ORANGE COUNTY TRANSPORTATION AUTHORITY (OCTA) AND VIETNAMESE COMMUNITY OF ORANGE COUNTY - 2016

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CERTIFICATE OF COVERAGE I 07/05/2016 PRODUCER: I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, Alliant Insurance Services, Inc. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE MEMORANDUM OR POLICY P.O. BOX 6450 BELOW: NEWPORT BEACH, CA 92658-6450 COMPANIES AFFORDING COVERAGE PH (949)756-0271 / FAX (949)756-2713 LICENSE NO, OC36861 COMPANY LETTER (A) BIG INDEPENDENT CITIES EXCESS POOL BIG INDEPENDENT CITIES EXCESS POOL MEMBER: CITY OF SANTA ANA ATTN: ED RAYA RISK MANAGER P.O. BOX 1988 SANTAANA, CA 92702-1988 COMPANY LETTER (B) COMPANY LETTER (C) COMPANY LETTER (D) COMPANY LETTER (E) COMPANY LETTER (F) THIS IS TO CERTIFY THAT THE MEMORANDUM OF COVERAGE OR POLICY(IES) LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY OR MEMORANDUM 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 COVERAGES AFFORDED BY THE MEMORANDUM OR POUCY(IES) DESCRIBED HEREIN ARE SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUM OR POLICY. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO I TYPES LTR OF COVERAGES EXCESS LIABILITY A OCCURRENCE FORM INCLUDING AUTOMOBILE LIABILITY MEMORANDUM MEMORANDUM MEMORANDUM OR OR POLICY OR POLICY POLICY NUMBER EFFECTIVE I EXPIRES BO-05 1 07/01/2016 1 07/01/2017 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS: AS RESPECTS AGREEMENT #C-2-0148 SENIOR MOBILITY PROGRAM. LIMIT DIFFERENCE BETWEEN BI & PD $10,000,000 POOL LIMIT AND COMBINED $1,000,000 SELF -INSURED RETENTION CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED SOLELY WITH RESPECT TO BODILY INJURY AND PRgP�k DAMAGE ARISING OUT OF OPERATIONS AS DESCRIBED BY OR ON BEHALF OF THE NAMED INSURED A ' ) SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS.eJ\Pw` wA \l 2� ll� ORANGE COUNTY TRANSPORTATION AUTHORITY ATTN: REBECCA POTTER, CPM SENIOR PROCUREMENT ADMINISTRATOR 550 S. MAIN STREET ORANGE, CA 92863-1584 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.