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OCEAN BLUE ENVIRONMENTAL SERVICES, INC. 1D
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OCEAN BLUE ENVIRONMENTAL SERVICES, INC. 1D
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Last modified
8/2/2016 11:12:46 AM
Creation date
7/14/2016 10:35:18 AM
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Contracts
Company Name
OCEAN BLUE ENVIRONMENTAL SERVICES, INC.
Contract #
A-2013-115-03
Agency
PUBLIC WORKS
Expiration Date
6/30/2017
Insurance Exp Date
7/1/2017
Destruction Year
2022
Notes
A-2012-106;, A-2013-115 & 01 & 02
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OCEAN BLUE ENVIRONMENTAL A- 2013 - 115 -02 REVIEWED BY: �/�,- • EUNIsq&0EREDIA (PG 1 OF 18) <br />-1--q% <br />A� o® CERTIFICATE OF LIABILITY INSURANCE <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDU��ICIED��ppBppYPAID CLAIMS. <br />712212016 <br />THIS 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($), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the pollcy(les) 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 Ileu of such endorsement(s). <br />PRODUCER <br />NOA NTAcr Nancy Asseaga <br />Commercial Lines- (818)464 -93W <br />PNONE F x <br />alL618- 464 -9386 A�c NOR 866-475-0866 <br />Wells Fargo Insurance Servlces, Inc. - CA LIOiF: 0008r108 <br />Eb AIL nancy.a,assenga@wellsfargo.com <br />15303 Ventura Boulevard, 7th Floor <br />INSURERS AFFORDING COVERAGE <br />NAICN <br />Sherman Oaks, CA 91403 -3197 <br />INSURER A: Starr Surplus Linea Ins. Co. <br />13604 <br />INSURED <br />INSURER s: Starr Indemnity and Liability Company _ <br />38318 <br />Ocean Blue Environmental Services., Inc. <br />INSURERO: Federal Insurance Company <br />20281 <br />925 West Esther Street <br />" <br />INSURER D: <br />INSURER E: <br />_ <br />S 1,000,000 <br />Long Beach, CA 90813 <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 9379327 REVISION NUMBER: See below <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 />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDU��ICIED��ppBppYPAID CLAIMS. <br />INSIR <br />lL <br />TYPE OF INSURANCE <br />aR <br />POLICYNUMBER <br />MMIUDYIYVYY <br />9%."CVYYY <br />LIMITS <br />A <br />I-XI <br />CLAIMS MADE OCCUR <br />�G0MWRCTALGENFRALUAQILrTY <br />1000065767151 <br />0710112015 <br />07107!2016 <br />EACH OCCURRENCE <br />$ 1,000.000 <br />AMAG TO REf I go <br />PREMISES(Ea.un-eneM <br />$ 60,000 <br />MEO EXPAny one etenn <br />$ 6,000 <br />PERSONAL& AOV INJURY <br />S 1,000,000 <br />GENT AGGREGATE UMITAPPLIES PER: <br />POLICY jg T LOG <br />GENERALAGGREGATE <br />5 2000,000 <br />PRODUCTS- COMPIOPAGG <br />S 21000,000 <br />Y` OTHER: 61R; $2%000 <br />$ <br />B <br />AUTOMaMLEUASILITY <br />S181PCA08265415 <br />0710112015 <br />0710112016 <br />OMBINED81NGLE LIMIT <br />$ LsOO,coD <br />X <br />ANYAUTO <br />BODILY INJURY (Per parnon) <br />$ <br />ALL SCHEDULED AUO <br />BODILY INJURY(PeaddenN <br />$ <br />X <br />HIREDAUTOS X NO0MOD <br />PROPERTY DAMAGE <br />dn <br />S <br />MCS -9D <br />g <br />A <br />UMBRELLA LIAR <br />X <br />OCCUR <br />1000386613151 <br />07101/2015 <br />07/01 12016 <br />EACHOCCURRENCE <br />$ 9,000,000 <br />AGGREGATE <br />$ 910001000 <br />X <br />EXGEBS LI0.E <br />CLAIMS -MADE <br />OED RETENTION <br />$ <br />G <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNER/EXECUTIVE <br />OFRUERIMEMBER EXCLUDED? ❑NIA <br />IMandalery In NR) <br />If as describe under <br />DE SdRIPP0NOFOPERATIONBb 1MV <br />004472796400 <br />O7I09I2015 <br />07/01/2016 <br />X STATUTE X EIH <br />USLBH <br />E,L, EACHACCIDENT <br />$ 1,000,000 <br />EL. OISEASE - EA EMPLOYE <br />$ 1,000,000 <br />F.L. DISEASE � POLICY LIMIT <br />$ 1,000,00Q <br />A <br />Follutlon Llabllity <br />1000065767151 <br />07101/2015 <br />07101!2016 <br />LImIle: 81,010,00 FdO OCommnce <br />Ddm$20,0c0; Occuronco Form <br />DESCRIPTION OF OPERATIONS I LOCATIONS IVBRIOLFS (ACOR0101, Adtllllonal Remarks esheduls, may be shsched lfmaro spnco is requiretl) <br />RE:Contraclk A -2013- 115 -02 Certificate Holder Is named as additional Insured as requiretl by writton contract. <br />City of Santa Ana <br />Attn: Public Works Department <br />20 Civic Center Plaza M -36 <br />Santa Ana, CA 92701 -0000 <br />The ACORD name slid logo are <br />ACORD 25 (2014101) <br />(rne —.10 0.. kood m 711V20mI <br />SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE W ITH THE POLICY PROVISIONS. <br />marks ofACORD <br />REPRESENTATIVn <br />All <br />
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