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CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01/10/2012 I 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 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). PRODUCER Aon Risk Services Northeast, Inc. New York NY Office CONTACT NAME: (AC.No.Ext): (866) 283-7122 aC No (847) 953-5390 E-MAIL ADDRESS: 199 water Street New York NY 10038-3551 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Steadfast Insurance Company 26387 ICF Jones & Stokes, Inc. 9300 Lee Highway INSURER B: Great Northern Insurance Co. 20303 INSURER C: Fairfax VA 22031-1207 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570045030509 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. Limits shown are as requested LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDDlYYYY MMIDDIYYYY LIMITS B GENERAL LIABILITY EACH OCCURRENCE $1, 000, 000 X COMMERCIAL GENERAL LIABILITY Package -Domestic DAMAGE OREN D PREMISES Ea occurrence $1,000,000 CLAIMS -MADE X❑ OCCUR MED EXP (Any one person) $10, 000 X Prod -Comp Op Ind in Gen'I Agg PERSONAL & ADV INJURY $1,000,000 X Contractual Liability GENERAL AGGREGATE $21,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG X POLICY PR,0� LOC B AUTOMOBILE LIABILITY 73522955 Automobile - All States 06 25 201106 25/2012 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS �—' o TU PROPERTY Pena accident) 1 � UMBRELLA LIAR EACH OCCURRENCE EXCESS LIAR HOCCUR CLAIMS -MADE �-- AGGREGATE DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN CAUSM STATU- TH- TORY LIMITS OR E. L. EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A\17(Mandatory E.L. DISEASE -EA EMPLOYEE in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT A E&O-MPL-Primary PEC 913140704 06/25/2011 06/25/2011 Prof Liab Agg - All $1,000,000 Errors & Omissions Overall policy aggr, $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: The Academy Hiqh School 1 - Professional Liability Liability is a Claims Made policy. There's no Additional Insured status on the Professional Liability coverage. 2 - The City, its officers, employees, agents, volunteers and representatives are included as Additional Insureds as their interest may appear. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. city of Santa Ana AUTHORIZED REPRESENTATIVE Planning and Building Agency 20 Civic Center Plaza, M-29 P.O. Box 1988 CA J/f Santa Ana, CA 92701 USA �.�oss JsLc�aledc/jpELfxorf �-jna ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD `m rn C. 0 v 0