Insurance - SDRMA - 2005-07-01 - , ar 22 06 0413p SD'MA ' (916) 231-4111 (916)231 4111 p.1
03./22.2006 l CERTIFICATE OF COVERAGE
Thi is to certify that age selected below has been issued to the member named below fo the perob indicated notwithstanding ny j'�®RM p
equ eme term, pandit on of any tact Or Whet Jo umenl with respect to which Iris el-U irate may be tied may ports the J 77 H
e-age closeted here is subject to all the terms exclusions,and meridians of the specific eerier-ace document,limits shown may have been
educed by paid clams This cenficate of nstrance or binder vtdences the limits of labrfty i effect at the inception of the policies shown This
ceNLCate is ued matter of nformabon only and conk no nghts upon the ertficate holder Thb certificate does not amend extend or
alter the coverage afforded by the politic listed below
•
Participating Member Member Number Company Affording Coverage:
Costa Mesa Sanitary District BOP-6819 Special Dis:rict Risk Management Authority
628 West 19th Street 1112 I Street. Suite 300
Costa,vlesa.CA 92627-2716
Sacramento, California 55614
Toll-Free 800 537 7790 wwwsdrma ore
Type of Coverage Policy Number I Effective Date i Expiration Date Limits
General Liability L$ASDRMA-200506 07/012005 071012006
Personal injury and Progeny De made
Oocurrence Form Per Oc $S.0055.000,01r Property y Damage 5500
Deductible
GLl Public Officials and Employees Errors LOASDRMA-200506 07/01/2005 070112006
Oatmer;e Form Per Occurrence $5,000,000
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General Aggregate 55.000,000
R! Personal Liability Coverage for Board LC.A-SDRMA-200506 07/01/2005 07/01/2006
Members
Oaurtimce Form Flier Occurrence 1500,000
GeneralAggregate $500,000
Deductible . $500
jgl,Employment Practices Liability LCA-SDRMA-201.50E • 07/01/2005 0710112005 . - -
Per Occurrence f $5,000,000
Occurrence Form General Aggregate $5,000,000
® Employee Benefits Liability LOA-SDRMA-2005 07:012005 07/01/2006
Per Occurrence y 701:10'
Ocoirrence Farm General Aggregate $5,000,000
iR Employee Dishonesty Coverage EDC-SDRMA-200506 07/0112005 07/01/2006
Per Occurrence -34003ff00
IX Auto Liability LCA-SDRMA-200506 37/01/2005 07/012006
Pe sonel Injury and Propel),Damage Per Occurrence S5000.000
Property Damage $1.000
Deductible
114 Auto Physical Damage LCA-SDRMA-200506 07/01/2005 ' 07/01/2005
I Limits on File -
® Uninsured/Underinsured Motorists UMISDRMA-200506 07/01/2005 07/01/2006
Each Ai-derrn750,000
❑ Trailer Coverage -
® Property Coverage !PPC-SDRM4.2005C6 07/012005 07(01/2006
Induces Fire,Theft and Fbod 111 Each Occurrence $1,000,000,000
Property Darage Property Damage $2.000
Deductible
Replacement cost for
Scheduled Property
® Boiler and Machinery'Coverage EMC-SDRMA-200506 07/01/2005 07/01/2006
Each ccurrence S 00 C 5 0-
Deductible S1,000
Replacement CoilTY
Scheduled Properly
® Workers'Comp. WCP SDRMA-200506 07/01/2005 07/012006
A Slalulcry t4orti:rs Comp Each Occurrence Si 5C,00
B =m:ACyers Lieo•Illy Coverage I Each Oxurrence $5,000,000
Description All listed Co rage is in effect only far the time pe led specified
Cancel:alien. 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 liability of any kind upon the company Autho:ized Signature
Declarations Summary SDRMA
Costa Mesa Sanitary District
sue. .
,y,, iizi,- As a member of the Special District Risk Management Property and Liability
r. A. it" {�• %..•:'. •d Program, the agency participates in a risk-financing program described in the
,A. Property and Liability Program 2005-2006 Declarations.
i f •``,ti.
tk The Declarations, along with the Memorandum of Coverages, Fifth Amended and
2.4s,' Restated Joint Powers Agreement and SDRMA's Bylaws encompass the risk-
" -. . /..ki-- financing coverage between SDRMA and your agency
•t4 44:4:,r �zi
` The Declarations contained on the following pages in this section describe the
I z+ q, t 'k yq; coverages for which the agency participates in as well as the Limits of Liability.
of --- ,h. , '4, rr SDRMA has prepared the following Coverage Matrix as a quick reference guide to
'`l.,..y.::::: � '\ ..c ?4;,ii . the coverages contained in the package program.
COVERAGE TYPE LIMIT DEDUCTIBLE
$5,000,000 Per None, Except$500 On
General Liability Occurrence, No Annual Properly Damage Per
Aggregate Occurrence
$5,000,000 Per None, Except$1,000 On
Auto Liability Occurrence No Annual Property Damage Per
Aggregate Occurrence
Scheduled Autos Only
Auto Physical Actual Cash Value (ACV), or $250/$500 or $500/$1,000
Damage stated value or actual cost Per Occurrence
of repair
Scheduled Locations Only
Boiler& Machinery Repair/Replacement Cost $1 000 Per Occurrence
with $100,000,000 Limit
Personal Liability $500,000 Per Board $500 per claim
Coverage for Board Member/Director Per Year
Members/Directors
Employee $400,000 Limit None
Dishonesty Coverage
$5,000,000 Per
Employee Benefits Occurrence/Annual None
Liability Aggregate
Employment $5,000,000 Per None
Practices Liability Occurrence/Annual
Aggregate
Scheduled Locations Only
Property Replacement Cost With $2,000 Per Occurrence
$1,000,000,000 Limit
$5,000,000 Per
Public Officials Occurrence/Annual None
Errors&Omissions Aggregate
This information is provided as a general description only, and is not intended to supersede specific policy documents
In the event of a conflict in language. the policy(s)will be the controlling document
2005 2006 Property nd Liability Coverage Documents Secti 2 Summary Toll-Free 800.537.7790
Special District Risk Ma agement Autho ity Fa 916.231.4111
www.sdrma.