ORANGE COUNTY CONSERVATION CORPS 9 - 2011

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OP ID: PC .a►�coRo CERTIFICATE OF LIABILITY INSURANCE DAT 03/22 /1D/1 F 03/221 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 BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endonsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 626-105-8031 Chapman License #0522024 626 05-0585 P. O. BOX 5455 Pasadena, CA 91117-0455 CONTACT NAME: PHONE FAX AC No: Z ADDRESS: PRODUCER ORANG-9 INSURERS AFFORDING COVERAGE NAIC # 07/20/11 INSURED Orange County Conservation Cor INSURER A. Great American Insurance Co 16691 Tai Tony Huynh INSURERB-Carolina Casualty Ins Co 10510 1853 N. Raymond Ave. Anaheim, CA 92801 INsuRERc:Nonprofits' Insurance Alliance 10023 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGO $ 3,000,000 INSURER D INSURER E EJ AUTOMOBILE INSURER F 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. ILTSRR TYPE OF INSURANCE ... UB POLICY NUMBER POLICY EFF POLICY DDEXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_x] OCCUR X PACS154680 07/20/10 07/20/11 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence S 100,00 MED EXP (Any one parson) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GENERA -AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGO $ 3,000,000 Emp Benef $ 1,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEOULEDAUTOS HIREOAUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per parson) $ BODILY INJURY (Per a=ident) $ PROPERTY DAMAGE (Pe accident $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE s AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICEWMEMBER EXCLUDED? (Mandatory In NH) If yes, descnne under DESCRIPTION OF OPERATIONS below N / A NPUWCGO012011 01/01111 01/01/12 X I WC STATU- OTH- E. L. EACH ACCI DENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1:000.000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 A Property coverage PAC5154680 07/20/10 07/20/11 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 1D1, Additional Ramarlrs Schedule, If more space Is required) The City of Santa Ana and their respective officers, employees, agents, volunteers and representatives are named additional insured with respect to the operations of the named insured per the attached CG 2026 endorsement. Such insurance isprimary and non-contributory. Workers Compensation coverage excluded evidence only. ICAI CITYTVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana, c,kfWk10V Eo n�S -T'O FORM AUTHORIZED y/REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) _ Laura tiO"o and logo are registered marks of ACORD Assistant CZ Attorney