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EVIDENCE OME. COVERAGE D6/30/ DOIYYYY) <br />5!30!2013 <br />This Evidence Of Coverage is used as a matter of Information only and con th Holder. This Evidence of Coverage does not <br />amend, extend, or alter the coverage afforded by the memoranda listed b <br />MEMORANDUM NUMBER: 144 <br />JOINT POWERS AUTHORITY NPAI <br />Alliance of Schools for Cooperative Insurance Programs ifiDistrict <br />16550 Bloomfield Avenue n <br />Cerritos, CA 90703 Santa Ana CA 927016322 <br />www.ASCIP.org <br />CONTACTNAME: Mr. Fritz Helrich, Chief Executive Officer <br />PHONE: (562) 404 -6029 <br />This Is to certify that the Alliance of Schools for Cooperative Insurance Programs (ASCIP) Memorandum of Coverages on insurance listed below have <br />been issued to the Covered Party named above -for the period - Indicated. Notwithstanding any requirement, term, or condition of any contract or other <br />document with respect to which this Evidence of Coverage may be used or may pertain, the coverages afforded by the Memorandum of Coverages <br />described herein are subject to all the terms, exclusions, and Conditions of such Memorandum of Coverages. <br />TYPEOFCOVERAGE ANep MEMORANDUM NUMBER (MCC) awoonEPP POLICY ERP LIMIT OF LIABILITY I COVERAGE <br />jMOLICIYEPP OLICY.EX <br />GENERALUAEILITV COMBINED SINGLE LIMIT PER OCCURRENCE S $5,000,000 <br />OCCURRENCE <br />Personal Inlury ✓ MOG #144 711 12019 7/112034 AGGREGATE._..�_� <br />E NIA <br />Errols R Omission <br />Employment practices <br />s� <br />3 <br />AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT PER OCCURRENCE E $5,000,000 <br />AUTOMOTIVE PHYSICAL DAMAGE MOC W4 7/1/2019 7/1/2014 ACTUAL CASH VALUE E <br />COMPREHENSIVE I COLLISION <br />S <br />RNYAUTO — ---- <br />3 <br />caned Auto <br />�Bd Auip S <br />E <br />PROPERTY ANACONDA COS SUBlECTT N POLICY LIMITS, TERMS, <br />SUILOING/ CONTENTS <br />S <br />FIRE. THEFT: RENTAL INTERRUPTION <br />S <br />WORKERS COMPENSATION MA NIA EACH ACCIDENT E <br />® WC STATUTORY LIMITS PEA EMPLOYEE <br />POLICY LIMIT $ <br />OTHER SUBIECTTO POLICY LIMITS, TERMS, AND CONDITIONS <br />EMPLOYEE DISHONESTY ICRIMED ------ b— ®--- .--- .«,.�. -_._ <br />S <br />.e.- ._. -. -.. $�.� <br />r <br />TO VC ti'1.. „.jj E <br />ADDITIONAL REMARKS; <br />As respects to agreement,,, <br />LISFl f SiC;dCA <br />Assistant Clty Attorney <br />CERTIFICATE HOLDER CANCELLATION <br />Should any of the above coverages for the Covered Party be changed or withdrawn prior <br />to the expiration date issued above, ASCIP will mail 30 days written notice to the <br />City, Of Santa Ana Certificate Holder, but failure to mail such notice shall Impose no obligation or liability of <br />Parks, Recreation & Community Services Agency any kind upon ASCIP, its agents, or representatives. <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br />AUTHORIZED REPRESENTATIVE: Fritz Heifich <br />°ASCIP NoInlnepowersauthodry pursuant to ArtkieI(caramandngwith SWW 6500) Chapter G afDivWm 7 of thin I ortho GmmmentCode andSedi"39603 and 81603 of the Educatlan Cad& R. 547 <br />N°G ' <br />CSRT NO.: 36511060 CLRL:R Cppn: AAA NanCY LaPaz 5(30IR01] IA: U,46 AN page 1 0! ] <br />