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G(/ � /K X <br />EVIDENCE OF COVERAGE <br />OATE(MMIOOIVWY) <br />317/2014 <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 listed below. <br />MEMORANDUM NUMBER: 144 <br />JOINT POWERS AUTHORITY (JPAI <br />JPA MEMBER <br />Alliance of Schools for Cooperative Insurance Programs <br />Santa Ana Unified School District <br />16550 Bloomfield Avenue <br />1601 E. Chestnut Avenue <br />Cerritos, CA 90703 <br />Santa Ana CA 92701 -6322 <br />www.ASCIP.org <br />CONTACT NAME: Mr, Fritz Holder, Chief Executive Officer <br />PHONE: (562)404 -$029 <br />This is to certify that the Alliance of Schools for Cooperative Insurance Programs (ASCIP) Memorandum of Coverages on insurance listed below have <br />been issued to the Covered Party named above for the period indicated. Notwithstanding any requirement, term, or condition of any contract or other <br />document with respect to which this Evidence of Coverage may be used or may pertain, the coverages afforded by the Memorandum of Coverages <br />described herein are subject to all the terms, exclusions, and conditions of such Memorandum of Coverages. <br />TYPE OF COVERAGE <br />AN$R <br />MEMORANDUM NUMBER (MOC) (MMIIONYYY) <br />P11201am. <br />LIMIT OF LIABILITY /COVERAGE <br />GENERAL <br />LIABILITY <br />COMBINED SINGLE LIMIT PER CCCURRENCE <br />$ $5,000,000 <br />OCCURRENCE <br />MOC #144 <br />7/1/2013 <br />7/1/2014 <br />AGGREGATE <br />$ N/A <br />Personal iniury <br />$ <br />Errors & Omission <br />$ <br />Employment Practices <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT PER OCCURRENCE <br />S $5,000,000 <br />AUTOMOTIVE PHYSICAL DAMAGE <br />MOC #144 <br />711/2013 <br />7/1/2014 <br />ACTUAL CASH VALUE <br />$ <br />COMPREHENSIVE / COLLISION <br />ANY AUTO <br />Owned Auto <br />[Elrod Auto <br />$ <br />$ <br />PROPERTY <br />'� <br />- <br />c <br />TCOST SUBJECT TO POLICY LIMITS <br />, TERMS, <br />BUILDING I CONTENTS <br />; q;,!'a� gan0 <br />V 1 <br />ANDACEME <br />$ <br />FIRE,THEFT, RENTAL INTERRUPTION <br />11 ,r)J �S.✓ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />NIA <br />I�r$z;.'IgY.iiCt <br />1 <br />EACH ACCIDENT <br />$ <br />FIWC STATUTORY LIMITS <br />1' <br />PER EMPLOYEE <br />$ <br />POLICY LIMIT <br />S <br />OTHER <br />SUBJECT-TO POLICY LIMITS, TERMS, AND CONDITIONS <br />EMPLOYER DISHONESTY (CRIME) <br />5 <br />S <br />$ <br />$ <br />ADDITIONAL REMARKS: <br />As respects to agreement with ROP <br />CERTIFICATE HOLDER <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 />City of Santa Ana <br />Certificate Holder, but failure to mall such notice shall impose no obligar on or liability of <br />Community Development Ageney -Santa Ana WORK Cent <br />1000 E. Santa Ana Blvd., Suite 200 <br />any kind upon ASCIP, Its agents, or representadves. <br />Santa Ana CA 92701 <br />AUTHORIZED REPRESENTATIVE: Fritz Helrch <br />'ASCIP Is alotnt powers authority pursuantWArticie I( commencingwit h Section 6500) Chapter 50f Division 7 of Title l 0fthe GovernMent COde and Secti0n539603 and 81603 ofthe Education Code. Rev5 -97 <br />CERT No.: 1e9493an CLIENT WI)E: ILA M1ancy Lopez 3/ 1/201A 9,.11,30 AN 2gFy 1 OE 2 <br />