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ORANCOU -19 VMXHAVERI
<br />^1 ir[� CERTIFICATE OF LIABILITY INSURANCE
<br />DATE DIYY " "'
<br />2/7/2014
<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 />Arthur J. Gallagher & Co. Insurance Brokers of CA, Inc.
<br />505 N Brand Blvd, Suite 600
<br />Glendale, CA 91203
<br />CONTACT
<br />NAME:
<br />PHONE FAX
<br />AIC No Ext: (818) 539.2300 Am, No: (818) 539.2301
<br />E-MAIL
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC9
<br />INSURER A:Great American Insurance Company
<br />INSURER B: Non Profits United
<br />16691
<br />INSURED
<br />INSURER C:
<br />Orange County Conservation Corps
<br />INSURER o
<br />1853 N. Raymond Ave.
<br />Anaheim, CA 92801
<br />INSURER E
<br />INSURER F
<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 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 />INNER
<br />TYPE OF INSURANCE
<br />NSR
<br />ME
<br />POLICY NUMBER
<br />MMIOI�mW
<br />MMI��VVXYY
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE I OCCUR
<br />X
<br />PAC5154680 -08
<br />712012013
<br />7 12012014
<br />PREMISES Ea occurrence
<br />$ 100,000
<br />MED EXP (Anyone person)
<br />$ 5,000
<br />X Professional $1M
<br />PERSONAL B ADV INJURY
<br />$ 1,000,000
<br />X
<br />Sexual Abuse$iM
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />GENL AGGREGATE LIMIT APPLIES PER:
<br />POLICY PEO� LOP
<br />PRODUCTS - COMPIOP AGO
<br />$ 3,000,000
<br />_
<br />$
<br />B
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANYAUTO
<br />1888
<br />711/2013
<br />71112014
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />5,000,000
<br />BODILY INJURY(Per person)
<br />$
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY Per accident
<br />_ (
<br />) $
<br />X
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />PROPERTY DAMAGE
<br />PER ACCIDENT)$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />IUMB560379506
<br />8/17/2013
<br />611712014
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />DED X RED ENTION$ 10,000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANY PROFRIETORIPARTNERIEXECUTIVE
<br />OFFICERAIEMSER EXCLUDED?
<br />(Mandatory In NH)
<br />If yes, ce rth. under
<br />NIA
<br />NPU -WCG 001.2014
<br />1/1/2014
<br />1/112015
<br />WC STATU- 0TH
<br />TORY LIMITS ER
<br />-!
<br />E.L. EACH ACCIDENT
<br />_
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE$
<br />-
<br />J_
<br />1,000,000
<br />E, L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTIONOFOPERATIONSbelow
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD tot, Additional Remarks Schedule, If more space is required)
<br />!The City of Santa Ana Its officers, employees, agents, volunteers and representatives are named additional insured with respect to the operations of the
<br />(named insured. Workers Compensation coverage excluded, evidence only.
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />The City of Santa Ana
<br />20 Civic Center Plaza
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />© 1988 -2010 ACORD CORPORATION. All rights reserved. do gill
<br />IILBIT
<br />ACORD 25 (2010/05) The ACORD name an EX;KMd marks of ACORD
<br />I
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