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ncoreo CERTIFICATE OF LIABILITY INSURANCE onTr llAnlloonvvrl <br />1^ 07106/2019 <br />THIS GER71FICATE 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 IN$URER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(los( must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />terms and conditions of the policy, certain policies may regLllro an endorsement. A statement on this certificate does not confer rights to ilia <br />certificate holder In Iluu of such endorsomont(s). <br />PRODUCER rnrr <br />N_IIE RbdriiJd ¢lanurljis _ yy _ <br />Dickerson Insurance Services, License NOM29112 Ir1rfb N RxR 32g) �15U 2379 I r�Ix ___ <br />1918 Riverside Drive e•h1AIL ( 1 1t.,nW. <br />nU�RESS Rodrigo@dIck0f5orngroup coal <br />L23)662os lD$ CA 90039 INSUNERtbJAI'TOIIUIIIG (OVERAGE IIAIC9 <br />(328J ss2-7200 _ (' I 1 .y -. Initially I Y <br />�.._ ._ � _ IIJ$Ulll n n NLVIV YpollMadnQ &eCen9r91 lOS rail cL rbin rRl,1 t2160 `d <br />INSURED DB <br />Charitable Ventures of Orange County -- <br />4041 MacArthur Blvd , Suite 510 INSURER q: _ <br />Newport. CA 02660 INsuarRU: <br />msunmtal <br />coVFRAGFL OPPTIPICATF nlnheacn. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOB THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECr TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE, POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSiiI_m-_. POLICY dEc POI is -Xfi <br />LTN TYPE OF INSURANCE JUR. POLICY NIIM1IEER MIIND{Y. YY ISMIbI "" LIMITS <br />GENERAL LIABILHY <br />EACH OCCURRENCE <br />51,000AID <br />X COMMERCIAI. GENERAL LIADILITY <br />CDIIIASMADg X] OCCUR <br />IT <br />F- <br />DAIAN C'IOREII <br />FREMI6&$�Eil bz<u p cll <br />A <br />PhPK1900984 <br />07M 512019 <br />0711512020 <br />MEO EXP (Any one II 1 <br />PERSONAL &AUV INJURY <br />S 5,000 <br />s 1,000,000 <br />GENERAL AGGREGATE <br />s 2,000,000 <br />GEN'L AGGIiEGArE LIMIT APPLIES PER'. <br />1FRODUCTS-COMP IDR AGO <br />$2,00009Q.. <br />X I POLICY I PAP I LOC <br />I <br />$ <br />AUTOMOBILELIABILITY <br />T—�� <br />4I pi@A SRI it <br />- <br />I 1 <br />.(f+q ssetl . li. _�. <br />ANYAUTO <br />BODILY INJURY(Pcr Rafso) <br />S <br />A <br />.I <br />AILOWnrh SCHEOVLED <br />(ALTOS AUTOS <br />X j Hlnt u Alorm X NIO OBWIED <br />PHPKI900984 <br />07/1512019 <br />07M 512020 <br />— <br />60DILY INJURY IPu n nl <br />I'ROI RT7 )XrAA—GE <br />— - - <br />s -- <br />s _. <br />.— <br />(I ar ncdddnlj - <br />)(' UTADHELLA LNO X OCCUR <br />j <br />EACH OCCURRENCC <br />S 4, 000.000 <br />A <br />� EXCESS LIAR I CLAIl1s•MADE <br />+ <br />• PIIUB67889'7 <br />07/15/2019 <br />07115/2020 <br />AGGREGATE <br />s4000,000 <br />..._ <br />I <br />DE6 1 %Z Real NTION$ <br />- <br />J <br />WORKERS COMPENSATION <br />AND EM1IPLOYEa S'LlpaIUTY <br />X YCSL\TU IL <br />YIN <br />ANY PROPRIETORWARTNERIEXECUTNE� <br />B OFFICOMEMBER E%CWDCD9 NIA F- WC201900011228 07/15/2019 07/15/2020 <br />7ORV LIMITS R <br />ra EACH ACCIDENTS 100011000 <br />(III dnlpry In Nat L_I <br />II YBI, d0[CIIIO Mtpf <br />PL OISrASE EA rM$ 1,099 g00 <br />--- <br />J <br />vt'uIPTII,N lIF OP[RA$19HIlyv'L <br />pl$TASC • IC$ 1,009 00g <br />i <br />DESCRNTION OF OPERAlIUNSI LODAPONSIVEIIICLE9 IAlInch ACORn 1el, Addlliou Iltp,nvrk¢$ceod,I Ir lore ¢Pncv is mquimdl <br />RL-: Summer Night Lights Program <br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on this policy pursuant <br />to written coniracl, agreement, or <br />memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance Carried by City shall be excess and <br />noncontributory. Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation. <br />REVIEWED 8 APPROVED <br />By RISkyYMANACtEMENT DiV1510N <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana <br />SHOULD ANY OF THE ABOVE BE <br />THE EXPIRATION DATE THIN <br />ACCORDANCE WITH THE POLICY <br />CA 92702 I <br />Rodrigo Banuelos j <br />01988.2010 ACORD CORPORATION. All rights rose, <br />i l.Vl\V 6J (Le IVIVoI 1110 ACOHU name and logo are registered marks of ACORD <br />