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271069
<br />AC CERTIFICATE OF'LIABILITY INSURANCE DATE IMMYDDIYYYY)
<br />416/2016
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOII THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />—TM—PORTANT: If the certificate —holder —is--,a-n—ADDITIONAL. -,-I"N--S ... U-R--ED,, the p`oI—icy-(i—es-)-m,-u,-st be —endorse—d.-R --- S-UB-R-0--G'A-T'-10—N IS W—AW-E" —0, -suh—ject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this, certificate does not confer rights to the
<br />certificate holder in lieu o,f such endorsements},
<br />PRODUCERcT
<br />NAME; Catherine Cory
<br />Commercial Lines - (818) 464-9300 PHONE 818-464-9458 FAX 861 -5687
<br />(AX, No, Ext): (A/C, I
<br />Wells Fargo Insurance Services USA, Inc. - CA Llc#: OD08408 E-MAIL
<br />ADDRE,ss: catherine.cory@wellsfargo.coi-n
<br />15303 Ventura Boulevard, 7th Floor INSURER(S),AFFORDING COVERAGE NAiC ft
<br />Shernian Oaks, CA 91403-3197
<br />INSURER A: Philadelphia Indemnity Insurance Company 18058
<br />INSURED t
<br />INSURER B Employers Assurance Company 1 25402
<br />Discovery Science Center of Orange County
<br />INSURER C
<br />dba Discovery Cube Orange County INSURER 0:
<br />2500 N. Main Street INSURER E
<br />Santa Ana, CA 92705
<br />INSURER
<br />SURER I
<br />COVERAGES CERTIFICATE NUMBER. 10353981 REVISION NUMBER: See below
<br />'THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALI. -THE TERMS
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />:Abi POLICY 1 061 EXP
<br />LTR TYPE OF INSURANCE POLICY NUM13ER (MM_jUQ1L1�Ka _(EM2p1= LIMITS
<br />X 'COMMERCIALGIENERALLIABILITY
<br />A X PHPK1432448 12/15/2015 1211512016 EACH OCCURRENCE 3 100 ,0,000
<br />DAMAGE TO RENTED.. - - --
<br />CLAIMS -MADE X OCCUR PREMISES . e)
<br />S 1,000�000
<br />acqu.r.
<br />I I IAny one Iren
<br />1 20,000
<br />PERSONAL & ADV INJURY 1,000,,000
<br />GEI AGGRIEGATE I IMIT APPLIFS PFR :1 AG G 2,000,000
<br />GENERAL RECIATE
<br />X PRODUCTS-CqMJEC7 AGG $ 2 000,000
<br />OTHER, Sexual AbusWyojeswion $ Induced
<br />COMBINED SINGLE MIT
<br />A AUTOMOBILE LIABILITY PHPK1432448 12115/2015 12/15/2016L_CLIMIT 1,000,000
<br />X ii ANY BODILY INJURY iPer person) $
<br />ALL OWNE I l SCHEDULED
<br />I AUTOS f I AUTOS BODILY INJURY (Per accideni $
<br />NON -OWNED P . I . 0 - P .. E . R . I .'. Y - D - AMAGE
<br />X HIRED AU LOS x
<br />AUTOS (Peraccident)
<br />A I x UMBRELLA I X OCCUR PHUB524655 12/15/2015 12/15/2016 EACH OCCURRENCE S 10,000,000
<br />EXCESS LIAB i
<br />I C�AIMS-MADE
<br />AqGREGATE S 10,000,000
<br />...... . .....
<br />OLD I I RETENTONs
<br />$
<br />WORKERS COMPENSATION ER o ri-i-
<br />B AND EMPLOYERWLIARILITY EIG1453813-04 04/01/16 X FSPITFAR-TRITE ER,
<br />Y�N�
<br />ANY PROPRIETOPIPARTI 1,000,000 D" E 1. EA(711 AC 'IDENT $
<br />'c"en"
<br />�52 1,512016 �IAI,711, Ol-,00i
<br />0FHCERJMi EXCLUDE N
<br />(Mandatory in I I DISEASE, EA EMPLOYEE S 1,000,000
<br />0 as, describe under
<br />CRTIPTION OFPERATIONS below 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional I Schedute, may be attached if more space is require �,CwedAL
<br />The City of Santa Ana, Parks, Recreation and Community Services Agency is included as Additional Insured for General Liabli asequired by writJ590
<br />contract.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana, its officers, agents, and employees SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />Parks, Recreation and Community Services Agency ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE
<br />The ACORD name and logo are registered marks of ACORD @ 1988-2'014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014/01)
<br />
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