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AS 10:35 UCI INSURAN"-.RISK MGMT ID=949821' 41 P02/62 No: 128 2003/2004 University of California, Irvine This certificate is issued to: Insurance & Risk Management The City of Santa Ana 250 Public Services Building Community Development Agency (M-25 Irvine, CA 92697-4530 20 Civic Center Plaza (949) 824-7419 Santa Ana, CA 92702-1988 CERTIFICA This is to certify that the University of Y OF CALIFORNIA OF SELF-INSURANCE is self -insured for the followine coverases: Type of Covert ge Self -Insured Limits I. GENERAL LIABILITY Each Occurrence qt® P $1,000,000 u�0 pLS Products and Completed Operations Aggregate $ P,???L Personal and Advertising Injury $ �RCK 51 General Aggregate (Bodily Injur, & Property Damage) $1,000 ASP, E pttorn sistant C tY II. AUTOMOBILE LIABILITY Vehicles Owned, Non -owned and Hired $ 1,000,000 each occurrence III. SPECIAL TERMS & CONDIT ONS: 1. The City of Santa Ana, its officers, agents and employees, representatives and volunteers, are hereby named as additional insured;, but only in connection with the activities of UCI under the sub agreement for the use of coin nunity development block grant funds. This provision shall apply to claims, costs, injuries or di mages but only in proportion to and to the extent such claims, costs, injuries, or damages are taus by or result from the negligent acts or omissions of the Regents of the University of Califo ia, its officers, agents, or employees. 2. This program of Self-insurance sha 1 be primary and non-contributing with respects to any insurance carried by or for the bene Fit of the additional insureds with respect to claims covered as outlined above. Severability of intc rests shall apply to all additional insureds, except with respect to the limits of liability outlined herei . 3. The insurance evidenced herein foil ws the provisions of the Bylaws and Standing Orders of The Regents of the University of Califo is and self-insurance programs as administered by the University of California, Office of me President, Office of Risk Management, which do not permit any assumption of liability which does not result from and is not caused by the negligent acts or omissions of its officers, agents, or mpioyees. Any indemnification or hold harmless clause with broader provisions than required un ler such Bylaws and Standing Orders shall invalidate this certificate. IV. ALL RISK PHYSICAL LOSS OR DAMAGE $ Replacement Cost (up to $2.5 million per occurrence) Should any of the above described progra s of self-insurance be materially modified or cancelled before the expiration date shown below, The Regents of the University of California will give 30 days written notice to the named certificate holder. DATE ISSUED: October 14, 2003 AU IGNATURE CERTIFICATE EXPIRES: Jane 30, 2 tatsrot