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211069
<br />tC CERTIFICATE OF LIABILITY INSURANCE oAT3(MWOV1r3YY(
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENL EX'? ND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW, THIS CERTIFICATE OF INSURANCE bOEB?NOT'CON5 IT TE 4 CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is on ADDITIONAL INSURED, the pollcy(los) must be endorsed, If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, cartel fk.policies may require art o?l.d? ji6ent. A statement on this certificate does not confer rights to the
<br />certificate holder In lleu of such endorsement's.: :,,}L,
<br />PRODUCER CAOMP or
<br />Commercial Lines - (818) 464-9300 PHONE
<br />e.n• FAX
<br />2c. Rol:
<br />Wells Fargo Insurance Services USA, Inc. - CA Lie#: 0008408 MAIL
<br />ADDRESS:
<br />15303 Venture Boulevard, 7th Floor INSURER S AFFORDING COVERAGE NAIC k
<br />Sherman Oaks, CA 91403-3197 INSURERA; Philadelphia Indemnity Insurance Company 18058
<br />INSURED INSURERB: Philadelphia Insurance Company. 23850
<br />Discovery Science Center INSURER 0: Employers Compensation Ins Cc 11512
<br />2500 North Main Street INSURER D: Travelers Casualty & Surety Co. of America 31194
<br />Santa Ana, CA 92705
<br />/
<br />. INSURER E:
<br />?
<br />?
<br />Dll 0?? ?n I w.,mcne.
<br />COVERAGES
<br />ocvrmnu Lu u.ao cm. ,.
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR TYPEOPINBURANCE DOL E OR POLICYNUMBER MO tln EFR PO OCOY EXP LIMnB
<br />A asN ERAL LIABILITY X PHPK953782 12/15/2012 12115/2013 EACH OCCURRENCE $ 1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY DAVAOETO ENT D
<br />REMISES Ea coomenee
<br />$ 300,000
<br /> CWMS-MADE OCCUR
<br /> MED EXP(Any one percent $ 6,000
<br /> PERSONAL B ADV INJURY S 1
<br />000
<br />000
<br /> ,
<br />,
<br /> GENERAL AGGREGATE $ 2
<br />000
<br />000
<br /> ,
<br />,
<br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000.000
<br />
<br />
<br />PRO- I
<br />X POLICY
<br />1 E]
<br />
<br />$
<br />A AUT OMOBILE LIABILITY PHPK953782 12115/2012 12115/2013 COMBINED SINGLE LIMIT
<br />_Ea 4gcld mt
<br />1,000,000
<br /> % ANYAUTO BODILY INJURY (Per person) $
<br /> ALL OWNED
<br />AUTOS SCHEDULED
<br />AUTOS BODILY INJURY Per adddani
<br />( ) I$
<br /> X HIREDAUTO$ X NON OWNED PROPERTYDAMAGE
<br />$
<br /> AUTOS Peramdd,m
<br /> $
<br />B UMBRELLA LIAR
<br />
<br />x OCCUR PHUB404496 12!1512012 12(1512013
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br /> X EXCESS LIAR CLAIMS-MADE AGGREGATE $
<br />
<br /> OED RETENTION$ $
<br /> WORKERS COMPENSATION We STATU. OTH-
<br />X
<br />C AND EMPLOYERS' LIABILITY EfG1453813-01 04/01113 04101114 .
<br /> Yin
<br />ANY PROPRIETOWPARTNERIEXECUTIVE
<br />OFFICERRAEMBEREXCLUDEDY O
<br />N/A E,L.EACH ACCIDENT If i,OW,000
<br /> fMandelon, In NH)
<br />H
<br />rib
<br />d
<br />I[
<br />01 E. L. DISEASE-EA EMPLOYE $ 1,001
<br /> Vyas esc
<br />e under
<br />M
<br />$
<br />,0un
<br /> OPERATIONS below EA. DISEASE-POLICY LIMIT
<br />1,000,OO0
<br />$
<br />D D&0, EPL, Fiduciary, Crime 105645707 06/3012012 06/3012013 3,ooo,op0
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ARach ACORD 101, Additional Remains Schedule, if more space Is required)
<br />CO 20 26 07 04 The City of Santa Ana, 20 CIVIC Center Plaza, Santa Ana, California 92701, its officers, employees, agents, volunteers and
<br />representatives are included as Additional Insureds for General Liability and defense of suits arising from the operations and uses performed by or on
<br />behalf of the Named Insured per the attached. Cancellation Notice to Scheduled Additional Insured also attached. The coverage is primary and
<br />non-contributory with other Insurance held by the City. Separation of Insureds applicable per the policy form.
<br />City of Santa Ana x3T 'O,/ .r2 O FORM
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Alin: Risk Mana ement 00- THE EXPIRATION DATE THEREOF, NOTICE WILL HE DELIVERED IN
<br />9 {?? ?JJ y ?4brC ?'
<br />20 GIVIO Canter Plaza ACCORDANCE W17H THE POLICY PROVISIONS.
<br />Santa Ana CA 92701 : Ura Stitt Sheerly AUTHORIZED REPRESENTATIVE p
<br />..,istant City Attorn?y/*M`(ytA4
<br />The ACORD name and logo are registered marks of ACORD 01988.2010 ACORD CORPORATION. All rinhts reserved,
<br />ACORD 25 (2010/05)
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