ORANGE COUNTY SUPERINTENDENT OF SCHOOLS 5 - 2009

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� - %e9- -0 "1 a w�'�Y1�Y IiY✓ "`j - °"t°'' CERTIFICATE OF LIABILITY INSURANCE DATE(n, 0MIVM THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEENIITHlSSUIP,IO IMUiER/S1, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. L i° Y .747 IMPORTANT; If the cendflcab holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. 9 SUBROGATION IS WAIVED, subject to the terms and Conditions of the policy, certain policies may require an Endorsement A statement on this Cerdticeta does not Confd rights tbtt6e certificate holder in lieu of such endorsements). ` t PRODUCER Imperial Insurance Agency 22938 Lyons Avenue Santa Clarb, CA 91321 Phone 661)290.2777 Fax (661)290.2770 CONTACT AnlhonY Ok ( NAME (661)290.2777 IAJC. t Ne: (661 )290-2770 anthonyeimperlaiapant.cam INSURERS) AFFORDING COVERAGE NAIC9 NSURERA; Cahn Insurance Company INSURED TMC Shooting Range Specialist 27431 Santa Clarita Rd. Santa Clams, CA 81350 INSURER B; United Financial Casualty Company INSURER C: INSURER D: INSURER E: Rockhlll insurance Company NSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ng TRR TYPE OF INSURANCE POLICY NUMBER MMD EFF MMO ExP LIMITS A GENERAL LIABILITY © COMMERCIAL GENERAL LIABILITY [I El CLANS-MADE 0 OCCUR ❑ Y 0400902319 04/30 @013 04l30Y2014 EACH OCCURRENCE E 1,000000.00 DRMAGE TO ELATED a 100,000.00 MED EXP (Any one Pnl ersePERSONAL a 5,000.00 & ADV INJURY S 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER © POLICY ❑ PR ' ❑ LOU PRODUCTS - COMP/OP AGO $ 1,000,000.00 $ B AUTOMOBILE LIABILITY ❑/ ANYAUTO ❑ ALLOWNED SCHEDULED AUTOS ❑ AUTOS ❑ HIRED AUTOS ❑ AUTOS ❑ _ 01704102 -1 07/02/2013 07/02/2014 =SINGLE LIMIT 1,000,000.00 BODILY INJURY (Per perem) $ BODILY INJURY (Per eccidmt S PROPERTY PMAar RO:E $ a ❑ UMBRELLA LUIS ❑ OCCUR ❑ EXCESS L AR ❑ CLAIMS -NAPE �py�T�/y T� 1 .0 AST/ D I �/^�� (-� "' 1 ^1 v� EACH OCCURRENCE a AGGREGATE S ❑ DIED ❑ RETENTIONS E A D EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNEREXECUTNE OFFICERIMEMEER EXCLUDED? idand.rory In NH) aye e dB ION hoer DESdRIPTION OF OPERATIONS below N/A A. Laura A. Assistant Ct OS$IDI Attorri Y ❑ STATU ❑ OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE a E . DISEASE - POLICY LIMIT a E Pollution Liabilily/Each Cont, Poliutio ENVP002231 -00 04104/2013 04/04 /2014 $2,000,000!$2,000,000 DESCRIPTION OFOPERATIONS/ LOCATIONS /VENICLES 1ANach ACORO 101,Adoldmal Remprks Sdwdula,I maespapab rsgrtlrM) - City of Santa Ana, its officers, agents and employees are named as additional insureds as respects to general liability policy limits per Additional Insured Blanket. 10 day notice of Cancellation will apply for non - payment of premium. CERTIFICATE HOLDER CANCELLATION City of Santa Ana Alto: Purchasing Dept SantaAna,IC Center 2701 Santa Ana, CA 92701.4010 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTNOR2 RES,IENTffATIVLAVE/ i�`�w�y /1 • 1 �..IC.�t �! ACORD 25 (2010105) OF 01988.204d ACOFfD CORPORAtION. All rights reserved. The ACORD name and logo are registered marks of ACORD