Insurance - CBIZ Inc - 2015-11-10Client#: 2372
CBIZINC
ACORD.. CERTIFICATE OF LIABILITY INSURANCEDATE(MWDDNYYY)
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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,
11/10/2015
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
NAME:
CBIZ Insurance Services, Inc.
A/CO Nc
700 W 47th St
Ext: AIC, No):
E-MAIL DLCBIZR!sk&Consulting@cblz.com
ADDRESS: g@cbiz.com
1100
$
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Kansas City, MO 64112
INSURER(S) AFFORDING COVERAGE NAIC0
INSURER A: Lexington Insurance Co 19437
INSURED
CBIZ, Inc. &subsidiaries
INSURER B:
6050 Oak Tree Blvd., South, Suite 500
INSURER C:
Cleveland, OH 44131
INSURER D:
INSURER E:
INSURER F:
PERSONAL &ADV INJURY $
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 CONTRACTOR 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.
INR
TYPE OF INSURANCE
ADDLSUBR
INSR
WD
POLICY NUMBER
POLICY EFF
MMIDD/YYYV
POLIM/CY EXP
MDD/YYY
LIMITS
GENERAL LIABILITY
$
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COMMERCIAL GENERAL LIABILITY
�OCCURRENCE
PREMISESOEaocco ance $
MED EXP (Any one person) $
CLAIMS -MADE F—I OCCUR
PERSONAL &ADV INJURY $
GENERAL AGGREGATE $
GEN'LAGGREG^ATE LIMIT APPLIES PER:
'.LG
OLhY PE`CT 7,LOC
PRODUCTS - COMP/OP AGG $
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
BODILY INJURY (Per person) $
ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURYPaccident)
(Per acctlenl $
)
NON -OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE $
Per accident)
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE $
I EXCESS LIAB
CLAIMS -MADE
AGGREGATE $
1 DEO I I RETENTION$
$
WORKERS COMPENSATIONWC
STATU- OTH-
ANDEMPLOYERS'LIABILfrY Y/N
ANY PROPRIEfOR/PARTNEWEXECUTIVE
OFFICER/MEMBER EXCLUDED?
N/A
T RV LIMIT R
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
(Mandatory In NH)
if yes, describe under
E.L. DISEASE -POLICY LIMIT $
_
DESCRIPTION OF OPERATIONS below
A
Prof Liab-E&O
020749175
12/15/2014 06/01/2016
$20,000,000 Aggregate
A
IA -Broker Dealer
02074917512/15/2014
06/01/201
$7,500,000 Sublimit
A
Invest Banking020749175
2/15/2014106/01/201
$1,000,000 Sublimit
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
RE: Professional Services Agreement
Costa Mesa Sanitary District
628 W. 19th Street
Costa Mesa, CA 92627 _VV
ACORD 25 (2010/05) 1 of 1
#S1216765/MI214750
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
CBIZ Insurance Services, Inc.
W 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
51 LW