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Insurance - BHI Management Consulting - 2013-10-25OP ID: JK CERTIFICATE OF LIABILITY INSURANCE COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD DATE 10125 /201YY) 10/25/2013 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 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 Phone: 415 -512 -2100 CONTACT Sweet 8 -Baker Ins. Brokers Inc Fax: 415 - 512 -1115 44 Second Street San Francisco, CA 94105 -3440 Roberta Gonzalez (415)512 -2136 PHONE FAX AIC No Ext: ac No: E-MAIL - ADDRESS: PRODUCER gHIMA -1 CUSTOMER ID #: INSURERS AFFORDING COVERAGE NAIC# INSURED BHI Management Consulting INSURER A: The Hartford NIAC 11000 EACH OCCURRENCE Attn: Brent H. Ives INSURER B: Philadelphia lnsuranceCc 18058 2459 Neptune Ct., Suite #110 Tracy, CA 95304 INSURER C 57SBAAV3592 11110/2013 11/1012014 AMAGE To RENTED PREMISES Ea eccunenca INSURER D MED EXP (Any one person) INSURER E CLAIMS -MADE I—XI OCCUR INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION 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. INSR LTR TYPE OF INSURANCE ADOL SUB POLICY NUMBER MM /DDIYYYV MM /DDfY YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 A X COMMERCIAL GENERAL LIABILITY X 57SBAAV3592 11110/2013 11/1012014 AMAGE To RENTED PREMISES Ea eccunenca $ 1,000,00 MED EXP (Any one person) $ 10,00 CLAIMS -MADE I—XI OCCUR PERSONAL &ADV INJURY $ 2,000,00 GENERAL AGGREGATE $ 4,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGO $ 4,000,00 No Deduct $ —1 1 X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 2,000,00 ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALL OWNED AUTOS A SCHEDULED AUTOS HIREDAUTOS 57SBAAV3592 11110/2013 11/10/2014 PROPERTY DAMAGE (Per accident) $ X No Deduct $ X NON -OWNED AUTOS $ UMBRELLA LRB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ I I $ - IEN -ION $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY EXCLUDED ?ECUTIVE F—] (Mandatory In NH) NIA WCSTATU- OTH- T RV LIMITS TI 1 H- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below B Professional Liab. PHSD870919 0812312013 08/2312014 Agg Limit 1,000,00 Retention 2,50 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate holder is included as Additional Insured only as respects work performed by the Named Insured per written contract. See Attached Additional Insured endorsement PI -PLSP for Professional Liability. Costa Mesa Sanitary District 628 W 19th St Costa Mesa, CA 92627 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE / ry� THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 11rya.�t4 \'J ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Kirby V 19SH -2009 ACOKU CUHPUKA 1 IUN. All rights reserVBO. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD Philadelphia Indemnity Insurance Company Additional Insured Schedule Policy Number: PHSD870919 Additional Insured Costa Mesa Sanitary District 628 W 19th St Costa Mesa, CA 92627 -2716 PI -PLSP -103 - Miscellaneous Professional Page 1 of