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. . • -' <br /> <br />Statewide Association of Community College?ERTIFICATE OF COVERAGE Issue Date <br />Protected Insurance Program for Schools 11/14/2011 <br />ADMINISTRATOR: LICENSE # 0451271 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />Keenan & Associates AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> <br />901 <br />Calle <br />Amanecerr <br />#20 #200 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE <br />, , AFFORDED BY THE COVERAGE DOCUMENTS BELOW. <br />San <br />Clemente, CA <br />92673 <br /> ENTITIES AFFORDING COVERAGE: <br />949-940-1760 <br />www.keenan.com ENTITY A: Statewide Association of Community Colleges <br />COVERED PARTY: ENTITY B: Protected Insurance Program for Schools <br />South Orange County Community College Dist <br />28000 Marguerite Parkway ENTITY C: <br />Mission Viejo CA 92692 ENTITY D: <br /> ENTITY E. <br />THIS IS TO CERTIFY THAT THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED PARTY NAMED ABOVE FOR THE PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE COVERAGE <br />AFFORDED HEREIN IS SUBJECT TO ALL THE TERMS AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. <br /> MEMBER <br />ENT <br />LTR TYPE OF COVERAGE COVERAGE <br />DOCUMENTS EFFECTIVE/ <br />EXPIRATION DATE RETAINED LIMIT <br />/ DEDUCTIBLE LIMITS <br />A GENERAL LIABILITY COMBINED SINGLE LIMIT EACH OCCURRENCE <br /> [ GENERAL LIABILITY <br />[ CLAIMS MADE (OCCURRENCE SW000107-25 7/1/2011 $ 50,000 $ 1,000,000 <br /> [ GOVERNMENT CODES 7/1/2012 <br /> [ ERRORS & OMISSIONS <br />A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT EACH OCCURRENCE <br /> [ ANY AUTO SW000107-25 7/1/2011 $ 50,000 $ 1,000,000 <br /> [ HIRED AUTO <br />[ NON-OWNED AUTO <br />7/1/2012 <br /> [ GARAGE LIABILITY <br /> [ AUTO PHYSICAL DAMAGE <br />A PROPERTY SWC 00107-25 7/1/2011 $ 5,000 $ 250,000,000 <br /> [ ALL RISK 7/1/2012 EACH OCCURRENCE <br /> [ EXCLUDES EARTHQUAKE & FLOOD <br /> [ BUILDER'S RISK <br />A STUDENT PROFESSIONAL LIABILITY SWC 00107-25 7/1/2011 $ 5,000 Included <br /> 7/1/2012 EACH OCCURRENCE <br />B WORKERS COMPENSATION [ ?/] WC STATUTORY LIMITS [ ?J OTHER <br /> [ EMPLOYERS' LIABILITY PIPS11708 7/1/2011 $ <br /> 7/1/2012 $ 1,000,000 <br /> E.L. EACH ACCIDENT <br /> EXCESS WORKERS COMPENSATION $ 1,000,000 <br /> [ I EMPLOYERS' LIABILITY $ E.L. DISEASE - EACH EMPLOYEE <br /> $ 1,000,000 <br /> E.L. DISEASE - POLICY LIMITS <br /> OTHER $ TQ T <br /> VD <br /> $ ??C+ <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL PROVISIONS: <br />CK <br />As respects to the agreement between between SAWIB and South Orange County CCD (Saddleback College . c?'{OR <br />SA E' <br />ney <br />LI <br />. Attor <br />City l <br />i <br />tant <br />/ <br />Ass <br />s <br />? <br />CERTIFICATE HOLDER: CANCELLATION ...... SHOULD ANY OF THE ABOVE DESCRIBED COVERAGES BE <br /> CANCELED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING ENTITY/JPA <br />WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOT <br />C <br />Community Development M-25 <br />`7 Agency I <br />E TO THE CERTIFICATE <br />HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL <br />City of Santa Ana IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE ENTITY/JPA, ITS <br />P.O. Box 1988 AGENTS OR REPRESENTATIVES. <br /> <br />Santa Ana CA 92702 ?j <br />9-?zl ./ <br /> Graham Grice AUTHORIZED REPRESENTATIVE <br />w 1165 am <br />CERT NO.: 11656359 CLIENT CODE: SOUTHORA Melissa Magnifico 11/14/2011 4:53:36 PM Page 1 of 3