Insurance - BHI Management Consulting - 2009-03-04 0(111E311"13"
ACORD CERTIFICATE OF LIABILITY INSURANCE OPID JK DATE(MM/DDIYYYY)
BHIMA-1 03/04/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
• Sweet & Baker Ins. Brokers Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
44 Second Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Francisco CA 94105-3440
Phone: 415-512-2100 Fax:415-512-1115 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: The Hartford 29424
INSURER B: Axis Surplus insurance Company
BHI Management Consulting
Attn: Brent H. Ives INSURER C:
2459NeptCt. , Suite #110 INSURER D:
Trac y CA 95e0
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 10 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1NSREAnm4 POLICY EFFEI.I IVE POLICY EXPIRATION
LTRINSRC TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DO/YY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $2,000,000
A X X COMMERCIAL GENERAL LIABILITY 57SBAAV3592 11/10/08 11/10/09 FRAEMISES(Eaoccurence) $300,000
CLAIMS MADE I X I OCCUR MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 2,000,000
GENERAL AGGREGATE $ 4, 000,000
GGEEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000
]S POLICY I�PRO-
JECT LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $2,000,000
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS 57SBAAV3592 11/10/08 11/10/09 (Perpsoon)
A X HIRED AUTOS
X NONOWNED AUTOS (Per accident)RY $
PROPERTY DAMAGE
Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO EA ACC $
OTHER THAN AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR [ I CLAIMS MADE AGGREGATE $
DEDUCTIBLE
RETENTION $ $
WORKERS COMPENSATION AND WI.SIA W- UIH
EMPLOYERS'LIABILITY _TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE EL.EACH ACCIDENT $
OFFICER/MEMRER EXCLUDED?
E.L.DISEASE-EA EMPLOYEE $
Sy s,ALPReenter
OTECIAL PROVISIONS below EL DISEASE-POLICY LIMIT g
OTHER
B Professional Liab. PHSD339804 08/23/08 08/23/09 Limit 1,000,000
Retention 5,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Certificate holder is named as Additional Insureds regarding General
Liability only as respects work performed by the Named Insured.
*10 day cancellation notice applies to non payment of premium.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Costa Mesa Sanitary District IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
628 W 19th St
Costa Mesa CA 92627 REPRESENTATIVES.
A ED REPRESENIJ
ACORD 25(2001/08) 0 ACORD CORPORATION 1988