREM SES TO occur ante <br />$ 100,000 <br />MED EXP (Any one parson) <br />$ 5,000 <br />PERSONAL &ADV INJURY <br />$ 5,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER <br />GENERAL AGGREGATE <br />$ 5:000,000 <br />POLICY ✓� PRO- <br />JECT [:] LOU <br />PRODUCTS - COMPIOP AGG <br />$ 5,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />CBP9589097 <br />4/30/2014 <br />10/31/2014 <br />COMB dEDISINGLE LIMIT <br />IS 1000,000 <br />BODILY INJURY (Par person) <br />$ <br />ANYAUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />NON -OWNED <br />HIREDAUTOS AUTOS <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED <br />RETENTION$ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PRO PRI ETORIPARTNERIEXEC UTIVE YIN <br />WCA2008815 -11 <br />5/24/2014 <br />5/24/2015 <br />,/ STATUTE 0RH <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />NIA <br />E. L. DISEASE - EA EMPLOYE <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />D <br />Pollution Liability <br />CCP2006941 -11 <br />10/31/2013 <br />10131/2014 <br />Each Poll Occurrence $5,000,000 <br />Professional Liability <br />Each Prof Liab Claim $5,000,000 <br />General Aggregate: $5,000,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached name space Is required) <br />All operations of the named insured subject to the terms and conditions of the policies. <br />As respects General Liability coverage, City of Santa Ana, its officers, agents & employees are added as Additional Insureds <br />and this insurance is primary per ENV2154AO906 attached. <br />As respects General Liability coverage, a Waiver of Subrogation is hereby included per CG24040509 attached. <br />CERTIFICATE HOLDER CANCELLATION <br />All operations <br />City Santa Ana <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Y of <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />20 Civic Center Plaza <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Santa Ana CA 92701 <br />AUTHORIZED REPRESENTATIVE <br />t <br />Grill Griffith <br />©1988 -2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD <br />CERT NO.: 21049190 Nasisea Rom 7/30/2014 9:25:52 AM (PET) rage 1 2SE -50 <br />