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Insurance - HF & H - 2011-11-22 • /-"N HILTONF OP ID: SW A�°RO CERTIFICATE OF LIABILITY INSURANCE DATE(MMID1/YYYY) 11122111 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(s). PRODUCER CONTACT 925-866-7050 NAME. CCI Financial S Ins.Solutions License#0381524 925-866-8275 Iuc N U ,Ex : FAX No): P O.Box 5076 EMAIL San Ramon,CA 94583-1328 ADDRESS: CCI House:previous Concal INSURER(S)AFFORDING COVERAGE NAICp INSURER A.Hartford I, uran Company 22357 INSURED HF&H Consultants,LLC INSURER B.Ame nCasualty Co of 201 North Civic Drive Ste 230 - Walnut Creek,CA 94596 INSURER C.H0 slo Ca allY Company INSURER D. INSURER E. 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INS WVDI POLICY NUMBER IMMIDDIYYYY) IMMIDDIYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE I S 2,000,000 _ A © COMMERCIAL GENERAL LIABILITY X 57SBAGB6653 12/15/10 12/15/11 DAMAGE TO RENTED PREMISES(Ea occurrence) I$ 300,000 ■© CLAIMS-MADE OCCUR MEDEXP(Any one person) S 10,000 I PERSONAL S ADV INJURY s 2,000,000 _ GENERAL AGGREGATE $ 4,000,000 I GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 4,000,000 7 POLICY I I PELT n LOC $ I AUTOMOBILE LIABILITY CEO B EDl,INGLE LIMIT $ 2,000,000 I A I ANY AUTO 57SBAGB6653 12115/10 12/15/11 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Pe accident) $ AUTOS _ AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per student $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESSLIAB CLAIMS-MADE i575BAGB6653 12/15/10 12115/11 AGGREGATE $ 3,000,000 DED I X I RETENTION 10.000 I S WORKERS COMPENSATION WC STATU- 0TH- AND EMPLOYERS'LIABILITY I X I TORY L MITS I ER Y/N B ANYPROPRIETOR/PARTNERIEXECUTIVE WC412259330 09/06/11 09/06/12 EL EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? ( N/A (Mandatory I NH) EL.DISEASE EA EMPLOYEE$ 1,000,000 II yes,desenbe under DESCRIPTION OF OPERATIONS below EL DISEASE POLICY LIMIT I$ 1,000,000 C Profesional Liab H71113087 06/01/11 06/01/12 Occur/Agg 2,000,000 Retro Date:8/1(89 Retention 25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Adding al Remarks Schedule ifmo spa equ ad) RE:Wastewater Rate Study Costa Mesa Sanitary District and its officers,agents and employees are named as Additional Insured with respect to General Liability as required by written contract per the attached. CERTIFICATE HOLDER CANCELLATION COSTAME SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Costa Mesa Sanitary District THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: District Clerk 628 West 19th St. AUTHORIZED REPRESENTATIVE Costa Mesa, CA 92627 ,0 I I ©1998-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Named Insured HF&H Consultants LLC • Policy Number 57SBAGB6653 Policy Term 12/15/10 12/15/11 BUSINESS LIABILITY COVERAGE FORM (b) Rented to, in the care, custody or b. Coverage under this provision does not control of, or over which physical apply to: control is being exercised for any (1) 'Bodily injury' or 'property damage' purpose by you, any of your that occurred; or 'employees' 'volunteer workers' any partner or member Of you are (2) 'Personal and advertising injury' a partnership or joint venture), or arising out of an offense committed any member (if you are a limited before you acquired or formed the liability company). organization. b. Real Estate Manager 4. Operator Of Mobile Equipment Any person (other than your 'employee or With respect to 'mobile equipment" registered in 'volunteer worker"), or any organization your name under any motor vehicle registration while acting as your real estate manager law any person is an insured while driving such c. Temporary Custodians Of Your equipment along a public highway with your Property permission. Any other person or organization responsible for the conduct of such person is Any person or organization having proper also an insured, but only with respect to liability temporary custody of your property if you arising out of the operation of the equipment, and die, but only only if no other insurance of any kind is available (1) With respect to liability arising out of the to that person or organization for this liability maintenance or use of that property and However no person or organization is an insured (2) Until your legal representative has with respect to: been appointed. a. 'Bodily injury' to a co- employee of the d. Legal Representative If You Die person driving the equipment; or Your legal representative if you die, but b. 'Property damage' to property owned by only with respect to duties as such. That rented to, in the charge of or occupied by representative will have all your rights and you or the employer of any person who is duties under this insurance. an insured under this provision. e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that yours which is a legally incorporated entity is less than 51 feet long and is not being used of which you own a financial interest of to carry persons for a charge, any person is an more than 50% of the voting stock on the insured while operating such watercraft with effective date of this Coverage Part. your permission. Any other person or The insurance afforded herein for any organization responsible for the conduct of such person is also an insured, but only with subsidiary not shown in the Declarations respect to liability arising out of the operation as a named insured does not apply to of the watercraft, and only if no other injury or damage with respect to which an insurance of any kind is available to that insured under this insurance is also an person or organization for this liability insured under another policy or would be an insured under such policy but for its However no person or organization is an termination or upon the exhaustion of its insured with respect to: limits of insurance. a. 