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EVIDENCE OF COVERAGE <br />DATE6 IYYYY) <br />4/16/20 /2015 <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: 77 <br />��^- .��.__...__m� <br />JOINT POWERS AUTHORITY (JPA)- <br />Alliance of Schools for Cooperative Insurance Programs <br />16560 Bloomfield Avenue <br />Cerritos, CA 90703 <br />JPA MEMBER— .� -.��_� <br />Rancho Santiago Community College District <br />2323 North Broadway <br />Santa Ana CA 92706 <br />www.ASCIP.org <br />CONTACT NAME! Mr. Fritz Helflch, Chief Executive Officer <br />PHONE: (662) 404-8029 <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 />__ <br />INNR <br />MEMORANDUM NUMBER (MCC) (MMIDDIYYYY) <br />POLICYEFF <br />POL014.m. <br />1Y:Ofa.m. <br />LIMIT OF LIABILITY) COVERAGE <br />GENERALLIABILITY <br />COMBINED SINGLE LIMIT PER OCCURRENCE <br />a $5,000,000 <br />OCCURRENCE <br />./ <br />MOO #77 <br />711/2014 <br />7/1/2015 <br />AGGREGATE <br />a NIA <br />Personal Inlury <br />a <br />Errors &Omission <br />a <br />Employment Practices <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT PER OCCURRENCE <br />a $5,000,000 <br />AUTOMOTIVE PHYSICAL DAMAGE <br />MCC #77 <br />711)2014 <br />7/1/2075 <br />ACTUAL CASH VALUEW <br />S <br />COMPREHENSIVE I COLLISION <br />ANY AUTO <br />Awned Auto <br />a <br />a <br />a <br />Auto <br />_Hired <br />PROPERTY <br />6UILUNG 7 CONTENTS <br />fl D�CNDIION805'f SUSJECi TO POLICY LIMITS, <br />TEflMS, <br />I; <br />FIRE, THEFT. RENTAL INTERRUPTION <br />$ <br />Is <br />AND WORKERS <br />AND EMPLOYERS' LIABILITY <br />MPLOYE S'LIAILIT <br />NIA <br />EACHACCIDENT <br />a $1,000,000 <br />PER EMPLOYED �,.a <br />$1,000,000 <br />© WC STATUTORY LIMITS <br />MCC #77 71112014 <br />711/2015 <br />POLICV LIMIT <br />a $1,000,000 <br />.A <br />OTHER <br />EMPLOYEE DISHONESTY (CRIME) <br />Q1 <br />SUEJECT TO POLICY LIMITS, TERMS, AND 0ONOITIONS <br />7AreeiLWIA <br />$ <br />ADDITIONAL REMARRS: `\��� As respects to Local Workforce Investme <br />4� <br />CERTIFICATE HOLDER <br />CANCELLATION <br />City of Santa Ana <br />Attn: Silvia Cuevas <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 />Certificate Holder, but (allure to mall such notice shall impose no obligation or liability of <br />any kind upon ASCIP, Its agents, or representatives. <br />20 Civic Center Plaza <br />Santa Ana CA 92701 <br />AUTHORIZED REPRESENTATIVE: Fritz Helrlch <br />'ASCIP Is a joint powers outhonly pursuant to Article I(comm811dng With SMUOn 6300)Chepter5 of01VIHon 7 oftitle l of the eovernment Codeand Sectlons 36603 and 81603 of the Education code. Rev5-97 <br />CER'P NO.'. 24296597 CL1RUT CODE, TI Nancy Loaea 4/16/2015 2151 :04 eM (POT) e,. 1 pf 2 <br />