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271000
<br />, CCIOR" CERTIFICATE OF LIABILITY INSURANCE
<br />TE
<br />DA 12/19/2013 (MMIDDNYYY)
<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 Lie*: OD08408
<br />CONTACT
<br />NAME:
<br />PHONE AIC No :
<br />E-MAIL
<br />ADDRESS:
<br />INSURERS) AFFORDING COVERAGE
<br />NAIC #
<br />15303 Ventura Boulevard, AID Floor
<br />INSURER A: Federal Insurance Company
<br />20281
<br />Sherman Oaks, CA 91403-3197
<br />INSURED
<br />Discovery Science Center of Orange County, Inc.
<br />INSURER B : Employers Compensation Ins Co
<br />11512
<br />INSURER C
<br />2500 North Main Street
<br />INSURER D :
<br />Santa Ana, CA 92705
<br />INSURER E:
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 7025672 REVISION NUMBER: Sep. hP.InW
<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 />INTR
<br />TYPE OF INSURANCE
<br />ADDLSUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDD/YYYY
<br />POLICY EXP
<br />MMIDDIYYYV
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />X COM MERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE 1XI OCCUR
<br />X
<br />3600-1448
<br />12115/2013
<br />12/15/2014
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TORE TED
<br />PREMISES IF, occurrence
<br />$ 300,000
<br />MED EXP An one person)
<br />$ 10,000
<br />PERSONAL$ ADV INJURY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOPAGG
<br />$ 2,000,000
<br />X POLICY PRO- LOC
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />7358-2541
<br />12/15/2013
<br />12/15/2014
<br />COMBINED SINGLE UMIT
<br />Ea eccldent)
<br />1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Paramount)
<br />$
<br />X
<br />NON -OWNED
<br />HIRED AUTOS X AUTOS
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />A
<br />UMBRELLA LIAR
<br />Xd
<br />OCCUR
<br />7989-0454
<br />12/15/2013
<br />12/15/2014
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$
<br />X
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION$
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNERIEXECUTIVE ❑
<br />OFFICERIMEMBER EXCLUDED4 N
<br />(Mandatory in NH)
<br />NIA
<br />EIG1453813-01 vgC'r q'q
<br />SeryY'f'� V A.+U'
<br />.CyLL
<br />e.
<br />4' 1 y 2A
<br />°`
<br />.WpY/(f"
<br />X WC STATU- OTH-
<br />TORV LIMITS
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L DISEASE-EAEMPLOYEE
<br />$ 1,000,000
<br />If yes, deecrlba under
<br />DE
<br />/f '!
<br />__ '(^
<br />E. L. DISEASE -POLICY LIMIT
<br />$ 1,000,000
<br />Lis
<br />sta
<br />Assistan
<br />City AMI
<br />r1o"v I
<br />DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space 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 />CERTIFICATE HOLDER CANCELLATION
<br />City Of Santa Ana
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Attn: Risk Management
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />The ACORD name and logo are registered marks of ACORD © 1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105)
<br />
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