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Insurance - BHI Management Consulting - 2012-11-28OP ID: JK CERTIFICATE OF LIABILITY INSU6A8L912 DATEIsaapoo YYY) 11/28/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NOLWIMIWWWWWRUIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 3ELOW. 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(les) 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 415- 512 -2100 CONTACT NAME, Sweet & Baker Ins. Brokers Inc 415- 512 -1115 44 Second Street San Francisco, CA 94105 -3440 Roberta Gonzalez (415)512.2136 Fax - AIC No Ell: A/C No: E -MAIL ADDRESS, PRODUCER gHIMA -1 CUSTOMER 10 #: INSURERS AFFORDING COVERAGE NAIC If INSURED BHI Management Consulting INSURERA:The Hartford NIAC 11000 $ 2,000,00 Attn: Brent H. Ives 2459 Neptune Ct., Suite #110 Tracy, CA 95304 INSURERB:Philadelphia Insurance Co X INSURER C: 57SBAAV3592 11110112 11/10/13 PREMISES Eacccummce INSURER D: INSURER E INBIIRER 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 TR TYPE OF INSURANCE FOOL SUB POLICY NUMBER MMIDDY/YYYY POLICY IDIIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 A X COMMERCIAL GENERAL LIABILITY X 57SBAAV3592 11110112 11/10/13 PREMISES Eacccummce $ 1,000,00 CLAIMS -MADE OCCUR MED EXP(Any one person) $ 10,00 PERSONAL S ADV INJURY $ 2,000,00 _ GENERAL AGGREGATE $ 4,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 4,000,00 $ X POLICY PRO LOC AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT (Ea accident) $ 2,000,00 ANY AUTO BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ALLOWNEDAUTOS A SCHEDULED AUTOS HIRED AUTOS 57SBAAV3592 11110112 11110/13 PROPERTY DAMAGE (Per accident) $ X X $ NON- OWNEDAUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS Me CLAIMS -MADE DEDUCTIBLE $ $ RPTF-NTION % _ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNE'EXECUTIVE VVCSTATU- 'OTH- TOR YLIMI T R E.L. EACH ACCIDENT $ OFFICER EMBER EXCLUDED? (Mandatory in NH) NIA T:� E. L. DISEASE -EA EMPLOYEE $ E.L. CISEASE- POLICY LIMIT $ Ifyes, describe under DESCRIPTION OF OPERATIONS below B Professional Liab. PHSD757229 08123/12 08123113 Limit 1,000,00 Retention 2,50 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) Certificate holder is included as Additional Insured only as respects work performed by the Named Insured per written contract. See Attached Additional Insured endorsement PI -PLSP for Professional Liability. Costa Mesa Sanitary District 628 W 19th St Costa Mesa, CA 92627 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 © 1988 -2009 ACORD ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD 15 -512 -210 All riahts reserved. Philadelphia Indemnity Insurance Company Additional Insured Schedule Policy Number: PHSD757229 Additional Insured Costa Mesa Sanitary District 628 W 19th St Costa Mesa, CA 92627 -2716 PI -PLSP -103 - Miscellaneous Professional Page 1 of