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CERTIFICATE <br />OF COVERAGE <br />07/26/2018 <br />1 <br />PRODUCER: <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO <br />TYPES <br />RIGHTS UPON THE CERTIFICATE HOLDER> THIS CERTIFICATE DOES NOT <br />Alliant Insurance Services, Inc. <br />AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER COVERAGE AFFORDED <br />P.O. BOX 6450 <br />BELOW. THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUTE A CONTRACT <br />OF <br />BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, <br />NEWPORT BEACH, CA 92658-6450 <br />AND THE CERTIFICATE HOLDER. <br />PH (949) 756-0271 / FAX (949) 756-2713 <br />LICENSE NO. OC36861 <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED and/or requesting a WAIVER <br />EFFECTIVE <br />OF SUBROGATION, the Memorandums of Coverage must be endorsed. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />BIG INDEPENDENT CITIES EXCESS POOL MEMBER: <br />CITY OF SANTA ANA <br />ATTN: DEBBIE SCOTT-LEISTRA, INTERIM <br />RISK MANAGER <br />P.O. BOX 1988 <br />SANTA ANA, CA 92702-1988 <br />COMPANIES AFFORDING COVERAGE <br />COMPANY LETTER (A) BIG INDEPENDENT CITIES EXCESS POOL <br />COMPANY LETTER (B) <br />COMPANY LETTER (C) <br />COMPANY LETTER (D) <br />COMPANY LETTER (E) <br />THIS IS TO CERTIFY THAT THE MEMORANDUMS OF COVERAGE LISTED BELOW HAVE BEEN ISSUED TO THE MEMBER NAMED ABOVE FOR THE PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE COVERAGE AFFORDED BY THE MEMORANDUMS DESCRIBED HEREIN IS SUBJECT TO ALL THE <br />TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH MEMORANDUMS. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />CO <br />TYPES <br />MEMORANDUM <br />MEMORANDUM <br />MEMORANDUM <br />LTR <br />OF <br />OR <br />OR POLICY <br />OR POLICY <br />LIMIT <br />COVERAGES <br />POLICY NUMBER <br />EFFECTIVE <br />EXPIRES <br />$2,000,000 <br />EXCESS LIABILITY <br />BO -05 <br />BODILY <br />LIMIT INCLUSIVE OF <br />A <br />OCCURRENCE FORM <br />ANDY <br />$1,000,000 <br />07/01/2018 <br />07/01/2019 <br />PROPERTY <br />SELF-INSURED RETENTION <br />INCLUDING AUTOMOBILE <br />DAMAGE <br />AND <br />LIABILITY <br />COMBINED <br />$1,000,000 <br />BICEP POOL LAYER <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS: <br />AS RESPECTS MEMORANDUM OF UNDERSTANDING (MOU) EFFECTIVE 7/1/18— 7/1/22 THE CITY OF SANTA ANA HAS AGREED TO <br />PROVIDE SERVICES AND FACILITIES TO COLLEGE AND CAREER PREFATORY ACADEMY TO ASSIST IN JOB SEARCHING AS OUTLINED IN <br />THE MOU. THIS INCLUDES SEXUAL ABUSE AND MOLESTATION LIABILITY COVERAGE. <br />CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED SOLELY WITH RESPECT TO BODILY INJURY AND PROPERTY DAMAGE <br />ARISING OUT OF OPERATIONS AS DESCRIBED BY OR ON BEHALF OF THE NAMED INSURED <br />COVERAGE IS PRIMARY AND NON-CONTRIBUTORY WITH RESPECT TO ANY INSURANCE CARRIEDpgC;ER IFICATE HOLDERS AS <br />REQUIRED BY CONTRACT ii <br />SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS. ` <br />X12 \P� <br />COLLEGE AND CAREER PREPARATORY ACADEMY <br />1669 E. WILSHIRE AVE. STE. 605 <br />SANTA ANA, CA 92705 <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED MEMORANDUMS OF COVERAGES BE <br />CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIL BE <br />DELIVERED IN ACCORDANCE WITH THE MEMORANDUMS OF COVERAGE <br />PROVISIONS. <br />I <br />PIAT <br />