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nc"rzo CERTIFICATE OF LIABILITY INSURANCE DATE100YY1
<br />�---- 0710512010
<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 ilia cortificate holder Is an ADDITIONAL INSURED, the pollcy(loe) must be endorsed. If SUBROGATION IS WAIVED, sub)oct to the
<br />forms and condlllons of the policy, certain policies may require an ondorsomcnl. A statement on this certificate does not center rights to ilia
<br />cortificato holder In Fail of such endorsornantisl,
<br />PRODUCER GDNTAGT m - —
<br />NAME Rndri <, Benu,2lyg,. _
<br />Dickerson Insurance Services, License #OM29112 'PIIoav ((FAX -(A);, y.'rxtJ;
<br />Ax.(A)C,NA,nxtf (323).4302374. ilnlc, nnl.
<br />1918 Riverside Drive E.SInIL ROJd(IGQJIGY,eI'saLl•OrOup.gDln _
<br />nuuHEs6
<br />Las Angeles CA 90039 _ 1 SURER IB) MiORDFIGCGVCRAGE. GAICP
<br />(623) 682 7200 INSunhnA 'J111ad 511M 1 clan II hnlufanrB f'Om,an 210g 66 r n v _.i y 4
<br />INSURED Charitable Ventures of Orange County IMUFFl B1) New York Marine S General Idsuranca Com,llony 16008'
<br />4041 MacArthur Blvd, SLAB 510 INSUFANKC:
<br />Newport, CA 02660 IFlspflF.R D:
<br />ulsunen u:
<br />INS9REF P:
<br />COVERAGF_S CFRTIFICATF NIIMRFR• oclnelnnl 1,11 IAxGCO.
<br />THIS IS TO CERTIFY 1LIAT THE POLICIES OF INSURANCE UBT"ED BCLCW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR 'rilE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CON'rRAC'r OR OTHER
<br />DOCUMENT WITH RESPECr TO WHICH Tills
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
<br />HEREIN 15 SUBJECT TO ALL THE 'rERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIN,ITS SHOWN MAY HAVE BEEN REOUCED BY PAID CLAIMS,
<br />LTR TYPE OF INSURANCE POLICY NUMBER MIMANYYYYV I ly
<br />0-6�M olIIyYV4
<br />LIMITS
<br />GENERAL LIABILITY
<br />IF—
<br />EACH OCCURRENCE
<br />'DUi
<br />51 Ogg gqo
<br />X GDIAMERCIA-MADC ALLIABILITY
<br />_..l
<br />I Y
<br />GF TORE1ITLD
<br />Ire-IIII6PSjEuas.,, cJ
<br />CLAIMSM,\DE X�OCCUR
<br />,
<br />MCD EXP(AnIcs. )
<br />S5,000
<br />A
<br />P11PK1990984
<br />071/512019
<br />07115/2020
<br />PERSONAL a ADYINJURY
<br />s 1,000.000
<br />GENENALAGGREGATF.
<br />52,000.000
<br />GENT AGGREGATE L IMIT APPLIES PER'.
<br />X .11T
<br />PRODUCTS -COMIIOP AGO ..
<br />S2,000,Q4O
<br />POLICYF—I LW
<br />5
<br />AUTOMOBILE
<br />LIABILITY
<br />I Y
<br />)eIC-09I11 x. ,➢T._.
<br />([a_-
<br />-
<br />BODILY INJURY (Per Femora
<br />5
<br />A
<br />_IA14YAUTO
<br />I AI I Owt1Ee SCUEDULCO
<br />AIITOn ALI FOS
<br />PHPK1990904
<br />07l15/2070
<br />07/16/202f1
<br />DOOIIY INJURY (Pu denp
<br />s
<br />X
<br />NON, M1EI1
<br />nuirn AurDS X 0
<br />r Rr dPYdA'Mticc
<br />-- -
<br />5
<br />"
<br />- Ill l'rjS
<br />(Per n ado,) _
<br />I
<br />I
<br />5
<br />—
<br />X
<br />UTAURELLALIAO X 1 OCCUR
<br />I y
<br />�;
<br />EGCHOCCORRENCE
<br />14.000.000
<br />A
<br />EXCCS('SLIAD GLA1LIa.I,U:L'E
<br />PlIUS678607
<br />07/1512019
<br />07/1W2021)l
<br />_
<br />AGGREGATE
<br />54,000,000
<br />1 PER 1 X I RETENTION 3 9.nD9
<br />I�
<br />a
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS 41ADILIW YIN
<br />ANY
<br />OFYICEIMEMRER EXCLUDES? %ELUTNC N
<br />❑
<br />NIA
<br />WC201900011228
<br />07115)2019
<br />�—
<br />07/15/2020
<br />nO SiAN OrII.
<br />X 7GRY LIMITS CR
<br />„
<br />AQQ OQ
<br />(Nnddnr Nip
<br />FL DISEASE I CMPIOVEf
<br />.
<br />s 1,000,000
<br />If 'es ,tl n5 Jot
<br />-
<br />.5745&&IJ Dr DPr
<br />Jlu PAT 2YSIlv91x.._
<br />C L D gCAbC POLICY LIMIT
<br />$ 1,00g ,0170
<br />I
<br />DESCRIPTI0NOF0PEM710NS I LOCATIONS? VEHICLES (Aaneh ACORD 101, AddIRD„DI Ran,orko achodula, it nmm op000 is te,iradl
<br />RE: Summer Night Lights Program
<br />City of Santa ARE, officers. agents, employees, and volunteers are named is additionally insured on [his policy PUrsusnl
<br />to written conlricl, agreement. or
<br />momofandum of understanding. Such insurance as is afforded by INS policy shall be primary, and any insurance carried by City shall be excess and
<br />nonconinhutory. Certificate of Insurance Shall provide thirty (30) day prior written Police of cancellation,
<br />REVIEWED & APPROVED
<br />By Risk MANA(jEMENT DIVISION
<br />City of SIGN Ana SHOULD ANY OF THE ABOVE UESC (p^'rjyy{(pQ ¢ tM1ELI/,(r;y�]>`-LF�L��- �'
<br />Risk Management Division ACCORDANCE WTHE ITH THE POLCYDATE R1RDVIS501. IIVC wl f„�^Ak-N
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE 1
<br />Santa Ana CA 92702 ( \ I
<br />Rodrigo Banuelos
<br />©1980.2010 ACORD CORPORATION. All rinhts reserved
<br />AUQHO 25 (2U10/Ob) The ACORD name and logo are registered marks o1 ACORD
<br />
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