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li% R CERTIFICATE OF LIABILITY INSURANCE <br />L-�'� <br />°"'! ' <br />07/0512010 <br />j$/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 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(los) must he endorsed, If SUBROGATION IS WAIVED, subloet to lho <br />terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />corifficato holder In Ilou of such endorsamont(a), <br />PRODUCER - <br />CO TACT <br />JJAIA,F Rodrigo Banu�alopr <br />Dickerson Insurance Services, License 4OM29112 <br />Pi1(11+C — 1tAk <br />. 1C, Na vul (323) 43U 2374 1(Afc, unr. <br />IC <br />Drive <br />rwa RodflgoOdiekefson+0ro0p.00IH .. <br />rtagVESs <br />Los Angeles <br />Los Apge Os CA 90039 <br />062-7200 <br />INUnnijtrORO1NGOCKURAE ION <br />NsuluMA `hlfhifkqltLigidmpnlly Insurnce Company 2104N4A <br />INSURED <br />Charitable Ventures of Orange County <br />Ilgspn+RO Nrmq Ygrk MaNI General nsuran,ge Comgxlly. 16008 <br />- <br />4041 MacArthur Blvd , Suite 510 <br />1NsunIn c, <br />Newport. CA 02660 <br />UI¢UYER U: <br />wsunsa u: <br />wsuncn F: i <br />COVERAGES CERTIFICATE NUMBER: REVISION NIIMRFR, <br />TPIIS 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 REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 4FIIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TD ALL THE 'TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ILTR �Y V TYPE OF INSVMNGE�A �IA LadaRi +POLICY NUAIBE0. --- IAIOIfOC11YYyY 1 TMI IiI <br />YYVIi —_ LlAllia <br />GENERAL UABIU fV <br />_, <br />�(- <br />EACHOCCURRENCE S 1,000,000 <br />x COIAMCRCIAi. GENERAL LIABILITY E— <br />liEWA ITO TEN fEb <br />R+IaRFU. sEo = 3lpoang___ <br />CLAIMS MADE I %� OCCUR <br />MED EXP JAI y ). Pooh 3 5,000 <br />A PHPK1990984 <br />0711512019 0711512020 rII+gONALa AUVINJURr $11000000 <br />_. <br />GCNFNALAGGREGATF 3 2,000 000 <br />GE_N'L AGGREGATE LIMIT APPLIES PER'. <br />PR0. <br />1 tIiDOUCTsCOI.It TOP A4G 32,000,QQQ <br />I • _. <br />x 1 POLICY L� <br />I I S <br />_— <br />AUTOMOBILE IJA01UIY <br />V Ii C 1.I. <br />.Ira icmd 1L _� <br />ANY AUTO - <br />BODILY INJURY (Pcr Pol Un1 S <br />ALL OV,IICl1 56NEDl1LE0 <br />AUTOt1 AUTOS <br />A X PHPK7990984 <br />RIF.I3 <br />HIREIl AUf05 x <br />BODILY INJURY (P1 uu p S <br />07715120/0 07115/2020 J Itul ERTPoKMACC _ _ <br />. iI AIJIO8 <br />nUl'pB <br />x UMORLLLA LIAU k i Of,CUR I <br />1 EACH O:CU0.RENCE S 4.000,000 <br />I� <br />A EXCESS Una _ AGLAIAts.Av.BE PHUB478B97 <br />TIED ;]RETENTIONS 1 _ <br />s <br />07/1572019 07115/2020 AGGREGATE54.000.000 <br />3 <br />WOnKEAS COMPENSATION <br />T T�. 0116 <br />AND EMPLOYERS' UADILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUrIVE <br />LIJ TITS ER <br />B eFFICEIMEMaEREXCLUOED? nNIA WC201900011228 <br />E14ACI <br />p7/19/2019 0711312020ACCI---5,JA0,001), <br />IAlnndnl,In N111 — <br />SE EAEMPLONEr 31,P00ICRj�TIQ02 <br />QOJ T kakaftz <br />..CPOLICY LIMIT S1,000 000 <br />IF F- <br />i <br />_.� <br />DGSCRIPTIOIJ OF OPERATIONS I LOL`ATONa I Ve111CLE9 (Aline➢ ACORP tat, Addlllvnvl rtPinmks admduly, IT nmm rtP^Pv le mgnirodl <br />BE: Summer Night Lights Program <br />City of Santa Ana, officers, agents, employees, and volunteers are named as additionally insured on [his policy pursuant to written coThncl, agreement or <br />memorandum of understanding. Such insurance as Is afforded by Ihla policy shall be primary, and any insurance carried by City shall be excess and <br />nonconlributory. Certificate of Insurance shall provide thirty (30) day prior wrillen notice <br />of cancellation. REVIEWED & APPROVED <br />By RISk MANAGEMENT IJIViSION <br />wcnlrrr.rn lC nvAxic.IX GANUCLLA I IUN <br />City of Santa Ana SHOULD ANY OF THE ABOVE 11ESC L <br />THE EXPIRATION DATE THERRO)III p �INILL 1l IViL.i.I Iff IN <br />Risk Management Division ACCORDANCE WITH THE POLICY PRWWI dd YY GG rl Y1L.1..FT `C <br />20 Civic Cenlo( Plaza <br />AUTI I2ED REPRESENTATIVE <br />Santa Anti CA 92702 <br />Rodrigo Banuelos <br />O 1988.2010 ACORD CORPORATION. All rights reservBd, <br />AUUHU 25 (zU1 Dlo5) The ACORD name and logo are registered marks of ACORD <br />