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211068
<br />.acco�Ra� CERTIFICATE OF LIABILITY INSURANCE
<br />DA2/24/20 5w)
<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 Had 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 Floor
<br />Sherman Oaks, CA 91403-3197
<br />NFMEAC Catherine Cary
<br />PHONE FAX
<br />. 8-464-9458
<br />81 IAIC. 866-968-5687
<br />Nol:
<br />_
<br />E-DMAIES : - Catherine.Cory@wellsfargo.com
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURER A: Philadelphia Indemnity Insurance Company 18058
<br />INSURED
<br />Discovery Science Center of Orange County
<br />2500 North Main Street
<br />INSURER B : Employers Compensation Ins Cc 11512
<br />INSURER C
<br />--'
<br />INSURER D: _
<br />Santa Ana, CA 92705
<br />---
<br />INSURER E:
<br />INSURER F:
<br />RE TED 1,000,000
<br />PREMISES (En occ rre e $
<br />COVERAGES CERTIFICATE NUMBER: 8//5899 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 />ILTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />im
<br />SUER
<br />21a
<br />POLICY NUMBER
<br />POLICY EFF
<br />POLICY EXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE � OCCUR
<br />X
<br />PHPK1269512
<br />12/15/2014
<br />12115/2015
<br />EACH OCCURRENCE $ 1,000,000
<br />RE TED 1,000,000
<br />PREMISES (En occ rre e $
<br />MED EXP Any oneperson) $ 20,000
<br />PERSONAL&ADVINJURY $ 1,000,000
<br />GEN'LAGGREGATE
<br />NX POLICY
<br />LIMITAPPLIES PER:
<br />❑ PRI
<br />[:]LOC
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS - COMPIOP AGG $ 2,000,000
<br />--____—_—____
<br />OTHER:
<br />_____.__.__._..__..._._-..___..._._..___—._._—..-.._..
<br />_
<br />Sexual AbuaelMoleelallon Included
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />PHPK1269512
<br />12/15/2014
<br />12/15/2015
<br />COMBINED tSINGLE D T $ 1,000,000
<br />BODILY INJURY (Per person) $
<br />x
<br />ANY AUTO
<br />ALL OS SCHEDULED
<br />AUTOS
<br />BODILY INJURY Per accident $
<br />( )
<br />X
<br />NONOWNAUTOS
<br />HIRED AUTOS x AUTOS ED
<br />ROW.rPERTY DAMAGE $
<br />A
<br />x
<br />UMBRELLA LIAB
<br />rl
<br />OCCUR
<br />PHUB483491
<br />12/15/2014
<br />12/15/2015
<br />EACH OCCURRENCE $ 10,000,000
<br />AGGREGATE $ M000,000
<br />EXCESS LIAR
<br />CLAIMS -MADE
<br />DED I I RETENTION$
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE YIN1,000,000
<br />OFFICERIMEMBER EXCLUDED? �N
<br />NIA
<br />EIG1453813-02
<br />04/01/14
<br />04/01/15
<br />X STRTUTE1. �R
<br />E.L. EACH ACCIDENT $
<br />E.L, DISEASE - EA EMPLOYE $ 1,000,000
<br />(Mandatary in NH)
<br />1f yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more apace 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 BY: EUNICE HEREDIA (PG. 1 of 2)
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Public Works Agency, M-21
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />P O Box 1988
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702
<br />Q7,,dr , l
<br />The ACORD name and logo are registered marks of ACORD
<br />ACORD 25 (2014/01)
<br />(Tms uelacno nnpbe n comAce,eoonsoen ssuea on IoP2015)
<br />@ 1988.2014 ACORD CORPORATION. All rights reserved.
<br />
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