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** INBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY ** <br />TIME RECEIVED REMOTE CSID DURATION PAGES STATUS <br />October 7, 2009 11:14:45 AM PDT 714 549 4812 42 1 Received <br />OCT -07 -2009 10:5b 'f 14 54J 4d12 r . V.LI ui <br />EVIDENCE OF COVERAGE <br />Orange County Department of Education <br />MEMORANDUM NUMBER: 74 <br />This Evidence of t wmp is used as a matter of ioforrnatioo only and confers no rights union the Certificate Helder. This Evidence of Coverage <br />does not amend, extend, or alter the coverage afforded by the memoraada listed below. <br />CERTIFICATE HOLDER INFORMATION <br />City of Santa Ana A E <br />lma AS TO FORM <br />Attu: Virginia O'Leary <br />62 Civic Center Plaza an Hodge <br />Santa A CA 92702 Deputy City Attorney <br />Coverage Period: Effective: 7 -1 -09 Expires 13:01 a.m.: 7 -1 -10 <br />This is to certify that the Alliance of Schools for COOpetuive Insurance Progam (ASCIP) Memoraadutn of Coverages on insurance listed Wow <br />have bean issued to the Cowed Party named above for the period 10610ated. NotwithsMading any requirement, tans, or condition of any contract <br />or other document with respcd to which this Evidence of Coverage may be uscd or may pertain, the eovemps afforded by the Memorandum of <br />Covemges described herein are subject to all the terns, cxdusions, led c0rgjtipnrs of such Memorandum of Coverages. <br />TYPE OF COVERAGE LIMIT OF LIABILITY /COVERAGE <br />Genaw Li"ty $1,000,000 Combined Single Limit Per OccurrOm <br />($5,000400 Agwegaie) <br />Automobile Liability $1.000,000 Combined Single Limit Pt'r Occurrence <br />Automobile Physical Damage Actual cash value <br />(CompnrbeasivelCollision) <br />properly - BuildinglContents Replacement cost subject to policy limits, terms, and conditions <br />(Fire, Theft, Rearm Interruption) <br />Employee Honesty (Crime) Subject to policy limits, terms, and Conditions <br />Should any of the above mvwmes for the C'ovaW Peaty be cbaaged at withdrawn prior to the expiration date issued dbov4 ASW will mail 30 <br />days written notice to the Certificate Holds, but fah7um to mail such notice shalt impose no obEgadon or liability of any hind upon AS©P, its agents, <br />Or mpmseatstive& if you have any questions, contact: <br />Ms. Paula Chu Tanguay, Chief Executive Officer <br />ASC1P • 16550 S1oomrrct =, CA 90703 9 (562) 404 -8029 <br />Authnrind Representative: <br />Date Issued: <br />* A5C(p is a joint powers audtoaq puesnatht bo Article t (�tmenc+ng with Section 6500) of Chapter 5 of Division 7 of Title t of the Govaw mt <br />Code and Swtioat 39M and 9 tf03 of rM Education Code. <br />744- - 09x10 -oflBC /k ,iliance of Schools for Operative insurance Programs <br />IIBS50 Htaa+&W Wx .e. C.,&w, CA 90703 (50) 44-8029 <br />TOTAL P.01 <br />