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- City of Santa Ana <br />f f Certificate of Self- Insurance <br />City of Santa Ana, Risk Management, M -28, 20 Civic Center Plaza, Santa Ana, CA 92701 <br />This is to certify that the City of Santa Ana is self - insured for the following coverage: <br />Type of Coverage Self - Insurance Limit <br />General Liability: Bodily Injury and Property Damage $1,000,000 <br />Terms, Conditions and Special Items: <br />The provisions under General Liability, above, shall apply only with respect to claims arising out <br />of the negligent acts or omissions of the City of Santa Ana, its officers, agents and employees or <br />any other person under its direction and control. <br />Cancellation: <br />Should any of the above described self - insured coverages be modified or cancelled before the <br />expiration date shown below, the City of Santa Ana will provide 30 days written notice to the <br />named certificate holder. <br />Certificate Holder <br />South Coast Air Quality Management District <br />Mobile Source Air Pollution Reduction Review <br />Committee (MSRC) <br />21865 Copley Drive <br />Diamond Bar, CA 91765 <br />16 <br />Certificate Effective Date: 07/01/2011 <br />Certificate Expiration Date: 07/01/2012 <br />0- , -� Zi� af �� <br />istant Personne irector <br />(714) 647 -5470 <br />Date Certificate Issued: 10/26/2011 <br />