Insurance - Crime Fidelity Coverage CMSD- 2015-07-01Issue Data
NON-MEMBER'S CERTIFICATE OF COVERAGE
07/01/2015
1.02
This Is to certify that coverages listed below have been issued to the Member named below for the Period indicated. This certificate is not an insurance
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policy or an agreement of coverage and does not amend, extend or alter the coverage afforded by the agreements listed herein. Notwithstanding any ^�r g
requirement, term, or condition of any contract or other document with respect to which this cetlificate may be issued or may Pei the coverage J
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assented herein is subject to all the terms, exclusions, and conditions of the specific coverage document
This certificate of coverage evidences the limits of liability in affect at the inception of the agreements shown; limits shown may have been reduced by paid
claims. This cedifeate is issued as a matter of information only and coffers no rights upon the certificate holder.
Participating Member. Member Number.
Entity Affording Coverage.
Costa Mesa Sanitary District BOP-6819
Special District Risk Management Authority
628 West 19th Street
1112 T Street, Suite 300
Costa Mesa, CA 92627-2716
Sacramento, California 95814
800.537.7790 vWew.sdrrna.or
Type of Coverage
Policy Number
Effective Date
Expiration Date
Limits
❑x Crime/Fidelity Coverage
EDC-SDRMA-201516
07/01/2015
1 07/01/2016
Per Occurrence $400,000
RECEIVED
JUN 22205
CDSTA MESA SANITARY DISTRICT
Description; All listed coverage is in effect only for the time period specified. -
Proof of Coverage: Coverage includes Designated Agent as Employee - Marcus Davis As Independent Treasurer for the Costa Mesa Sanitary District.
Cancellation: Should any of the above-described policies be cancelled before the expiration dates thereof, the issuing company will endeavor to mail 30 days
written notice to the above-named certificate holder, but failure to mail such notice shall impose no obligation or lhai of any kind upon the com an .
Certificate Dates:
Effective Date
Expiration Date
Certthc lte Type:
F-1AdditionalCovered Party ❑ Loss Payee
07/01/2015
07/01/2016
Q Evidence of Coverage
CERTIFICATE HOLDER
Costa Mesa Sanitary District
626 West 19th Street
Costa Mesa, CA 92627-2716
G ory S. Hall - Chief Executive Officer