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2021-22 Declarations - Uninsured-Underinsured Motorist CoverageDeclarations – Uninsured/Underinsured Motorist Coverage 2021-22 Property/Liability Coverage Documents Uninsured/Underinsured Motorist:1 of 2 Tel 800.537.7790 Special District Risk Management Authority Fax 916.231.4111 Rev. 07/01/2021 www.sdrma.org MEMBER COVERED:Costa Mesa Sanitary District 290 Paularino Avenue Costa Mesa, California 92626 Your District/Agency/City has elected to participate in the risk financing coverage programs described below as “THE PACKAGE PROGRAM” and in such other programs as are indicated herein. These DECLARATIONS together with the Memorandum, the Uninsured/Underinsured Motorist Coverage Agreement attached as Exhibit C, the terms and conditions of the Sixth Amended and Restated Joint Powers Agreement and Bylaws, or successor documents thereto, constitute the entire agreement concerning risk-financing coverage between the Special District Risk Management Authority and your District/Agency/City. Please read the Sixth Amended and Restated Joint Powers Agreement and Bylaws of the Special District Risk Management Authority (hereinafter “SDRMA”), or successor documents thereto, together with the Memorandum of Coverages, hereinafter referred to as the “Memorandum” and the Uninsured/Underinsured Motorist Coverage Agreement, to ascertain all of your District's/Agency's/City’s rights and obligations regarding its relationship with the Special District Risk Management Authority. COVERAGE PERIOD: July 1, 2021 at 12:01 a.m. to July 1, 2022 at 12:01 a.m. COVERAGE – BODILY INJURY SDRMA will pay those sums a Covered Individual or anyone occupying an Owned Auto, as defined in the Uninsured/Underinsured Motorist Coverage Agreement, is legally entitled to recover as Damages because of Bodily Injury from the owner or driver of an Uninsured Motor Vehicle. The term Uninsured Motor Vehicle includes Underinsured Motor Vehicles. The damages must result from Bodily Injury sustained by anyone occupying an Owned Auto. The owner’s or driver’s liability for these damages must result from the ownership, maintenance or use of the Uninsured Motor Vehicle. This Agreement does not apply to any persons who are entitled to workers’ compensation benefits as a result of the accident. LIMIT(S)$1,000,000 per accident, subject to the terms, conditions and exclusions as provided in the Memorandum, and subject further to the terms, conditions and exclusions of the Uninsured/Underinsured Motorist Coverage Agreement contained in Exhibit C. The maximum Uninsured/Underinsured Motorist Coverage when more than one covered individual is covered under different Memorandums of Coverage issued to different Member/Agency(s) injured in the same accident, is limited to a maximum of $1,000,000 under all such Memorandums of Coverage. COVERAGE – PROPERTY SDRMA will pay those sums up to $10,000 which the Member, or any Declarations – Uninsured/Underinsured Motorist Coverage 2021-22 Property/Liability Coverage Documents Uninsured/Underinsured Motorist:2 of 2 Tel 800.537.7790 Special District Risk Management Authority Fax 916.231.4111 Rev. 07/01/2021 www.sdrma.org DAMAGE owner or operator of an Owned Auto as defined in the Coverage Agreement, is legally entitled to recover as Property Damage (but not loss of use) from the owner or driver of an Uninsured Motor Vehicle. The Property Damage must result from actual direct physical contact between the Owned Auto and the Uninsured Motor Vehicle provided that the owner or operator of the Uninsured Motor Vehicle is identified, or the Uninsured Motor Vehicle is identified by its license number. LIMIT(S)$10,000 per accident, subject to the terms, conditions and exclusions as provided in the Memorandum, and subject further to the terms, conditions and exclusions of the Uninsured/Underinsured Motorist Coverage Agreement contained in Exhibit C. MEMBER DEDUCTIBLE $25,000 per occurrence per auto accident, Property Damage only. 7799643.1