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HomeMy WebLinkAboutMINOR MOD CERT OF LIABILITY INS 1.25.19® DATE (MNVDDtYYYlr7 AC CERTIFICATE OF LIABILITY INSURANCE 8/23/2016 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(S), 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 Garre#jmosier /Griffith /Sistrunk NAMME: Jasl nn Rowe Risk Management & insurance Services PHONE E ; 949 -559 -3377 a No): 949 -559 -6703 12 Truman E-MAIL ast nrtr m s.com Irvine, CA 92626 ADDRESS -I ..,r".e, ercnanr�ir_rnveaerG NAIC# www.9m9S.COM 0684519 INSURER A : Travelers Property Casualty Co of America 25674 INSURED INSURER B: Tait & Associates, Inc. INSURER C: Tait Environmental Services, Inc. 701 Parkcenter Dr. INSURER b��, Santa Ana CA 92705 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 31460092 REVISION NUMBER: LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED CLAIMS. CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID EXCLUSIONS AND ADDL SUBR POLICY EFF POLICY EXP LIMITS I TR TYPE OF INSURANCE IN D D POLICY NUMBER MWDD MMIDD COMMERCIAL GENERAL UABILITY EACH OCCURRENCE S DAfi4AG�'? ftENTEE3 FI i PREhrIISES Ea occurrence S CLAIMS -MADE OCCUR MED EXP (Any one person) S PERSONAL & ADV INJURY S GENERAL AGGREGATE S GEN'L AGGREGA'T'E LIMIT APPLIES PER: � � LOC PRODUCTS - COMPlOP AGG S POLICY JECT S OTHER: 810- 7138R642- 16 -CAG COMBINED SINGLE LIMIT 911/2016 9/112017 Ea accident S 1,000,000 A AUTOMOBILE LIABILITY BODILY INJURY (Per person) S ✓ ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) S AUTOS ONLY AUTOS PROPERTYDAMAGE S ✓ HIRED Y X1,000 Comp. e. AUTOS ONLY ✓ AUTOS O ONLY Dd Per accident S i $1000 Coll. Ded. UMBRELLA LIAR OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE S DED RETENTION S UB- 3G182680 -16 9/1/2016 9/112017 ,� STATUTE ERN - A WORKERS COMPENSATION 1,000,000 AND EMPLOYERS' LIABILITY Y l N E.L EACH ACCIDENT S ANYPROPRIETORIPARTNER1IXECUrIVE N I A OFFICERIMEMBEREXCLUDEO? E.L.DtSEASE- EAEMPLOYEW S 1,000,000 (Mandatory in NH) I; yes, describe under E.L. DISEASE -POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: Evidence of Insurance FOR PROPOSAL USE ONLY CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Tait & Associates Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PQ BOX 11118 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 92711 AUTHORIZED REPRESENTATIVE Michael Finn ©1988 2045 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2016103) 3_460092 1 1r- =3 �/:4 # Sas2i =rs: sss i 8!2 f2Gi5 3:39 :0'3 ?V (P =I , -�3e _ c_. _