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<br />... <br />( <br /> <br />. <br /> <br />A . /021- 0],0 <br /> <br />Association of California Water Agencies I Joint Powers Insurance Authority <br />5620 Birdcage Street, Suite 200, Citrus Heights, CA 95610 <br /> <br />CERTIFICATE OF COVERAGE <br /> <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION QNL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN <br />THOSE PROVIDED IN THE COVERAGE DOCUMENT. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED Y THE <br />COVERAGE DOCUMENTS LISTED HEREIN, <br /> <br />MEMBER <br />Orange County Water District <br />P.O. Box 83DD <br />Fountain Valley, CA 92728-83DD <br /> <br /> <br />COVERAGE INFORMATION <br />This is to certify that coverage documents listed herein have been issued to the Member Agency herein for the Coverage period indicated. Notwithstanding any <br />requirement, term or condition of any contract or other document with respect to which the certificate may be issued or may pertain. the coverage afforded by the <br />coverage documents listed herein is subject to aU the terms, conditions and exclusions of such coverage documents. <br /> <br />T e of Covera e Certificate # Effective Date Ex ¡ration Date <br /> <br />General Liability <br />(i1J Commercial General Liability <br />21 Contractual Liability <br />21 Products/Completed Operations <br />21 Occurrence <br /> <br />MOLC-1DD1D3 <br /> <br />1 D/1/2DD3 <br /> <br />1 D/1I2DD4 <br /> <br />Limits <br />A99re9ate <br />Per Occurrence <br /> <br />$S.DDD,DDD <br />$S,DDD.DDD <br /> <br />Auto Liability <br />1<1 OWned Autos <br />(i1J Hired Autos <br />21 Non-Owned Autos <br /> <br />MOLC-1DD1D3 <br /> <br />1 D/1I2DD3 <br /> <br />1 D/1I2DD4 <br /> <br />Per Occurrence <br /> <br />$5.DDD.DDD <br /> <br />Auto Physical Damage <br />Scheduled Autos <br />Hired Autos <br /> <br />Property <br />Special Form <br />Mobile Equipment <br />Boiler and Machinery <br />Crime <br /> <br /> <br />Workers' Compensation <br />Coverage A - Workers' Camp. <br />Coverage B - Employer's Liability <br /> <br />CERTIFICATE HOLDER <br /> <br />The City of Santa Ana <br />AUn: City Manager <br />P,O. Box 1988 <br />Santa Ana. CA 927D2 <br /> <br />DESCRIPTION <br />The Certificate Holder, and their respective directors, officers, agents, representatives <br />and employees have been added as Additional Covered Parties to the Liability Program, <br />but solely with respect to those causes of action arising directly out of the activities <br />covered by the MWD Long-Term Groundwater Storage Program. <br /> <br />CANCELLATION: Should any of the coverage documents herein be cancelled before the expiration date thereof, ACWNJPJA will eRdea"sr ta provide 30 days written <br />notice to the certificate holder named herein. <br /> <br />Signed by: <br /> <br />''''. f <br />\. ./ <br /> <br />(Au/th. r;zed Represèn~tj,ve) <br />l/ <br /> <br /> <br />Date: March 30. 2004 <br /> <br /> <br />fYWr <br />