'Bodily injury' to a co-'employee' of the 3. Newly Acquired Or Formed Organization person operating the watercraft; or Any organization you newly acquire or form, b. "Property damage to property owned by other than a partnership, joint venture or rented to, in the charge of or occupied by limited liability company and over which you you or the employer of any person who is maintain financial interest of more than 50% of an insured under this provision. the voting stock, will qualify as a Named 6. Additional Insureds When Required By Insured if there is no other similar insurance Written Contract, Written Agreement Or available to that organization. However Permit a. Coverage under this provision is afforded The person(s) or organization(s) identified in only until the 180th day after you acquire Paragraphs a. through f. below are additional or form the organization or the end of the insureds when you have agreed, in a written policy period,whichever is earlier and Form SS 00 08 04 05 Page 11 of 24 Named Insured HF&H Consultants LLC Policy Number 57SBAGB6653 BUSINESS LIABILITY COVERAGE FORM Policy Term. 12/15/10 12/15/11 contract, written agreement or because of a (e) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement,or the issuance of the permit. with the distribution or sale of the A person or organization is an additional products; insured under this provision only for that (f) Demonstration, installation, period of time required by the contract, servicing or repair operations, agreement or permit. except such operations performed at the vendor's premises in However no such person or organization is an connection with the sale of the additional insured under this provision if such product; person or organization is included as an additional insured by an endorsement issued (g) Products which, after distribution by us and made a part of this Coverage Part, or sale by you, have been labeled including all persons or organizations added or relabeled or used as a as additional insureds under the specific container part or ingredient of any additional insured coverage grants in Section other thing or substance by or for F —Optional Additional Insured Coverages. the vendor or a. Vendors (h) 'Bodily injury' or 'property Any person(s)or organization(s) (referred to damage' arising out of the sole negligence of the vendor for its below as vendor), but only with respect to own acts or omissions or those of 'bodily injury' or 'property damage' arising its employees or anyone else out of "your products' which are distributed acting on its behalf. However this or sold in the regular course of the vendor's exclusion does not apply to: business and only if this Coverage Part provides coverage for 'bodily injury' or (i) The exceptions contained in 'property damage' included within the Subparagraphs(d) or(f); or 'products-completed operations hazard' (ii) Such inspections, adjustments, (1) The insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions: undertakes to make in the usual course of business, in This insurance does not apply to: connection with the distribution (a) 'Bodily injury' or 'property or sale of the products. damage for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of whom you have acquired such products, liability in a contract or agreement. or any ingredient, part or container This exclusion does not apply to entering into, accompanying or liability for damages that the containing such products. vendor would have in the absence of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only (c) Any physical or chemical change with respect to their liability for 'bodily in the product made intentionally injury' property damage' or 'personal and advertising injury" by the vendor caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization. or the substitution of parts under instructions from the manufacturer and then repackaged in the original container Page 12 of 24 Form SS 00 08 04 05 Named Insured HF&H Consultants LLC Policy Number 57SBAGB6653 Policy Term 12/15/10 12/15/11 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded e. Permits Issued By State Or Political to these additional insureds, this Subdivisions insurance does not apply to any (1) Any state or political subdivision, but 'occurrence' which takes place after only with respect to operations you cease to lease that equipment. performed by you or on your behalf for c. Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organization from has issued a permit. whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to: of that part of the land or premises (a) 'Bodily injury' 'property damage' leased to you. or 'personal and advertising (2) With respect to the insurance afforded injury' arising out of operations to these additional insureds, this performed for the state or insurance does not apply to: municipality or (a) Any 'occurrence which takes (b) 'Bodily injury' or 'property damage' place after you cease to lease that included within the 'products- land or be a tenant in that completed operations hazard' premises; or f. Any Other Party (b) Structural alterations, new (1) Any other person or organization who construction or demolition is not an insured under Paragraphs a. operations performed by or on through e. above, but only with behalf of such person or respect to liability for 'bodily injury' organization. 