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EVIDENCE /'�� f /tl /""w DATE {MMtDD1YYYY) <br />�f COVERAGE 4118/2011 <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 th,e coverage afforded by the memoranda listed below. <br />MEMORANDUM NUMBER: 77 <br />JOINT POWERS AUTHORITY tJPA) JPA MEMBER <br />Alliance of Schools for Cooperative Insurance Programs Rancho Santiago Community College District <br />16550 Bloomfield Avenue 2323 North Broadway <br />Cerritos, CA 90703 Santa Ana CA 92706 <br />www.ASCIP.org $' w p'p 0 <br />CONTACT NAME: Mr. Fritz Heirich„ Chief Executive Officer AM <br />PHONE: (562) 404 -8029 <br />This is to certify that the Alliance of Schools for Cooperative Insurance Programs (ASOP) Memorandum of Coverages on insurance fisted 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 ADD[ MEMORANDUM NUMBER (MCC) POLICY EFF POLICY EXP LIMIT OF LIABILITY I COVERAGE <br />INSR (MMIDDIYYYY) 12:41a.m. <br />_—__......__..._._._ ........._._. _ ................Y... ...... _.... ,.....�..._._.__ <br />GENERAL LIABILITY COMBINED SINGLE LIMIT PER OCCURRENCE $ $5,001),000 <br />OCCURRENCE ✓ MOC #77 711/2015 71112016 AGGREGATE s N/A <br />.y ...Personal Injury $ <br />..Errors & Omission $ <br />Employment Practices <br />AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT PER OCCURRENCE $ <br />......._.mm_... .._...... <br />AUTOMOTIVE. PHYSICAL DAMAGE ACTUAL CASH VALUE .........�...� $ <br />COMPREHENSIVE I COLLISION $ <br />ANYAUTO _. _.. <br />PROPERTY . __....._.,__._�...._._ REPLACEMENT COST SUBJECT TO POLICY LIMITS. TERMS.. <br />AND CONDITIONS <br />BUILDING /CONTENTS S <br />FIRE, THEFT, RENTAL. INTERRUPTION $ <br />$ <br />WORKERS COMPENSATION NIA '.. EACH ACCIDENT $ $1,000,000 <br />AND EMPLOYERS' LIABI.......CITY _... <br />WC STATUTORY LIMITS MOC #77 7/1/2015 7/1/2016 PER EMPLOYEE $ $1,000,000 <br />POLICY LIMIT $ $1,000,000 <br />OTHER SUBJECT TO POLICY LIMITS, TERMS, AND CONDITIONS <br />EMPLOYEE DISHONESTY (CRIME) _......m ..................... S <br />loy $ <br />ADDITIONAL REMARKS <br />As respects to Class WIO Seeds to Trees (Spring 2015 Semester) y�y <br />(Includes Professional Liability and Defense of Child Care /Sexual Abuse Claims) <br />_....... .... .............. <br />CERTIFICATE HOLDER CANCELLATION <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 failure to mail such notice shalt/ impose no obligation or liability of <br />City of Santa Ana any kind upon ASCIP, its agents, or representainves. <br />Attn: PRCSA /Silva Cuevas __.m.._... _._ <br />20 Civic Center Plaza, M -23 <br />Santa Ana CA 92701 <br />AUTHORIZED REPRESENTATIVE: Fritz Heirlch <br />...._..._ ...... .......� ..,�_..._..,_......_.w __..... ......._ .._.,.m._.._._. . _ ...... ._..._. .... ..._ .__..Y._.. <br />*ASCIP is a joint powers authority pursuant to Article 1(commencing with Section 6500) Chapter 5 of Division 7 of Title 1 cf the Government Code and Sections 39503 and 81603 of the Education Code. Rev S-97 <br />29497495 177 1 1.5/16 All Types WC I Nancy Lopez 1 4/18/2016 1.1:06:46 AM (PnT) I Page, t of 2 <br />