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<br />304363
<br />iCC71?L? CERTIFICATE OF LIABILITY INSURANCE � ��'A/2014 "'H I
<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 polioy(ies) must be endorsed. if SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain polities may require an endorsement. Astatement on this Certificate does not confer rights to the
<br />Commercial Lines - (BIB)464-9300
<br />Wells Fargo Insurance Services, Inc. -CA Lie#: OD08408
<br />15303 Ventura Boulevard, 7th Floor
<br />Sherman Oaks, CA 91403.3197
<br />----- ----- ........ ... ..........___.....__,_ -_..._
<br />INSURED
<br />Ocean Blue Environmental Services., Inc.
<br />925 West Esther. Street
<br />Co,
<br />Long Beach, CA 90813 1 INSURER F
<br />Dr1VCRQfIOR (PRTIFiC.ATF NI.IMRPR, 796227.4 RFVSIOKI NUM8ER: Seab.1m
<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 />ft
<br />TYPE OF IN SURANCE.
<br />ACDL
<br />eVeR
<br />POLICY NUMBER
<br />P0LICY EFF.
<br />MO COY2XYY
<br />LIMITS
<br />A
<br />X , COMMERCIAL GENERAL LIABILITY
<br />__
<br />X.
<br />SLSLEIL72035014
<br />07/0112014
<br />07101/2015
<br />EACH OCCURRENCE
<br />,.b..,C.E�.....
<br />g 1.0aU,000
<br />__
<br />Iyl
<br />PRE I ES(E.eeourrenw j
<br />100,000
<br />CLAIMS MADE a OCCUR
<br />MED EXP An oneaern
<br />6 A000
<br />PERSONAL 6 ADV INJURY
<br />5 Ie00.000
<br />_i
<br />G_E_M1fL AGGREGA TE LI1I��MIr APPLIES PER
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUOTS - COMPIOP AGG
<br />S 0,000,000
<br />POLICY JCCt D LOC
<br />S
<br />OTHER SIR'.$25;000
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />SISIPCA08268414
<br />07101/2014.07/01
<br />/2015,
<br />°e%1NI11 e 111
<br />g 1,000,000
<br />BODILY INJURY (Per
<br />S
<br />x
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />eODILYINJURY {Pereacidonl}
<br />5
<br />_
<br />AUTOS AUTOS
<br />NON,QWNED
<br />-
<br />PROPERTY DAMGE
<br />......
<br />g
<br />HIRED AUTOS AUTOS
<br />,ObieoUld.nt
<br />- .- ..- ..- _ .. ... ........ ... . .. ...
<br />i $
<br />x
<br />MCS -90
<br />A
<br />UMBRELLA LIAR
<br />x
<br />OCCUR
<br />SLSLXNV73026314
<br />0710112014
<br />07/01/2015
<br />EACH OCCURREPIOE.
<br />is n,006,6oa
<br />AGGREGATE
<br />$ 41000AU0
<br />—
<br />EXCESS LIAa
<br />CLAI M9 -MACE
<br />QED X RETENTIONS 10,000
<br />$
<br />1
<br />WORKERS COMPENSATION
<br />I PER H-
<br />ER
<br />AND EMPLOYERS'LIA9ILITY
<br />.......- .__STATUTE _
<br />A PROPRIETOR(PARTNER(EXBCUTIVE
<br />EL EACH ACCIDENT
<br />g
<br />UNY
<br />OFFICEWMEM BER EXCDE01
<br />(MandMery inNH)
<br />NIA
<br />EL DISEASE�EA EMPLOYEE',
<br />_ -
<br />S
<br />EL DISEASE. POLICY LIMIT
<br />_
<br />S
<br />It yes, describe under
<br />DEBCRIPTIONOF OPERATIONS below
<br />A
<br />Pollution Liability
<br />SLSLEIL72035094
<br />0710112014
<br />7/0112018
<br />Umna SHL00,000
<br />BIRS100,000
<br />Clalma Meda
<br />DESCRIPTION OF OPERATIONS /LOCATIONS (VEHICLES IACORDEeI,Additionsl Re ,imrka$chedulo,maybealtachGdlr Hnotespacelsrequlredi
<br />Certificate Holdor, Its officers, agents, and employees are named as Additional Insured as respects General Liability per policy forms
<br />'fj
<br />This Insurance is primary and non- contribuatory with any other insurance carried by or for the benefit of the additional lnsuuP ypy
<br />eOR,GK
<br />A
<br />t, city AttOFiw1
<br />1 r`MTIrIr ATP PITH npw f::A Nr PI I ATInIa t
<br />City of Santa Ana
<br />Alin Purchasing e
<br />g p artment
<br />SHOULD ANY OF THE ABOVE: DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92,701 -0000
<br />AUTHORIZED REPRESENTATIVE f r� Ar .41 Ar
<br />The ACORD name and logo are registered marks of ACORD ® 1988.2014 ACORD CORPORATION. All rights reserved,
<br />ACORD 25 (2014101).
<br />pM• �nm�,erenl +a,•soeW!I[a,rvs YgrmdlarveJ ao us2o,n1
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