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Francine Digitally signed by <br />Francine R. Villareal <br />R. Villareal 09:27:38-0700'S <br />s <br />COUNTY OF ORANGE <br />CERTIFICATE OF SELF-INSURANCE <br />Office of Risk Management, 601 N. Ross Street, 5th Floor, Santa Ana, CA 92701 <br />Coverage: This is to certify that the County of Orange is self -insured for the following <br />coverage: <br />Type of Coverage <br />Self -Insurance Limit <br />General Liability: Bodily Injury and Property Damage <br />$1,000,000 per occurrence <br />$2,000,000 per aggregate <br />Automobile Liability - Vehicles owned, non -owned, and hired <br />$1,000,000 per occurence <br />Workers' Compensation - $20,000,000 SIR applies <br />Employers' Liability <br />Statutory <br />$1,000,000 per occurrence <br />Terms, Conditions and Special Items: <br />The provisions under General Liability, above, shall apply only with respect to claims arising out of the <br />negligent acts or omissions of the County of Orange, its officers, agents and employees. <br />Cancellation: <br />Should any of the above described self -insured coverage be modified or cancelled bet -ore the <br />expiration date shown below, the County of Orange will provide 30 days written notice to the named <br />certificate holder. <br />Indemnified Party: <br />City of Santa Ana, its officers, employees, agents, volunteers and representatives pursuant to the terms <br />and conditions of License Agreement LA-160. <br />Certificate Holder <br />City of Santa Ana <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana, CA 92701 <br />ATTN: Risk Management Division <br />900 W. MacArthur Blvd., Santa Ana, CA 92704 <br />RE: Ballot Drop Box <br />DATE: August 14, 2020 - Until Terminated <br />Effective Date: 08/14/20 <br />Expiration Date: Until <br />Rhonda Marshall <br />Risk Management <br />14)285-5500 <br />ite Certificate <br />qy=s.,,o iuwc�vmu�cma¢��wmn <br />REVIEWED & APPROV®BY. <br />®' Risk Management Analyst <br />