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h - k-I'l1-2,64 A�=Ra CERTIFICATE OF LIABUTTI ,S RANCE DATE oerzsolzrz012 Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO AI9HTS 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 vork NY Office 199 water Street New York NY 10038-3551 USA CONTACT NAME: HONE Exry: (866) 283-7122 FAX 11411 953-5390 AIC. No. E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED ICF ]Ones & stokes, Inc. 9300 Lee Highway Fairfax VA 22031-1207 USA INSURER A: AXIS surplus Insurance Company 26620 INSURERB: Great Northern insurance Co. 20303 INSURER C: Sentry Ins A Mutual company 24988 INSURER D: INSURER E: INSURER F: 1J1VIf PluffIOCR. 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. S Limits shown are as requested TYPE OF INSURANCE O LTR INSR WVD POLICY NUMBER MMIDD MMIDDIYYYY LIMITS B GENERAL LIABILITY EACH OCCURRENCE S1,000,000 X COMMERCIAL GENERAL LIABILITY Package - Domestic DAMAGE$1,000,000 PREMISES Ea occurrence) CLAIMS -MADE X❑ OCCUR MED EXP (Any one person) $10, 000 X Prod -Comp Op Intl in Gen'] Agg r0 0 PERSONAL & ADV INJURY $1, 000 , 000 X Contractual Liability GENERAL AGGREGATE $2 , 000, 000 Oro G EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP ASS X POLICY PRO LOC o I 1 73522955 /25 2013 0 1- B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT AUtomobi T- Al St tes Ea accident $1,000,000 BODILY INJURY ( Per person) X ANY AUTO j p ALL OWNED SCHEDULED AUTOS AUTOS r� 1 BODILY INJURY Per accident)y ( X HIRED AUTOS X NON -OWNED 1 ` PROPERTY DAMAGE AUTOS Y O. HODGE (Per accident w UMBRELLA LIAB OCCUR \ EnGr I JCC::RREtJCE U EXCESS LIAB CLAIMS -MADE '� AGGREGATE 7E.L. DED RETENTION C WORKERS COMPENSATION AND 90-17617-01 06 25/2012 06/25 2013 WC STATU- OTH- EMPLOYERS' WC LIABILITY X Y LIMITS ER YIN workers Comp ANY PROPRIETOR/PARTNER/EXECUTIVE C [Y EACH ACCIDENT NIA 90-17657-02 06/25/2012 06/25/2013 $1,000,00 (Mandatory in NH) workers Comp E.L. DISEASE -EA EMPLOYEE $1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 A E&U-MPL-Primary EB2 768043/01/2012 06/25/2012 06/25/2013 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 High School 1 - Professional Liability Liability is a Claims Made policy. There's no Additi onal 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.88 Box 19CA Santa Ana, CA 92701 USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 3'