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Insurance- White Nelson Diehl Evans LLP 2015-05-13CERTIFICATE OF LIABILITY INSURANCE I °"5Y�139115 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 AD I L Ohly(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain p tea may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MAY 15 2904191CONTACT STEVE SCHNEIDER NAME: SILVER CREEK INSURANCE AGENCY orvE 714-838-0693 FAX 714-838-9438 17742 IRVINE BLVD SUITE 203 GUJIA 1110A SANITARY DIS IC IL Ext: AIC No: MAILBS ADDRESS: TUSTIN CA 92780 INSURED WHITE NELSON DIEHL EVANS LLP 2875 MICHELLE, SUITE 300 IRVINE, CA. 92606 SENTINEL INS. CO. LTD SENTINEL INS. CO. LTD 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. /NSR LTR TYPE OF INSURANCE AINSR DOL 9UD POLICY NUMBER MMmDYEFF f1'YYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY COMMERCIAL COMMERCIAL GENERAL LIABILITY 57SBABH5586 6/1/15 6/1/16 EACH OCCURRENCE $ 1000000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300000 MED EXP (My one person) $ 10000 CLAIMS -MADE ©OCCUR PERSONAL B ADV INJURY $ 1000000 A X GENERAL AGGREGATE $ 2000000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2000000 POLICY PRO LOC JECT $ AUTOMOBILE LIABILITY 57SBABH5586 6/1/15 6/1/16 (ECO. BINEDt SINGLE LIMIT $ 1000000 BODILY INJURY (Per Parson) $ ANY AUTO A ALL OWNED SCHEDULED AUTOS AUTOS X BODILY INJURY (Par accilent) 8 NON -OWNED HIRED AUTOS AUTOS PROPERN DAMAGE $ Per accident $ UMBRELLA LIAR OCCU 57SBABH5586 6/1/15 6/1/16 EACH OCCURRENCE $ 4000000 A EXCESS LIAB CLAIM:R -MADE X _ AGGREGATE $ 4000000 DED RETENTION$ 10 000 $ B WORKERS COMPENSATION ANDEMPLOYERS'LIASILITY YIN ANY PROPRIETORIPARTNERIEX OFFICERIMEMBER EXCLUDED?ECUTIVE❑ NIA 4 57WECDX233 6 1 / /15 6/1/16 WC S TH - T RV /MITTATLL D E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYE $ 1000000 (Mandatory, in NH) If yes, describe under - -DESCRIPTION OFOPERATIONS below EL.DISEASE -POLICY LIMIT $ 1000000 A Business Interruption 57SBABH5586 6/1/15 6/1/16 =: mom.^••_•_^_==•••W=•==•_ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mare space is required) RE: White Nelson Diehl assns LLP Those usual to the insured's operations. The District, its directors, officials, officers, employees, agents and volunteers are named as additional insured per additional insured frons SS4170 and SS4171 attached to this policy. Business liability wavier of subrogation applies to the certificate holder per form SS0008, Blanket Waiver of Subrogation applies to workers compensation per from WC000313 attached to this policy. Coverage is primary and non-contributory per the business liability coverage form SS0008. 30 day advanced notice of cancellation, 10 day notice for non-payment cancellation. Costa Mesa Sanitary District 628 W. 19th Street Costa Mesa O/F�o CA 92627 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANC TH THE POLICY PROVISIONS. AUTHORIZED reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 57 SEA BH5586 ,OL THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON -ORGANIZATION CITY OF VISTA 200 CIVIC CENTER DR VISTA CA 92084-6275 CITY OF RANCHO SANTA MARGARITA, ITS ELECTED AND APPOINTED BOARDS, COMMISSIONS, OFFICERS, AGENTS, AND EMPLOYEES ARE AN ADDITIONAL INSURED PER THE BUSINESS LIABILITY COVERAGE FORM SS0008 ATTACHED TO THIS POLICY. CITY OF RANCHO SANTA MARGARITA ATTN: CITY MANAGER 22112 EL PASEO RANCHO SANTA MARGARITA, CA 92688 CCOSTA MESA SANITARY DISTRICT \ 628 W 19TH ST /\ COSTA MESA, CA 92627 THE CITY OF RANCHO CUCAMONGA ITS OFFICERS, OFFICIALS, EMPLOYEES, DESIGNATED VOLUNTEERS, OR AGENT SERVING AS INDEPENDENT CONTRACTORS IN THE ROLE OF CITY OFFICIALS CITY OF GILROY, ITS ELECTED OFFICIALS, OFFICERS, AGENTS, AND EMPLOYEES 7351 ROSANNA STREET GILROY, CA 95020 Form IH 12 00 11 85 T SEQ. NO. 002 Process Date: 02/27/15 Printed in U.S.A. Page 001 Expiration Date: 06/01/16