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Insurance - BHI Management Consulting - 2014-08-14BHIMA -1 OP ID: JK A144 O CERTIFICATE OF LIABILITY INSURANCE 0081141201 YY) 0 811 412 01 4 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 PRODUCER Sweet o Baker Ins. Brokers Inc AUG 1 44 Second Street O �O�L San Francisco, CA 94105 -3440 O i Roberta Gonzalez (415)512.2136 6UJIA INYn SWIM 01331 CONTACT NAME: PHONE FAX A/C No Eat), INC. No: E -MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: The Hartford INSURED BHI Management Consulting INSURER e: Philadelphia Insurance Co 18058 Attn: Brent H. Ives 2459 Neptune Court INSURER C: X 578BAAV3592 Tracy, CA 95304 INSURER D: ETORENTED PREMISES INSURER E : CLAIMS -MADE 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 R TYPE OF INSURANCE Dl SUB POLICY NUMBER MMIDOY� MMIDDtYEYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,08 A X COMMERCIAL GENERAL LIABILITY X 578BAAV3592 11110/2013 11/10/2014 ETORENTED PREMISES $ 1,000,08 CLAIMS -MADE OCCUR MED EXP(Any one person) $ 10,000 PERSONAL B ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP ADD $ 4,000,000 S X POLICY PRO LOC ECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 2,000,000 BODILY INJURY (Per person) $ ANY AUTO 57SBAAV3592 11/10/2013 11/1012014 BODILY INJURY (Per accident) $ ALLOWNED SCHEDULED AUTOS NON -OWNED Ix HIRED AUTOS X AUTOS PROPERTY DAMAGE PER ACCIDENT $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ H AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ IM OFFICEREMBER EXCLUDED? (Mandatory In NH) N/A WC STATU- OTH- T RY LIM TS E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION CF OPERATIONS Innow B Professional Liab _ PHSD963561 0812312015 Agg Limit 1,000,00 7312014 Ded 2,50 DESCRIPTION OF OPERATIONS I LOCATIONS 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 Distric 628 W 19th St Costa Mesa, CA 92627 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ntYC1-101,44 ,JVAaa3-Y41!DA W44 Joan Kirby 415- 512.2107 © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Philadelphia Indemnity Insurance Company Additional Insured Schedule Policy Number: PHSD963561 Additional Insured Costa Mesa Sanitary District 628 W 19th St Costa Mesa, CA 92627 -2716 PI -PLSP -103 - Miscellaneous Professional Page 1 of 2