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TT LIABILITY 'SC DATE YYYY)66 411/2014 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(les) must 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 Garrett/MOSier/Griffith/Sistrunk Risk Management & Insurance Services 12 Truman Irvine, CA 92620 CONTACT H "N 949 559-6700 FAX AIC Nol: (949)559-6703 -L MAIDRESS: Al INSURERS AFFORDING COVERAGE NAIC4 s.com w 0884519 INSURER A. Great Divide Insurance Company 25224 INSURED Belshire Environmental Services Inc. INSURER B: Nautilus Insurance Company 17370 INSURER C: 25971 Towne Centre Drive Foothill Ranch CA 92610 INSURER D: INSURER E : BODILY INJURY (Per person) $ INSURER F: ---— ..... )tlDtiL000 Kl=VIJIUN 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY EFF PNSR J OLICY EXP N WVD POLICY NUMBER MM/DD MMIDDrfym LIMBS A_ COMMERCIAL GENERAL LIABILITY GLP01548949-12 4/1/2014 4/1/2015 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DA AGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEMLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 POLICY✓❑ PE0 LOC PRODUCTS -COMP/OPAGG $ 1,000,000 Evidence Only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 ( Griff Griffith I f �--- ©1988-2014 ACORD CORPORATION. All rights reserved. :ORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD No.: 19692856 Marissa Romo 4/1/2014 10:12:00 AM Page 1 of 1 OTHER: A AUTOMOBILE LIABILITY BAP1547282-12 4/1/2014 4/1/2015 OMBINEDSINGLE LIMITEa . dnl $ 1,000,0( ✓ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ ✓ HIRED AUTOS ✓ AUTOSWNED MCS -90 Included PROPERTY DAMAGE Per accident $ Pollution Liab Included $ B UMBRELLA LIAB ✓ OCCUR FFX1547284-12 4/1/2014 4/1/2015 EACH OCCURRENCE $ 1 000,00 ✓ EXCESS LIAB CLAIMS -MADE I I I AGGREGATE $ 1,000,00 DED I I RETENTION $ $ A WORKERS COMPENSATION WCA1547285-12 4/1/2014 4/1/2015 PER OTH- AND EMPLOYERS' LIABILITY Y / N ✓ STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED7 NIA E.LEACH ACCIDENT $ 1,000,00i (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYE $ 1,000,001 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ 1,000,00( B Contractors' Professional Liability CCPC1547283-12 4/1/2014 4/1/2015$000,000 Each Claim/Agg. $50,000 DED B Contractors' Pollution Liability CCPC1547283-12 4/1/2014 4/1/2015 111,o nPi IMP ft )ESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) .. NOV 2 6 2014 ENVIRONMENTAL HEALTI DEPARTMENIT ERTIFICATE HOLDER CANCELLATION Evidence Only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 ( Griff Griffith I f �--- ©1988-2014 ACORD CORPORATION. All rights reserved. :ORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD No.: 19692856 Marissa Romo 4/1/2014 10:12:00 AM Page 1 of 1