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Statewlde Association of Community Collage L.,ERTIFICATE OF COVERAGE <br />Issue Dete <br />Protected Insurance Program for Schools <br />7/9!2015 <br />ADMINISTRATOR: LICENSE# 0451271 <br />THIS CERTIFICATE IS ISSUED ASA 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 NOT AMEND, EXTEND OR ALTER THE COVERAGE <br />San Clemente, CA 92673 <br />AFFORDED BY THE COVERAGE DOCUMENTS BELOW, <br />ENTITIES AFFORDING COVERAGE: <br />949.940.1780 <br />www.keenan.com <br />ENTITY A: 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 />Mission Viejo CA 92692 <br />ENTITY C: <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, NOTWITHSTANDINGANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPEOTTO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THECOVERAGE <br />AFFORDED HEREIN IS SUBJECT TO ALL THE TERMS AND CONDITIONS OF SUCH COVERAGE DOCUMENTS, <br />MEMBER <br />ENT <br />TYPE OF COVERAGE <br />COVERAGE <br />EFFECTIVE/ <br />RETAINED LIMIT <br />LIMITS <br />LTR <br />DOCUMENTS <br />EXPIRATION DATE <br />/DEDUCTIBLE <br />A <br />GENERAL LIABILITY <br />COMBINED SINGLE LIMIT EACH OCCURRENCE <br />[ YI GENERAL LIABILITY(( <br />MADE <br />SWC 00107.29 <br />7/1/2015 <br />$ 5D,000 <br />$ 1,000,000 <br />I {CLAIMS (V) OCCURRENCE <br />[ �/I.GOVERNMENT CODES <br />711/2016 <br />I SII ERRORS a OMISSIONS <br />II <br />A <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT EACH OCCURRENCE <br />[t <br />SWC 00107-29 <br />7/1/2015 <br />$ 50,000 <br />$ 1,000,000 <br />NANON-OWNED <br />N- WNEDAUTp <br />7/1/2016 <br />[ `GARAGE LIABIUTY <br />[ �I AUTO PHYSICAL DAMAGE <br />A <br />PROPERTY <br />SWC 00107-29 <br />7/1/2015 <br />$ 5,000 <br />s 250,250,000 <br />[ y 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 />{ IWC STATUTORY LIMITS {OTHER <br />[ EMPLOYERS' LIABILITY <br />PIPS11712 <br />7/1/2015 <br />$ <br />7/1/2016 <br />s 1,000,000 <br />E.L EACH ACCIDENT <br />$ 1,000,000 <br />EXCESS WORKERS COMPENSATION$ <br />[ I EMPLOYERS' LIABILITY <br />E.L. DISEASE - EACH EMPLOYEE <br />S 1,000,000 <br />E.L. DISEASE - POLICY LIMITS <br />OTHER <br />S <br />DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIRE9TRIC710N915p ECIAL PROVISIONS: <br />As respects to the agreement between between SAWIB and South Orange County CCD (Saddleback College). JL-',� <br />CERTIFICATE HOLDER: <br />CANCELLATION ...... SHOULD ANY OF THE ABOVE DESCRIDGD COVERAGES BE <br />CAN% -L- E THE EXPIRATION DATE THEREOF, THE ISSUING ENTITY/JPA <br />---Clty-Of-Santa Ana ---- <br />Community Development Agency M-25 <br />WILL <br />HOLDE ppTTMAIL_��r``DY�SW ITNTE. OT TE <br />_..... <br />XwY�i���YX14�ia �F 1t 11 <br />P.O. Box 1988 <br />X2fiK�19ffiC61sNk�PGk1. <br />Santa Ana CA 92702 <br />John Stephens AUTHORIZED REPRESENTATIVE <br />-�,.Lcron�a„ 1.— <br />25532029 1 Sculic." 115116 BUN.[ P-1 P&L I uv.xgn BhRNCR I 1/9/3015 P:20:12 PH (Poll I P., 1 of 3 <br />