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EVIDENCE <br />OF COVERAGE DATE (MMIDDIYYYY) mm <br />4/24/2015 <br />This Evidence of Coverage Is used as a matter of information only and confers no rights upon the Certificate Holder, This Evidence of Coverage does not <br />amend, extend, or alter the coverage afforded by the memoranda lusted below. <br />MEMORANDUM NUMBER: for} <br />JOINT POWERS AUTHORITY ( JPA) <br />_. ..... ........... <br />JPA MEMBER <br />Alliance of Schools for Cooperative Insurance Programs <br />Santa Ana Unified School District <br />16550 Bloomfield Avenue <br />1601 P. Chestnut Avenue <br />Cerritos, CA 90706 <br />Santa Ana CA 92701 -6322 <br />www.ASCIP.org <br />CONTACT NAME: Mr. Fritz Heirich, Chief Executive Officer <br />PHONE: (562) 4074 -8029 <br />This is to certify that the Alliance of Schools for Cooperative Insurance <br />Programs (ASCIP) Memorandum of Coverages on insurance listed below have <br />been issued to the Covered Party named above for the period indicated. <br />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 />ADDL. POLICY EFF POLICY EXP <br />TYPE OF COVERAGE INSR MEMORANDWMNWM.BERfMOGI... (MMIDDIYYYY) 12 :01a.m. III LIMIT' OF LIABILITY ICOVERAGE <br />GENERAL LIABILITY <br />COMBINED SINGLE LIMIT PER OCCURRENCE $ $75,000,000 <br />OCCURRENCE V MOC #144 7/1/20114 <br />7/1/2 015 AGGREGATE $ N/A <br />Personal lnlury <br />Errors & Omission <br />$_ <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT PER OCCURRENCE $ $5,000,000 <br />. ±.... AUTOMOTIVE PHYSICAL DAMAGE: M #144 7/1/2014 <br />7/1/20715 ACT AL CASH VALUE. $, <br />COMPREHENSIVE I COLLISION <br />$ <br />ANY AUTU <br />.., _......... ......... .......... $. <br />�.....Qwned / ut ..... _ ...... ..... <br />$ <br />.... Hired Auto <br />_ ...................._. <br />PROPERTY <br />REPLACEMENT COST SUBJECT TO POLICY LIMITS, TERMS,..__........,... <br />AND CONDITIONS ...._._.. ... ............._......., <br />BUILDING; CONTENTS <br />$. <br />FIRE, THEFT, RENTAL INTERRUPTION <br />Is <br />$ <br />............ .. ..... ............._.......... _ m.....,. <br />........._._... <br />$.. <br />_..m..... ............ <br />WORKERS COMPENSATION NIA <br />.......,. _......_......... <br />EACH ACCIDENT $. <br />AND EMPLOYERS" LIABILITY <br />-- -..... -- -..... - - -- . -... -. _... <br />I <br />� WC STATUTORY LIMITS <br />PER EMPLOYEE $ <br />= ... .........__.. .., ..._........ ... <br />�y O <br />V <br />POLICY LIMIT $ <br />OTHER q <br />� ICK LIMITS, TERMS, NS <br />SUBJECT TO POLICY AND CONDITIONS <br />EMPLOYEE DISHONESTY CREME <br />G } <br />"." <br />� <br />ADDITIONAL REMARKS <br />As respects to agreement <br />_ <br />CERTIFICATE HOLDER <br />...__....._. . ...... _ ...,.... .................. <br />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 />Certificate Holder, but faliure to mail such notice shall impose no obligation or liability of <br />City of Santa Ana <br />any kind upon ASCIP, its agents, or representatives. <br />_...._._ <br />Attn: PRCSA <br />20 Civic Center Plaza - M -2.3 <br />Santa Ana CA 92701 <br />f <br />AUTHORIZED REPRESENTATIVE: Fritz Hei ICh <br />*ASCIP is a Joint powers authority pursuant to Article 1 (commencing with section 6500) Chapter 5 of Division 7 of Title 1 of the Government Code and Sections 39603 and $1603 of the Education Code. Rein 5 -47 <br />CERT Nor 14567702 CLIENT CODE; 144 Nancy Lopez 4/24/2019 8x07:55 AM {PDTj Page: 5 of 2 <br />