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Statewide Association of Community College �ERTIFICATE OF COVERAGE <br />Issue Date <br />Protected Insurance Program for Schools <br />7/9/2015 <br />ADMINISTRATOR: LICENSE It 0451271 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY <br />Keenan & Associates <br />AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />901 Calls Amanecer, #200 <br />CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE <br />San Clemente, CA 92673 <br />AFFORDED BY THE COVERAGE DOCUMENTS BELOW, <br />ENTITIES AFFORDING COVERAGE: <br />949- 940 -1760 <br />www,keenan.com <br />ENTITYA. Statewide Association of Community Colleges <br />ENTITY B: Protected Insurance Program for Schools <br />COVERED PARTY: <br />South Orange County Community College Dist <br />28000 Marguerite Parkway <br />ENTITY C: <br />Mission Viejo CA 92692 <br />ENTITY D: <br />ENTITY E', <br />THIS IS TO CERTTIFYTHAT THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED PARTY NAMEDABOVE FOR THE PERIOD INDICATED, NOTWITHSTANDINGANY <br />REQUIREMENT,hERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE COVERAGE <br />AFFOR DED HERPIN IS SUBJECT TO ALL THE TERMS AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. <br />MEMBER <br />ENT <br />LTR <br />TYPE OF COVERAGE <br />COVERAGE <br />DOCUMENTS <br />EFFECTIVEI <br />EXPIRATION DATE <br />RETAINED LIMIT <br />I DEDUCTIBLE <br />LIMITS <br />A <br />GENERAL LIABILITY <br />COMBINED SINGLE LIMIT EACH OCCURRENCE <br />14GENERALLIABILITY <br />CLAIMS MADE (4 OCCURRENCE <br />SW000107 -29 <br />7/1/215 <br />$ 50,000 <br />$ 1,000,000 <br />I <br />I GOVERNMENT CODES <br />7/1/2016 <br />I ERRORS &OMISSIONS <br />II <br />A <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT EACH OCCURRENCE <br />ANY AUTO <br />SWC 60107 -29 <br />711/2015 <br />$ 50,000 <br />s 1,000,000 <br />I HIRED AUTO <br />7/1 /2016 <br />I NON- OWNEDAUTO <br />I GARAGE LIABILITY <br />I AUTO PHYSICAL DAMAGE <br />A <br />PR[[[[[[OPERTY <br />SWC00107 -29 <br />7/1/2015 <br />s 5,000 <br />s 250,250,000 <br />t ALL RISK <br />7/1/2016 <br />EACH OCCURRENCE <br />t EXCLUDES EARTHQUAKE & FLOOD <br />I BUILOER'S RISK <br />A <br />STUDENT PROFESSIONAL LIABILITY <br />SWC00107 -29 <br />7/1/2015 <br />$ 5,000 <br />s Included <br />7/1/2016 <br />EACH OCCURRENCE <br />B <br />WORKERS COMPENSATION <br />t I WC STATUTORY LIMITS I✓I OTHER <br />11/j EMPLOYERS' LIABILITY <br />PIPS11712 <br />7/1/2015 <br />$ <br />7/1/2016 <br />e 1,000,000 <br />E.1— EACH ACCIDENT <br />$ 1,000,000 <br />EXCESS WORKERS COMPENSATION <br />$ <br />I I EMPLOYERS'LIANLITY <br />E.L. DISEASE. EACH EMPLOYEE <br />S 1,000,000 <br />E.L. DISEASE - POLICY LIMITS <br />OTHER <br />S <br />5 <br />DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIRESTRICTIONSISPECIAL WOVISIONS: <br />As respects to the agreement between between SAWIB and South Orange County CCD (Irvine Valley College).9- tpc_r— �''-�� r qq). q <br />J <br />I <br />1I.A1 <br />f. <br />CERTIFICATE HOLDER: <br />CANCELLATION ...... SHOULD ANY OF THE ABOVE DESCRIBED COVERAGES BE <br />CANCELED a O THE EXPIRATION DATE THEREOF, THE ISSUING ENTI7YIJPA <br />Cityof,SantaAna <br />WILL L� MAIL 30 DAV W IT E E I CATE <br />D AM 0T0 HG � ���`Y�� � <br />20 Civic Center Plaza�25�24iYb <br />w Y <br />Santa Ana CA 92702 <br />atsxwxaxiwxxxxxx: <br />John Stephens AUT14DRIZED REPRESENTATIVE <br />]551203e .SOIITxOeA t5 /16 Supe[ Pool PsL I DGCANl1 app RCR 1 1/9/2015 A:]eaP P11 (PDT) I Pu9e 1 of 6 <br />