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EVIDENCE OF COVERAGE <br />OATSYYYY) <br />3/222/20/20 19 <br />This Evidence of Coverage is used as a matter of information only and confers no rights upon the Certificate Holder. This Evidence of Coverage does not <br />amend, extend, or alter the coverage afforded by the memoranda listed below. <br />MEMORANDUM NUMBER: 77 <br />JOINT POWERS AUTHORITY (JPA) <br />Alliance of Schools for Cooperative Insurance Programs <br />16550 Bloomfield Avenue <br />Cerritos, CA 90703 <br />www.ASCIP.org <br />CONTACT NAME: Mr. FrItZ J. Helrjch, Chief Executive Officer <br />PHONE: (562) 404-8029 <br />JPA MEMBER <br />Rancho Santiago Community College District <br />2323 North Broadway <br />Santa Ana CA 92706 <br />This is to certify that the Alliance of Schools for Cooperative Insurance Programs (ASCIP) Memorandum of Coverages on insurance listed below have <br />been issued to the Covered Party named above for the period indicated. Notwithstanding any requirement, term, or condition of any contract or other <br />document with respect to which this Evidence of Coverage may be used or may pertain, the coverages afforded by the Memorandum of Coverages <br />described herein are subject to all the terms, exclusions, and conditions of such Memorandum of Coverages. <br />TYPE OF COVERAGE <br />ADDL <br />INSR <br />MEMORANDUM NUMBER (MOC) <br />POLICY EFF <br />(MM/DONYYY) <br />POLICY EXP <br />12:01a.m. <br />LIMIT OF LIABILITY/COVERAGE <br />GENERAL <br />LIABILITY <br />OCCURRENCE <br />Personal Injury <br />,/ <br />MOC #77 <br />7/1/2018 <br />7/1/2019 <br />COMBINED SINGLE LIMIT PER OCCURRENCE $ $5,000,000 <br />AGGREGATE $ N/A <br />$ <br />Errors & Omission <br />$ <br />Employment Practices <br />$ <br />AUTOMOBILE <br />LIABILITY <br />AUTOMOTIVE PHYSICAL DAMAGE <br />COMPREHENSIVE / COLLISION <br />ANVAUTO <br />Owned Auto <br />MCC #77 <br />7/1/2018 <br />7/1/2019 <br />COMBINED SINGLE LIMIT PER OCCURRENCE $ $5,000,000 <br />ACTUAL CASH VALUE $ <br />$ <br />$ <br />Hired Auto <br />$ <br />PROPERTY <br />BUILDING / CONTENTS <br />FIRE, THEFT, RENTAL INTERRUPTION <br />REPLACEMENT COST SUBJECT TO POLICY LIMITS, TERMS, <br />AND CONDITIONS <br />$ <br />$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />WC STATUTORY LIMITS <br />NIA <br />MOC #77 <br />7/1/2018 <br />7/1/2019 <br />EACH ACCIDENT $ $2,000,000 <br />PER EMPLOYEE $ $2,000,000 <br />POLICY LIMIT Is $2,000,000 <br />OTHER <br />EMPLOYEE DISHONESTY (CRIME) <br />SUBJECT TO POLICY LIMITS, TERMS, AND CONDITIONS <br />ADDITIONAL REMARKS: <br />As respects to classroom and office lease for Centennial Education Center 3/21/19 - 7/1/19 <br />CERTIFICATE HOLDER <br />City of Santa Ana <br />Attn: Sylvia Cuevas <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br />CANCELLATION ray <br />Should any of the above coverages forthe Coverbged or withdrawn prior <br />to the expiration date issued above, ASCIP. <br />SCIP 11 1 -d ys written notice to the <br />Certificate Holder, but failure to mail such 'ce shaU,rrolrpose no obligation or liability of <br />any kind upon ASCIP, its agents, or representatives. <br />r^ <br />AUTHORIZED REPRESENTATIVE: Fritz J. Helrlch <br />*ASCIP is ajoint powers authority pursuantto Article I(commencing with Section 6500)Chapter 5 of Division 7 oftitle lofthe Government Code and Sections 39603 and I31603 ofthe Education Code. Rev 5.97 <br />49692159 177 118/19 All Types WC I Nancy Lopez 13/22/2019 11:23:15 AM (POT) I Page 1 of 2 <br />