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271069
<br />.4ct?0' CERTIFICATE OF LIABILITY INSURANCE
<br />DATE1//8!2018/201PI VY)
<br />3
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />Certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Commercial Lines - (818) 464-9300
<br />Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408
<br />CONTACT
<br />NAME:
<br />PHONE FAX
<br />fAIC. No EMIL uc N.):
<br />E4AIL
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE NAICe
<br />15303 Ventura Boulevard, 7th Floor
<br />INSURER A: Philadelphia Indemnity Insurance Company 18058
<br />Sherman Oaks, CA 91403-3197
<br />INSURED
<br />Discovery Science Center
<br />INSURER B: Philadelphia Insurance Company 23850
<br />INSURER C: Employers Compensation Ins Co 11512
<br />2500 North Main Street
<br />INSURER D: Travelers Casualty & Surety Co. of America 31194
<br />Santa Ana' CA 92705
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 5465122 REVISION NUMBER: See below
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSRTypE
<br />LTR
<br />OF INSURANCE
<br />UBR
<br />POLICY NUMBER
<br />POLICYEFF
<br />MM D
<br />POUCYEXP
<br />MMIDD
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MAGE OCCUR
<br />X
<br />PHPK953782
<br />'
<br />12!15!2012
<br />12115/2013
<br />EACH OCCURRENCE $ 1,000,000
<br />DAMAGE
<br />PREMISES Ea occurrence S 300,000
<br />MED EXP (Any one person) $ 5,000
<br />PERSONAL 8 ADV INJURY $ 1,000,000
<br />GENERAL AGGREGATE $ 2,000,000
<br />GEN'L AGGREGATE
<br />LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOP AGS $ 2,000,000
<br />X POLICY
<br />PRO- LOC
<br />Jpr.T 71
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABIUTV
<br />PHPK953782
<br />12/15/2012
<br />12/15/2013
<br />COMBINED SINGLE LIMIT Ea eccide1,000,000
<br />M
<br />BODILY INJURY (Par person) $
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (PeremitleM) $
<br />PROPERTYDAMAGE $
<br />Per a.dent
<br />X
<br />X NON�OWNED
<br />HIRED AUTOS AUTOS
<br />B
<br />UMBRELLA LIABX
<br />OCCUR
<br />PHUS404496
<br />12/15/2012
<br />12115/2013
<br />EACH OCCURRENCE $ 10,000,000
<br />AGGREGATE S
<br />X
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />DED RETENTIONS
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPMETORIPARTNEWEXECUTIVEE.L.
<br />OFFICE"EMBER EXCLUDED9 ❑N
<br />NIA
<br />EIG1453813-00
<br />04/01/12
<br />04/01/13CRY
<br />X WC STATU- OTH-
<br />LIM
<br />EACH ACCIDENT g 1,000,000
<br />E.L. DISEASE - EA EMPLOYE $ 1,000,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DE SCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />D
<br />D&O, EPL, Fiduciary, Crime
<br />105645707
<br />06/30/2012
<br />06/30/2013
<br />3,000.001)
<br />DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Attach ACORD 101, AddlUonal Remarks Schedule, if more a pace is required)
<br />CG 20 26 07 04 The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701, its officers, employees, agents, volunteers and
<br />representatives are included as Additional Insureds for General Liability and defense of suits arising from the operations and uses performed by or on
<br />behalf of the Named Insured per the attached. Cancellation Notice to Scheduled Additional Insured also attached. The coverage is primary and
<br />non-contributory with other insurance held by the City. Separation of insureds applicable per the policy form.
<br />ORM
<br />City of Santa Ana
<br />Attn: Risk Management
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />ACORD 25 (2010105)
<br />City Attorney
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />9f�
<br />The ACORD name and logo are registered marks of ACORD
<br />(mk nnM . r, o.—mmmni.a 618111. ewes. u9,zo 11
<br />
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