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Statewide Association of Community College <br />OF COVERAGE <br />Issue <br />Issue Date <br />Protected Insurance Program for Schools <br />7/912015 <br />ADMINISTRATOR: LICENSE # 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 Calle Amanecer, #200 <br />CERTIFICATE DOES NOTAMEND, 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 />ENnrYA 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 CERTIFY THAT THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE COVERED PARTY NAMED ABOVE FOR THE PERIOD INDICATED. NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE COVERAGE <br />AFFORDED HEREIN IS SUBJECT TO ALL THE TERMS AND CONDITIONS OF SUCH COVERAGE DOCUMENTS. <br />MEMBER <br />ENT <br />COVERAGE <br />EFFECTIVE/ <br />RETAINED LIMIT <br />LTR <br />TYPE OF COVERAGE <br />DOCUMENTS <br />EXPIRATION DATE <br />/DEDUCTIBLE <br />LIMITS <br />A <br />GENERAL LIABILITY <br />COMBINED SINGLE LIMIT EACH OCCURRENCE <br />[ yI GENERAL LIABILITY// <br />CLAIMS MADE <br />SWC 00107-29 <br />7/1/2015 <br />$ 50,000 <br />$ 1,000,000 <br />[ (YIOCCURRENCE <br />[ GOVERNMENT CODES <br />711/2016 <br />[ ERRORS & OMISSIONS <br />[1 <br />A <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT EACH OCCURRENCE <br />t �AINVAUTO <br />SWC 00107 -29 <br />7/1/2015 <br />$ 50,000 <br />s 1,000,000 <br />[ IREDANIE <br />7/1/2016 <br />[ NON -OWNE D AUTO <br />[ LIABILITY <br />21GARAGE <br />[ AUTO PHYSICAL DAMAGE <br />A <br />PR((((((OPERTY <br />SWC 00107 -29 <br />711/2015 <br />$ 5,000 <br />s 250,250,000 <br />[v ALL RISK <br />711/2016 <br />EACH OCCURRENCE <br />[ EXCLUDES EARTHQUAKE & FLOOD <br />I BUILDER'S RISK <br />A <br />STUDENT PROFESSIONAL LIABILITY <br />SWC 00107 -29 <br />7/1/2015 <br />$ 5,000 <br />s Included <br />7/1/2016 <br />EACH OCCURRENCE <br />B <br />WORKERS COMPENSATION <br />[ I WC STATUTORY LIMITS [y�OTHER <br />[Y EMPLOYERS'LIABILITY <br />PIPS11712 <br />7/1/2015 <br />$ <br />7/1/2016 <br />$ 1,000,000 <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />EXCESS WORKERS COMPENSATION <br />$ <br />[ I EMPLOYERS'UABIUW <br />E.L. DISEASE - EACH EMPLOYEE <br />S 1,000,000 <br />E.L. DISEASE - POLICY LIMITS <br />OTHER <br />$ <br />$ <br />C <br />DESCRIPTION OF OPERATIONS)LOCATIONSNEHICLESIRESTRICT IONSISPECIAL PROVISIONS: <br />As respects to the agreement between between SAWIB and South Orange County CCD (Saddleback College). <br />CERTIFICATE HOLDER: <br />CANCELLATION ...... SHOULD ANY OF THE ABOVE DESCRIBED COVERAGES BE <br />CANCELED SEE THE EXPIRATION DATE THEREOF, THE ISSUING ENTITY /JPA <br />-- City-of-Santa Ana - - - -- -- <br />- y - - - -- -_- <br />WILL L 9IR MAIL 30 DAYS WRITTE ICE 0 T E CERTIFICATE <br />HOLDER NAMED TO �iE�L��E�F�r '������a�k�����Yf%._._.. <br />R <br />Community Development Agency M -25 <br />W009D Fg4Y1YJ41�4%%wtiA�Ni�m N41 <br />P.O. Box 1988 <br />�ffiC64#PGd€2S. <br />Santa Ana CA 92702 <br />John Stephens AUTHORIZED REPRESENTATIVE <br />r� Iw <br />255]2029 R S. OPROPA HORA 1 15 /16 Super Pool P &L I OE¢NIM BARKER 1 7/9/2015 4:20:12 PM (EDT) Page 1 of 3 <br />