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271069 <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />2/24/2015 <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(ies) 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 />15303 Ventura Boulevard, 7th FIOOr� <br />Sherman Oaks, CA 91403-3197 <br />CONTANAME: Catherine Cory <br />PHONE FAX <br />IANC No ExIG 818-464-9458 AIC No : 866-96_8-5687 <br />ADpRIEs : catherine.cory@wellsfargo.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A: Philadelphia Indemnity Insurance Company <br />18058 <br />INSURED <br />Discovery Science Center of Orange County <br />INSURER B: Employers Compensation Ins Co <br />E <br />11512 <br />INSURER C <br />GEN'L AGGREGATE LIMIT APPLIES PER; <br />X POLICY 1:1JECT ] LOC <br />OTHER: <br />2500 North Main Street <br />INSURER D: _ <br />Sexual Abuse/Molestation $ Included <br />Santa Ana, CA 92705 <br />INSURER E <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS X AUTOS <br />INSURER F; <br />PHPK1269512 <br />COVERAGES CERTIFICATE NUMBER: 8775899 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />MPOLI CY EFF <br />MDD/YYYY <br />POLICY EXP <br />MM DD[YYYY <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE a OCCUR <br />X <br />PHPK1269512 <br />12/15/2014 <br />12/15/2015 <br />EACH OCCURRENCE $ 1,000,000 <br />DAMAGE TO RENTED 1,000,000 <br />PREMISES.(Ea_occurr.nce $ <br />MED EXP (Any one person) $ 20,000 <br />PERSONAL & ADV INJURY $ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER; <br />X POLICY 1:1JECT ] LOC <br />OTHER: <br />GENERAL AGGREGATE $ 2,000,000 <br />PRODUCTS - COMP/OP AGG $ 2,000,000 <br />Sexual Abuse/Molestation $ Included <br />A <br />AUTOMOBILE <br />X <br />XNON-OWNED <br />I$ <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />HIRED AUTOS X AUTOS <br />PHPK1269512 <br />12/15/2014 <br />12/15/2015 <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />Ea accident) <br />BODILY INJURY (Per person) $ <br />BODILY INJURY (Per accident) $ <br />DAMAGE <br />PeOa PROPERTY <br />$ <br />A <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />PHUB483491 <br />12/15/2014 <br />12/15/2015 <br />EACH OCCURRENCE $ 10,000,000 <br />AGGREGATE T $ 10,000,000 <br />DEO I RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y/N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? 7N <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N / A <br />EIG1453813-02 <br />04/01/14 <br />04/01/15 <br />PER OTH- <br />X STATUTE ER <br />E.L. EACH ACCIDENT $ 1,000,000 <br />- <br />E.L. DISEASE - EA EMPLOYEE $ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />The City of Santa Ana is included as Additional Insured for General Liability as required by written contract. <br />DISCOVERY SCIENCE CENTER A-2013-028 REVIEWED EY� � °� r �� .. EC NICE HEREDIA (PG. '1 of 2.) <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana <br />Public Works Agency, M-21 <br />20 Civic Center Plaza <br />P O Box 1988 <br />Santa Ana CA 92702 <br />AUTHORIZED REPRESENTATIVE <br />�e? w <br />Fhe ACORD name and logo are registered marks of ACORD <br />ACORD 25 (2014/01) <br />(This -dific to replaces c flficafea 8775897 issued on 224/2015) <br />