GOODWILL INDUSTRIES OF O.C. - 2015 DONATION-2015

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(Q/ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIOD/`/1' X 6/22/2015 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). _ PRODUCER POms &Associates Insurance Brokers CA License #0814733 5700 Canoga Ave. #400 Woodland Hills CA 91367 INSURED Goodwill Industries of Orange County, D$A: Please 410 N. Fairview $t. CONTACT _NAME: Gizelda Parr AHONo E.t. (800)578 -8802 FAX (818)999 -9321 E-MAHL s: 9Parr @pomsassoc. com INSURER(S)AFFORDING COVERAGE NAIC # Indemn INSURER A:Philadelphia ity Ins /PHI INSURERH:Tokio Marine $cecialty/PHI 18058 _ 11216 _ INSURER C: _ INSURER O: 7/1/2015 INSURER E EACH OCCURRENCE Santa Ana CA 92703 INSURER F: PREIMSGSOEa occurrencel RCVIJIUIV NUIVItltHI: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AOOL SUER EXP LTR TYPE OF INSURANCE POLICYNUMBER MMIDWYM MMI�OYIWYV LIMITS WVQ X COMMERCIAL GENERAL LIABILITY Attn: Leticia Lopez 20 Civic Center Plaza, M -25 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 A CLAIMS -MADE OCCUR X PHPK1352966 7/1/2015 7/1/2016 EACH OCCURRENCE $ 1,000,000 PREIMSGSOEa occurrencel $ 1,000,000 MED EXP(Anyone person) $ Excluded PERSONAL &ADV INJURY_ $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER POLICY ❑ PRO- ❑ JECT LOG _GENERAL AGGREGATE $ 3,000, P00 — _ PRODUCTS - _COMP/OP AGG _. $ 3,000,000 OTHER: Employee Bement. $ 1,000,000 A AUTOMOBILE X LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON - OWNED HIRED AUTOS AUTOS r— PHPK1352966 7/1/2015 7/1/2016 COMBINED SINGLE LIMIT Es aorid.m) $ 000,000 BODILY INJURY (Per person) '— $ BODILYINJURY (Per accident) -- $ PROPERTY DAMAGE (Peraccitlent)___ _ -- $ Underinsured motorist EACH OCCURRENCE $ 1,000,000 $ 10 000 000 --- $ X UMBRELLA UAH OCCUR EXCESS LIAB CLAIMS -MADE N/A PUB503739 7/1/2015 7/1/2016 AGGREGATE $ 10,000 000 OED X RETENTIONS 10,000 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNEMEXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ PER �OTH- STATUTE ER _ E.L. EACH ACCIDENT $ - $ (f yes, d ory In and If yes, describe under E.L. DISEASE - EA EMPLOYE —.. $ DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is roquired) The City of Santa Ana, its officers, employees, agents, and representatives are named as additional insured per attached endorsement. Primary Non - contributory wording applies per attched endorsement. LLLJJJ �O (0 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) City Of Santa Ana Community Development Agency SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Leticia Lopez 20 Civic Center Plaza, M -25 AUTHORIZED REPRESENTATIVE Santa Ana, CA 92701 John Toef /1372 (0 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)