'property damage' or 'personal and d. Architects, Engineers Or Surveyors advertising injury' caused, in whole or (1) Any architect, engineer or surveyor but in part, by your acts or omissions or only with respect to liability for 'bodily the acts or omissions of those acting injury' 'property damage' or 'personal on your behalf: and advertising injury' caused, in whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of those acting on (b) In connection with your premises your behalf: owned by or rented to you; or (a) In connection with your premises; (c) In connection with 'your work' and or included within the 'products- (b) In the performance of your completed operations hazard' but ongoing operations performed by only if you or on your behalf. (i) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to (ii) This Coverage Part provides 'bodily injury' 'property damage or coverage for 'bodily injury' or 'personal and advertising injury' property damage' included arising out of the rendering of or the within the products- failure to render any professional completed operations hazard' services by or for you, including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, 'Bodily injury' 'property damage' or reports, surveys, field orders, 'personal and advertising injury' change orders, designs or arising out of the rendering of, or the drawings and specifications; or failure to render any professional (b) Supervisory inspection, architectural, engineenng or surveying architectural or engineering services, including: activities. Form SS 00 08 04 05 Page 13 of 24 Named Insured HF&H Consultants LLC BUSINESS LIABILITY COVERAGE FORM Policy Number 57SRAGS6653 Policy Term. 12/15/10 12/15/11 (a) The preparing, approving, or This General Aggregate limit does not failure to prepare or approve, apply to 'property damage' to premises maps, shop drawings, opinions, while rented to you or temporarily reports, surveys, field orders, occupied by you with permission of the change orders, designs or owner arising out of fire, lightning or drawings and specifications; or explosion. (b) Supervisory inspection, 3. Each Occurrence Limit architectural or engineering Subject to 2.a. or 2.b above, whichever activities. applies, the most we will pay for the sum of all The limits of insurance that apply to additional damages because of all 'bodily injury' insureds are described in Section D — Limits 'property damage' and medical expenses Of Insurance. arising out of any one occurrence' is the How this insurance applies when other Liability and Medical Expenses Limit shown in insurance is available to an additional insured the Declarations. is described in the Other Insurance Condition The most we will pay for all medical expenses in Section E. — Liability And Medical Expenses because' of 'bodily injury' sustained by any General Conditions. one person is the Medical Expenses Limit No person or organization is an insured with shown in the Declarations. respect to the conduct of any current or past 4. Personal And Advertising Injury Limit partnership, joint venture or limited liability Subject to 2.b. above, the most we will pay for company that is not shown as a Named Insured in the sum of all damages because of all the Declarations. 'personal and advertising injury' sustained by D LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal LIMITS OF INSURANCE and Advertising Injury Limit shown in the Declarations. 1 The Most We Will Pay 5. Damage To Premises Rented To You Limit The Limits of Insurance shown in the Declarations and the rules below fix the most The Damage To Premises Rented To You we will pay regardless of the number of: Limit is the most we will pay under Business Liability Coverage for damages because of a. Insureds; 'property damage to any one premises, while b. Claims made or 'suits' brought; or rented to you, or in the case of damage by fire, c. Persons or organizations making claims or lightning or explosion, while rented to you or bringing 'suits' temporarily occupied by you with permission of 2. Aggregate Limits the owner The most we will pay for In the case of damage by fire, lightning or explosion, the Damage to Premises Rented To a. Damages because of 'bodily injury' and You Limit applies to all damage proximately 'property damage' included in the caused by the same event, whether such 'products-completed operations hazard' is damage results from fire, lightning or explosion the Products-Completed Operations or any combination of these. Aggregate Limit shown in the 6. How Limits Apply To Additional Insureds Declarations. The most we will pay on behalf of a person or b. Damages because of all other 'bodily injury' 'property damage or 'personal organization who is an additional insured and advertising injury' including medical under this Coverage Part is the lesser of: expenses, is the General Aggregate Limit a. The limits of insurance specified in a shown in the Declarations. written contract, written agreement or This General Aggregate Limit applies permit issued by a state or political separately to each of your 'locations' subdivision; or owned by or rented to you b. The Limits of Insurance shown in the 'Location' means premises involving the Declarations. same or connecting lots, or premises Such amount shall be a part of and not in whose connection is interrupted only by a addition to the Limits of Insurance shown in street, roadway or right-of-way of a the Declarations and described in this Section. railroad. Page 14 of 24 Form SS 00 08 04 05