Insurance - SDRMA- Employee-Public Official Dishonesty Coverage 2020-07-01Issue Date
NON-MEMBER'S CERTIFICATE OF COVERAGE
7/1/2020
Provider Special District Risk Management Authority
1112 T Street, Suite 300 AS116,
Sacramento, California 95814 SDRMA.
800.537.7790 www.sdrma.org
Member Costa Mesa Sanitary District Member Number: 6819
290 Paularino Avenue Certificate Number: 7
Costa Mesa, California 92626
This is to certify that coverages listed below have been issued to the Member named above for the period indicated. This certificate is not an insurance
policy or an agreement of coverage and does not amend, extend or alter the coverage afforded by the agreements listed herein. 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 coverage
described herein is subject to all the terms, exclusions, and conditions of the specific coverage document. This certificate of coverage evidences the limits
of liability in effect at the inception of the agreements shown; limits shown may have been reduced by paid claims. This certificate is issued as a matter of
information only and confers no rights upon the certificate holder.
Type of Coverage
Policy Number
Effective Date
Expiration Date
Limits
General Liability
LCA-SDRMA-202021
7/1/2020
7/1/2021
Employee/Public Officials Dishonesty
Per Occurrence $1,000,000
RECEIVED
JUN 15 2020
Costa Mesa Sanitary District
Proof of Coverage: Coverage includes Designated Agent as Employee - Marcus Davis As Independent Treasurer for the Costa Mesa Sanitary District.
Cancellation: Should any of the above-described policies be cancelled before the expiration dates thereof, the issuing company will endeaver 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.
Certificate Dates:
Effective Date
Expiration Date
Certificate Type:
Additional Covered Party ❑ Loss Payee
7/1/2020
7/1/2021
X Evidence of Coverage
Certificate Holder
Costa Mesa Sanitary District`�-�-
290 Paularino Ave
Laura S. Gill - Chief Executive Officer
Costa Mesa, CA 92626