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acroiz® CERTIFICATE OF LIABILITY INSURANCE °nOE7105120/YY""' <br />�✓� 07/05/2019 _ <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 be endorsed. If SUBROGATION IS WAIVED, subject to tho <br />terms and conditions of the policy, certain policies may reyulro an endorsement. A statement on this certificate does not eonfor rights to the <br />certificate holder In Ilou of such endorsementis). <br />PROOUCER <br />Dickerson Insurance Services, License VOM29112 <br />1910 Riverside Drive <br />Los Angeles CA 90039 <br />(323)062-7200 <br />INSURED <br />Charitable Ventures of Orange County <br />4041 MacArthur Blvd , Suite 510 <br />Newport, CA 02660 <br />CERTIFICATE NUMBER; <br />PIIDnE if <br />(A15, Nu t.xq 1929)'t30 27A.. lyre% , ia'q <br />BAIAIL RodrtOO(f�diGkefsongrtxgl.cem ._ . <br />AeV.esss <br />WU RERg4(AH'UI I No cave RnG13 Irntc E <br />INSUITIGKA PIT IOAillgldakrdmntphyIneurenrnCcmpBliy 21gAg <br />ipslI) Now York Marine A Gonnrol lnsuralrgD Gnmp6lly 16000 <br />INSURMIC: <br />Irlsunrn D: _ _ <br />INSURNIi Wt <br />TO CERTIFY THAT THE POLICIES INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR 'rcr POLICY <br />INDICATED. NOTWITHSTANDING <br />INDI UI <br />ANY REQUIREMENT, TERM OR CONDITION ANY CONTRACT DOCUMENT WITH RESPECT TO WHICH <br />H Tills <br />OR OTHRRDESCRIBED <br />BEISSUED <br />CERTIFICATE MAY BE ISSUED OF MAY PERTAIN, THE INSURANCE AFFORDED POLICIES <br />D POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />MS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />N ED <br />LTR TYPEOFIl150RANCE INan Y POIJCYNUMBER AIOIIDDTYYY II�I0Iv YYY1 LIMITS <br />GCNERAL LIABILITY <br />EACH OCCURREIJCE <br />51000,000 <br />X CCMMCRCIAL GENERAL LIABILITY <br />._,..I <br />� <br />"6AIIACE'RoFEN'rCn <br />IIRIIIB SLf <br />CLAIMS MADE X] OCCUR <br />1� <br />MED EXP(Any NIB pr d <br />Smoo <br />A <br />PHPK1900984 <br />07115/2010 <br />07115/2020 <br />PERSONAL a AOV INJURY <br />41,000000 <br />— <br />( <br />GEH.RALAGGREGAIE <br />5 2.000.000 <br />l^ <br />GEN'L AGGREGATE LIMIT APPLIES PER'. POLICY <br />x'I ( 1 <br />I <br />PRO LOT COMP MP ACT <br />- <br />5 z.,oQo oa9._ <br />AUTOMOBILE LIABILITY <br />I V <br />� <br />I <br />TTIaKIRiL015t0 'L M) I- <br />-( <br />LL.490,0110_.. <br />ANY AUTO <br />BODILY INJURY (Pcr POrv0) <br />S <br />A <br />jALLOJVTIED AUTD$ULen <br />PHPK1990984 <br />07115/2019 <br />07116/2020 <br />BOOIIY INJURY Tl d.e <br />S —� <br />NO F.I1 <br />X NIREIT tUTOS X <br />PROP I krr DAYi'AGE <br />s <br />AD <br />(Per ddu.nl__._.. <br />X UAIORE"Uno X OCCUR <br />r y <br />r- <br />vrNrrcuaneNCE 54,000.000 <br />A <br />I Excess unO I eLnnpsslADE <br />I <br />PHUB678897 <br />0711512019 <br />07/15/2020 <br />_ <br />I AGGREGATE 5 4,000,000 <br />mm�Reno <br />06D X I RETENTION D nnn <br />( <br />AND EMPLOYERBENMIRON <br />_ <br />7rAfjV LI{ITS V01 <br />LIABILITY YIN <br />B <br />ANY PROPRIETORIPARTNERIE%ECI)TNE <br />OFI'ICE/MEMBERE%CLUIJCUI N <br />N!A <br />WC201966611226 <br />97ri26 i519 <br />07115/2020 <br />rl LACHACCIDEIIT E <br />(ANndn1 qII NRI <br />CL OIRCARE EA CMPI OYEf S 1,(100.000 <br />II yee, do ko IN., <br />nlPre N 1 oPg11ABQ y Ea�aw <br />--- <br />UI$r 1$C POLICY LlfAll S 1,000,000 <br />1 <br />OGSCRIPI'IONOFOPEnATIONSILOCAIIONSIVEIIICLEB (AlInc4 ACOfl0101, Addlllennlnmgvrkv Bchadnlv,Rmvrn enoco Nragclrvdl —� <br />RE: Summer Night Lights Program <br />City of Santa Ana, OIOCers, agents, employees, and volunteers are named Be additionally insured on this policy Pursuant 10 Written COLINIGI, agreement. or <br />memorandum of understanding, Such Insurance as Is afforded by this pollcy shall be primary, and any insurance carried by City shall he excess and <br />noncontributory. Certificate of Insurance shall provide thirty (30) day prior written notice of cancellation, REVIEWED & APPROVED <br />By RISk MANAGEMENT DIVISION <br />T,cnIP 1,111. ntlwcry GANGtLLA I IUN <br />City of Santa Ana SHOULD ANY OF THE ABOVE DCSCB [jr•�yI�p(� I�' rLIICL rye '❑ }fit pL <br />Risk Manvilanient Division ACCORDANCE THE IWI HTHE POLICY ATE THL. RP ROEIS54T , <br />2.0 Civic Cenler Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana CA 92702 1 <br />Rodrigo Banuelos " (� <br />0)1980.2010 ACORO CORPORATION. All rmlitR reverved. <br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD <br />