BIG BROTHERS SISTER OF ORANGE COUNTY-2011

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quo QO DATE CERTIFICATE OF LIABILITY INSURANCE 10/01/201 YYY) to /ol /zolz 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 CERTIFI9ARPE I!4® IMPORTANT: If the certificate holder is an ADDITIONAL IISU12 ED, the oolllc3sDrilfist be endorsed. 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). EACH OCCURRENCE PRODUCER 1- 909 - 243-8260 CONTAG 1 Hays of California Insurance Services - Ontario- PHONE " FAX CLAIMS -MADE X OCCUR (AIC, Nb;f7tff+ (AIC, No): Empire Towers IV ADDRESS: 3800 Concours, Suite 3400 PRODUCER Ontario, CA 91764 CUSTOMER ID #: Kelly Peterson INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA: Nonprofits Insurance Alliance Big Brothers /Big Sisters of Orange County INSURERB: Oak River Insurance Company 14131 Yorba Street, Suite 200 INSURER C: Tustin, CA 92780 INSURER D: S 1,000,000 INSURER E: COVERAGES CFRTIFICATF NIIMRFR• 29416096 RGVISIANI NIIIMRFR• 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MPOLICY / MMIDD /YYYY LIMITS • GENERAL LIABILITY 20120647ONPO 02/11/12 02/11/13 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE RENTED PREMISES S ( (Ea occurrence) S 100, 000 CLAIMS -MADE X OCCUR MED EXP (Any one person) S 10,000 PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEML AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 3,000,000 X POLICY PRO LOC JE, S • AUTOMOBILE LIABILITY 20120647ONPO 02/11/12 02/11/13 COMBINED SINGLE LIMIT (Ea accident) S 1,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED A11T05 BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON -OWNED AUTOS $ A X UMBRELLA LIAB X OCCUR 20120647ONPO 02/11/12 02/11/13 EACH OCCURRENCE S 3,000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE S 3,000,000 DEDUCTIBLE $ X RETENTION $ 10, 000 S B 2200054868 -121 02/11/12 02/11/13 LIA X AND EMPLOYERS' LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR /PARTNERlEXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER /MEMBER EXCLUDED' El NIA (Mandatory in NH) E.L. DISEASE- EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Santa Ana is named as Additional Insured per attached form CG 20 26 07 04. M kV l•/'11Y 1•GLLM I IV IY % - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 USA Kelly Peterson nparxs © 1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 29416096