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ACC>R® CERTIFICATE OF LIABILITY INSURANCE I DATE eAMIDnttVYY7
<br />07/05/2010
<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 ON 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(los) must be endorsed. If SUBROGATION IS WAIVED, subject to the
<br />terms and conditions of the policy, certain policies may racialist on endorsement. A statoment on this certificate does not confer rights to the
<br />certificate holder In Lou of such endorsamonHsl.
<br />r,w„w.l.,
<br />......
<br />fdAlAL1 Rtldfigo,[jaltUCfp3
<br />Dickerson Insurance Services, License NOM29112
<br />Pi p)Ic "` FAX "
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<br />1910 Riverside Drive
<br />.InjS Nn cxn' (020) A50-2$7d... _ _ (Al;11,11
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<br />Apaflto RoddgB(1g01cYe.fspR•qrbup Gp01
<br />LDS Angeles CA 90039
<br />(323) OB2-7200.
<br />INSUnERtbJ_AirORDINO COVERAGE
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<br />IN'r.4nHI A ('htlagcslryllla 11lcfLntl51(y lnsuranro CalgpunV.
<br />INSURED.tNsyprnp
<br />Charitable Ventures of Orange County
<br />New. Yorlt Ma11nC8 Gonlarallnsuance Compipy, 1161100
<br />4041 MacAdhur Blvd, Suite 510
<br />INSURERe; _ _ _
<br />Newport, CA 02660
<br />INmmeR e:
<br />INSUIiEq P:
<br />COVERAGES CERTIFICATF NHMRFP- acvlc 1n1,1 MI IMGCO.
<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 RBOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER
<br />DOCUMENT WITH RESPECT' TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICICS DESCRIBED
<br />HEREIN 15 SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INER ri Yl ea( _ . ' - 5 " -"- - Mfim [FF- --POLICY %iy-
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<br />GENERAL LIABILITY
<br />I
<br />EACH OCCURRENCE
<br />31 OOO,OOO
<br />s1,000---
<br />X COMMERCIAL GENERAL LIABILITY
<br />-- ._,. _
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<br />S5,000
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<br />PHPKi990904
<br />07/15/2019
<br />07115/2020
<br />PERSONAL a ACV auURY
<br />s1,000000
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<br />GEHFRALAGGREGATF
<br />2,000.000
<br />GENT AGGREGAT E LIMI T APPLIES PER'.
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<br />4
<br />�S z.QQo,000-
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<br />BODILY INJURY (Per pmsenl
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<br />ALLOW101 SCHEDULED
<br />nuloP nu rNs
<br />PHPK1990984
<br />07/1512010
<br />07l15/2020
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<br />BODILY INJURY (P., VVKle,lIB
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<br />X
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<br />5 4,000,000
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<br />(EXCESS IIAB cLnnasdJACC
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<br />PHUB676597
<br />OW1512019
<br />07/15/2020
<br />AGGREGFTE
<br />$ 4,000,000
<br />X I
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<br />RED RETamIONS IQ
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<br />WORKERS COMPENSATION ^—
<br />AND EMPLOYERS'
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<br />LIABILITY YIN
<br />TORYUl', CIT
<br />ANY PROPRICTORIPARTNERIE%ECUTIVF
<br />B OFrICEMEMBER EXCLUDUm NIAF WC201900011228 07/1512010 07/15/2020
<br />EL LACH ACCICENT y1Q00000
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<br />EL DISEASE EA EMPLOYEE a 1,O0Q 000
<br />Il yes,tl mY Pnde,
<br />yIPTION nF nf+pnAT ON•��
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<br />r: L PI$rnyC hOLICV LIIAII S 1.000 OOO
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<br />DESCRIPTION OF OPERATIONS; LOCATIONS VfiItiLLEe IAIIPeII ACORD 101, Addlllonsl Ra nmkn echod,l If ,sin spots is rognimd)
<br />RE'. Summer Night Lights Program
<br />Oily of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy Pursuant
<br />to written coRlracl, agreement. or
<br />memorandum of understanding. Such insurance as Is afforded by Ihls policy shall be primary, and any insurance carried by City shall he excess and
<br />noncontributory. CertificaUt of Insurance shall provide thirty (30) day prior wrillen notice of Cancellation,
<br />REVIEWED & APPROVED
<br />EU
<br />By Risk MANAGEMENT DiVISiON
<br />lsAIVUtLLA I IUN rr J- llr
<br />City of Earn Ana SHOULD ANY OF THE ABOVE DOSC �•F
<br />THE EXPIRATION DATE POLICY
<br />P;Of[�yl1y . IME. Weir
<br />�N
<br />Risk MBIIagUmOl11 Division THE ACCORDANCE WITH THE THBRER 15iJ1 C
<br />20 Civic Center Plaza
<br />AUTHOR¢EO REPRESENTATIVE
<br />Santa Ana CA 92702 I - s 0
<br />Rodrigo Banuelos
<br />@ 19II0.2010 ACORD CORPOfiATION. All rights reserved,
<br />Awf(u ID (<U MUD) Ino ADORU name and logo are registered marks o1 ACORD
<br />
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