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EVIDENCE OF COVERAGE <br />GATE9 /20IVVYV) <br />2/29/2016 <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 />JOINT POWERS AUTHORITY (JPA) <br />Alliance of Schools for Cooperative Insurance Programs <br />16550 Bloomfield Avenue <br />Cerritos, CA 90703 <br />www.ASC I P. org <br />CONTACT NAME: Mr. Fritz Heirich, Chief Executive Officer <br />PHONE: (562) 404 -$029 <br />JPA MEMBER <br />Rancho Santiago Community College District <br />2323 North Broadway <br />Santa Ana CA 92706 <br />This is to certify that the Alliance of Schools for Cooperative Insurance Programs (ASCIP) Memorandum of Coverages on insurance listed below have <br />been issued to the Covered Party named above for the period indicated. Notwithstanding any requirement, term, or condition of any contract or other <br />document with respect to which this Evidence of Coverage may be used or may pertain, the coverages afforded by the Memorandum of Coverages <br />described herein are subject to all the terms, exclusions, and conditions of such Memorandum of Coverages. <br />TYPE OF COVERAGE <br />ADDL <br />INSR <br />MEMORANDUM NUMBER (MOC) (MMIDDIYYYY) <br />POLICY EFF <br />POLICY EXP <br />12:01a , ,m <br />LIMIT OF LIABILITVI COVERAGE <br />GENERAL <br />LIABILITY <br />OCCURRENCE <br />Personal Injury <br />MOC #77 <br />7/1/2015 <br />7/1/2016 <br />COMBINED SINGLE LIMIT PER OCCURRENCE <br />$ $5,000,000 <br />AGGREGATE <br />$ N/A <br />$ <br />Errors & Omission <br />$ <br />Employment Practices <br />$ <br />AUTOMOBILE <br />LIABILITY <br />AUTOMOTIVE PHYSICAL DAMAGE <br />COMPREHENSIVE I COLLISION <br />ANYAUTO <br />COMBINED SINGLE LIMIT PER OCCURRENCE <br />$ <br />ACTUAL CASH VALUE <br />$ <br />$ <br />PROPERTY <br />BUILDING I CONTENTS <br />FIRE, THEFT, RENTAL INTERRUPTION <br />REPLACEMENT COST SUBJECT TO POLICY LIMITS, <br />AND CONDITIONS <br />TERMS, <br />$ <br />$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />WC STATUTORY LIMITS <br />NIA <br />b�'e <br />EACH ACCIDENT <br />$ <br />PER EMPLOYEE <br />$ <br />POLICY LIMIT <br />$ <br />OTHER <br />- <br />EMPLOYEE DISHONESTY (CRIME) <br />p <br />�.1\Cj <br />``11n <br />( <br />Il <br />piVI�S <br />SUBJEv TO POLICY LIMITS, TERMS, AND CONDITIONS <br />$ <br />$ <br />ADDITIONAL REMARKS: <br />As respects to Class VVIO Seeds to Trees (Spring 2016 Semester) <br />CERTIFICATE HOLDER <br />City of Santa Ana <br />Attn: PRCSA /Silva Cuevas <br />20 Civic Center Plaza, M -23 <br />Santa Ana CA 92701 <br />CANCELLATION <br />Should any of the above coverages forthe Covered Party be changed orwithdrawn prior <br />to the expiration date issued above, ASCIP will mail 30 days written notice to the <br />Certificate Holder, butfailure to mall such notice shall Impose no obligation or liability of <br />any kind upon ASCIP, its agents, or representatives. <br />AUTHORIZED REPRESENTATIVE: Fritz Heirich <br />"ASCIP is a)oint powers authority pursuantto Article I( commencingwit h Section 6500) Chapters of Division 7of Ttle l ofthe Government Code and Sections 39603 and 81603ofthe Education Code. Rev 5 -97 <br />26794979 1 77 1 15/16 All Types An I Nancy Lopez 1 2/29/2016 3:07:37 PM (PST( I Page 1 of 2 <br />