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ORANCNT-01 PPRASI
<br />4 rrc� CERTIFICATE OF LIABILITY INSURANCE oAT8/512013 '
<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 Hou of such endorsement{s).
<br />PRODUCER CONTACT
<br />NAM9
<br />cnapman """"° 1 626 405-8031 '"" J 1 (626)405.0585
<br />a Division of Arthur J. Gallagher 8 Co. a MAILo E.u: IAtc, Nu;,,
<br />Insurance Brokers of California, Inc. E-MAIL
<br />PO Box 6455 s:
<br />Pasadena, CA 91117-0455 INSURERS) AFFORDING COVERAGE _ NAICN _
<br />INSURER A:Great American Insurance Compan 16691
<br />INSURED INSURER B:^- _ --
<br />Orange County Asian & Pacific Islander Community Alliance INSURERC:
<br />12900 Garden Grove Blvd #214A INSURER D : _
<br />Garden Grove, CA 92843 INSURER E:
<br />INSURER F: Y._..............
<br />COVERAGES CERTIFICATE NUMBER: _ REVISION NUMBER: _
<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 WK THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 70 ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR A D SUE ^� POLICY EFF POLICY EXP
<br />LTR _ TYPE OF INSURANCE POLICYNUMBER MMIDpl4YYY MID MWI'YYY LIMITS
<br />GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br />A X COMMERCIAL GENERAL LIABILITY X PAC033097800 1011612012 1011512013 iAM Ear R€RTE6' 100,000
<br />� PREMISES (Ea occurrence) $ _
<br />CLAIMS -MADE OCCUR MED EXP (Any are person) $ 5,000
<br />X Professional List Inc PERSONAL& ADV INJURY $ 1,000,00
<br />X Sexual Abuse 1nel GEN_ER_AL AGGREGATE $ 2,000,00
<br />GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGO $ 2,000,000
<br />X POLICY PRa LOC $
<br />_... _......... _ .
<br />AUTOMOBILE LIABILITY BI MNED SINGLE LIMI ", 00000
<br />Ea acddentl $
<br />A ANY AUTO PAC033097800 10/16/2012 1011512013 BODILY INJURY (Per persanl $
<br />ALLCA NED SCHEDULED aCo1LY INJURY (Par aoddantj $
<br />AUTOS _ AUTOS
<br />X II AU X NON -OWNED PROPERTY DAMAGE $
<br />., AUTOS _Torgur"ant}
<br />UMBRELLA LIAR _ OCCUR a _ yo) re -- EACH OCCURRENCE $
<br />EXCESS LIPS _ CLAIMS -MADE 'AC
<br />GREGATE � $
<br />DED RETENTION$ - /`r •^-�"$
<br />WORKERS COMPENSATION _ WC STATLL OTtt-
<br />ANDEMPLOYERSLIAMUTY YIN �^' µs�(�A lotac,ic TORY LIMITS J F,R
<br />ANY PROPRIETORIPARTNFRID(EGUTNE Attor e EL EACH ACCIDENT S
<br />OFFICERlMEMBER EXCLUDEDO N t A a t ley p -
<br />(MandatorylnNH) )+`aS1San / E.L DISEASE-EAEMPLOYEE$
<br />f yes, descdb. under
<br />DESCRIPTION OF OPERATIONS below E,1.. DISEASE-POLICYLIMIT $_
<br />A Employee Dishonesty PAC033097800 1011612012 0 112013 Deductiible: $1,000 50,000
<br />A Forgery & Alteration PAC033097800 10/15/2012 1011512013 Deductible: $1,000 50,000
<br />DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES (Attach ACORD I01, Additional Remarks Schedule, if more space is required)
<br />OCAPICA 12900 Garden Grove Blvd Suites: 210A, 214A, 220A, 222B, 225E and 224B, Garden Grove, CA 92843
<br />City of Santa Ana, its officers, employees, agents, volunteers, and representatives are named additional insured with respect to the operations of the named
<br />insured. Such insurance is Primary and Non -Contributory.
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Cityof Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />1000 E. Santa Ana Blvd. Suite 200
<br />Santa Ana, CA 92701 --- —
<br />AUTH RR )XEEED REEPPn/PRESENTATIVE
<br />Oq 1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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