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, . 31.Jan-2Q05 Driver Alliant Insurance Services 600 Montgomery Street 9th Floor San Francisco, CA 94111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER (415) 403.1400 INSURED CSU Fullerton, Foundation 2600 Nutwood Ave., Suite 275 Fullerton, CA 92631-3599 Attn: Bill Herbert INSURERS AFFORDING COVERAGE Please refer to Coverages section below. 481 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CoverageType Insurer Policy EffectiveDate ExplratlonDate L.lmllType Amount SIR Fund LJab1l1 AGPIP S.I.R Fund AGPIP-0405--01 Excess SIR E&O Uab Evidence of Insuran Onl GENESIS YXB3OO954A' 01-Jul-2004 01-Jul-2005 Generalliabili - Each Occurrence Autoliabill Incl. tn GL limit HireG'NonOwned Auto Incl. In GL limit ProdJCom 1.0 rations InclinGLLimit Contractual Liabili IncllnGLUmit 01-JuI-2004 01-Jul-20Q5 Generalliabili -Each Occurrence re ate - Combined Cov. A & B Auto Liabili Incl. In GL limit HireG'NonOwned Auto Incl. In GL limit ProdJCom .0 rations InclinGLlimit Contractual Liabili InclinGLUmit 01-Jul-2{J05 SIR Errors & Omissions Excess SIR Errors & Omissions 01-Jul-2004 01-Jul-2005 GeneralLiabili - Each Occurrence ""'.00) Excess SIR Liabif GENESIS YXB3OO954A' $750,COO $3,00::>,00::> $250,000 $750,000 ExcessL.labili For Evidence of Insurance Onl Schools Excess Uability Fund T0704-19J1247 $14,000,000 APPROVED AS TO FORM DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLEs/EXCLUSIONS ADDED BY ENDORSEMENTS/SPECIAL PROVISIONS City of Santa Ana, its officers, employees, agents, volunteers and representatives are named additional insureds as respects Consult Agreement between the City of Santa Ana and CSU Fullerton Foundation for leisure class program. Project Title: Family or Neighborhood Oral History Workshops. Project Period: Janua 2005 - December 2005. IMPORTANT If tI1e certificate hoider is an AODITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate hoider in I~u of such endorsement(s). If SUBROGATION IS WAIVED, subject to Ihe loons and conditions of the policy, certain poiicies may require an endorsement. A statement on Ihis certificate does not confer rights to the certificate holder In lieu of such endorsemen s. The Cartificate of Insurance on this form does f\Ot constitute a contract betwean the issuing insurer(s}, autl10rizad representative Of producer, and the certificate holder, nOf does it aflirma~vely or negativelyarneod,extendorattarlheooverageafforded by the poIicias listed thereon. DISCLAIMER City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Attn: Clerk of The City Council 6476-1741 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLOER NAMED TO THE LEFT, BUT FAILURE TO DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZEDREPRESENTATlVE~.....v ~ ~