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Insurane - Rogers, Anderson, Malody & Scott, LLP - 12-19-2019ROGEAND-01 LWEST s T ACQRQ� CERTIFICATE OF LIABILITY INSURANCE 164 - " DATE(MM/DD/YYYY) 12/19/2019 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 have ADDITIONAL INSURED provisions or 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 Orion Business Insurance and Risk Management Services, Inc. 1250 Corona Pointe Court, Suite 302 Corona, CA 92879 CONTACT NAME: PHONE 951 281-5353 FAX 951 7 (AIC, No, Ext): ( ) (AIC, No):(951) 37-5083 ASS: DDRE INSURERS AFFORDING COVERAGE NAIC # INSURER A: Insurance Company of the West 0 27847 INSURED INSURER B: Travelers Indemnity Cornpanv 25658 INSURER C Rogers, Anderson, Malody & Scott LLP 735 E. Carnegie Drive CLAIMS -MADE ❑ OCCUR Suite 100 INSURER D: INSURER E: San Bernardino, CA 92408 INSURER F: DAMAGE TO RENTED PREMISE Ea occurrence $ nnVFRAnFS CFRTIFIr.ATF N1IMRFR- 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ❑ OCCUR DAMAGE TO RENTED PREMISE Ea occurrence $ MED EXP (Any oneperson) $ RECEIVEM PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY FI JERCOT LOC GENERAL AGGREGATE $ DEC 2 01 PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY A ANY AUTO �'OSt�eSRBII1tory R�tC1c� COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE Pera ccident $ AUTOS ONLY AUTOS ON�� UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECU TIVE YIN X WSD 5035483 03 1/1/2020 1/1/2021 X PTATUTE ERER T-7 H 1,000,000 E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 1,000,000 E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below B Errors & Omissions 106850737 1/112020 1/1/2021 See Description DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Professional Liability $4,000,000 Per Claim; $4,000,000 Aggregate; $35,000 Per claim Deductible Workers Compensation and Professional Liability Waiver of subrogation applies to Cert holder Costa Mesa Sanitary District, its directors, officials, officers, employees, agents and volunteers. Costa Mesa Sanitary District 290 Paularino Ave Costa Mesa, CA 92626 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE kA a,.1&' ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -BLANKET WC 99 06 34 (Ed. 8-00) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). The additional premium for this endorsement shall be 2% of the total California Workers' Compensation premium otherwise due. Schedule Person or Organization ANY PERSON OR ORGANIZATION FOR WHOM THIS WAIVER IS REQUIRED. Job Description ALL CALIFORNIA OPERATIONS. Policy Number: WSD 5035483 03 Insured: Rogers Anderson Malody & Scott LLP Endorsement Effective: 01/01/20 Issue Date: 01/01/2020 WC 99 06 34 (Ed. 8-00) Coverage Provided by: Insurance Company of the West Countersigned by: