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Last modified
6/20/2022 11:13:44 AM
Creation date
7/20/2018 2:55:33 PM
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Contracts
Company Name
DISCOVERY SCIENCE FOUNDATION
Contract #
N-2018-140
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
8/8/2018
Destruction Year
2023
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271050 <br />A� a� CERTIFICATE OF LIABILITY INSURANCE <br />DAT7/312016vYv1 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Commercial Lines - 213-253-6700 <br />USI Insurance Services National, Inc. - CA Lic#: OD08408 <br />777 South Figueora SC Ste 2100 <br />Los Angeles, CA 90017 <br />CONTACTNorah.Jacobo <br />NAME: <br />PHONE FAX <br />Exl AIC No: <br />E MAIL. <br />ADDRESS: Norah.Jacobo@usi.com <br />INSURER(S) AFFORDING COVERAGE <br />NAICW <br />INSURERA: Philadelphia Indemnity Insurance Company <br />18058 <br />INSURED <br />Discovery Science Center of Orange County <br />dba. Discovery Cube Orange County N-2018-140 <br />2500 N. Main Street <br />Santa Ana, CA 92705 <br />INSURER B: Travelers Property Casualty CO Of America <br />25674 <br />INSURER C: <br />INSURER D: <br />INSURER E <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 13274314 REVISION NI IMRI See below <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 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 INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />WyD <br />POLICY NUMBER <br />POLICY EFF <br />MMiODIYYVY <br />POLICY E%P <br />fMMIDCVYYYYILIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MACE I OCCUR <br />X <br />PHPK1843692 <br />7/1/2018 <br />.7/1/209g <br />EACH OCCUR <br />$ L000,oco <br />FENCE <br />PREMISES Ea occurrence) <br />$ 100,000 <br />MEO EXP (Any one person) <br />$ 5,000 <br />PERSONAL It ADV INJURY <br />S 1,000,000 <br />GEHL AGGREGATE LIMIT APPLIES PER: <br />PRD- <br />X POLICY JECT LOG <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMPIOP AGG <br />$ 2,000,000 <br />Sexual Abuse/Molestation <br />IS Included <br />OTHER: <br />I <br />A <br />AUTOMOBILE <br />LIABILITY <br />PHPK1843692 <br />7/1/2018 <br />".7/1/2019 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ T000,000 <br />X <br />ANY AUTO <br />BODILY INJURY (Per person) <br />$ <br />11 OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accidanl) <br />$ <br />X <br />HIRED NON -OWNED <br />AUTOS ONLY X AUTOS ONLY <br />PROPERTY DAMAGE <br />Per accidanl <br />$ <br />$ <br />A <br />X <br />1 UMBRELLALIAB <br />X <br />OCCUR <br />PHUB567098 <br />7/1/2018 <br />7/1/2019 <br />EACH OCCURRENCE <br />$ 5,000,000 <br />AGGREGATE <br />$ 5,000,000 <br />EXCESS UAB <br />CLAIMS -MADE <br />DEO i RETENTION$ <br />$ <br />1 <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMERE%CLUDEO? C <br />NIA <br />U6003K35535418 <br />04I01/18 <br />04/01/19"' <br />PER 'ER"- <br />X STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L DISEASE - EA EMPLOYEE <br />S 1,000,000 <br />(Mandatory In NH) <br />If yes, describe under <br />EL DISEASE-POLICVLIMIT <br />$ 1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (ACORD 401. Additional Remarks Schedule, may be attached it more space is required) <br />The City of Santa Ana, its officers, agents, and employees and the City of Santa Ana Parks, Recreation and Com try Services Boy is named as <br />additional insured as it relates to general liability in accordance with the terms and conditions of the policy. The to t{v 'rage' rimary and <br />noncontributory where required by written contract.Umbrella follows form as it relates to additional insureds. <br />City <br />City of Santa Ana <br />Parks, Recreation and Community Services Agency <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br />SHOULD ANY OF TH5aSOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />ge/.� <br />The ACORD name <br />ACORD 25 (2016/03) <br />Qhls cPIS,au replaces ceuftee# 92742B5laved M LY201 B) <br />are registered marks of ACORD © 1988.2015 ACORD CORPORATION. All Hants reserved <br />
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