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271069
<br />7DATE (MMIDD11YYYY) 31 0
<br />CERTIFICATE OF LIABILITY INSURANCE 3/2412017yyy'
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 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 />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollicy(jes) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights, to the certificate holder, in lieu of such endarsement(s).
<br />PRODUCER CONTACT
<br />NAME� Ronald Rodriguez
<br />Corrinnercial Lines - 213-253-6700 11.11 -11. - .... . ............ .. ... . . .... . ... . .......... . ... . ........
<br />PHONE 818-447-2014 FAX
<br />(A/C, No, Ext)� ... . . ........ . . ..... . . . ............ ........ .... (A/C, Nei: 866-968-5687
<br />Wells Fargo Insurance Services, Inc. - CA Lic#: OD08408 E-MAIL
<br />ADDRESS: ron.rodriguez@wellsfargo.corn
<br />333 S. Grand ..... . ......... ... .. .. ... . ...... . ....
<br />INSURER(S) AFFORDING
<br />COVERAGE
<br />COVIERIAG11E . ..... .............................- . NAIL
<br />Los Angeles, CA 90071 INSURERAPhiladelphiIndemnity Insurance Company 18058
<br />INSURED . :
<br />INSURER B. Travelers Property Casualty Co of America 25674
<br />Discovery Science Center of Orange County
<br />INSURER C
<br />dba Discovery Cube Orange County . .... . . . ........ . .. . .
<br />,INSURER D: .. . ..... . .....
<br />2500 N. Main Street INSURE RE
<br />Santa Ana, CA 92705
<br />INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: 11590574
<br />REVISION NUMBER., See below
<br />THIS IS TO CERTIFY FHAT 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
<br />OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED
<br />BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE
<br />BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR TYPE OF INSURANCE INIO WVn POLICY NUMBER
<br />P6_L1_1ffY_BPF POLICY EXP . . .. . ....
<br />fMMIDD1YYYYJ (MMtDOIYYYY) LIMITS
<br />A
<br />X
<br />.- COMMERCIAL GENERAL LIABILITY
<br />x
<br />PHPK1590101
<br />12115/2016
<br />7/112018
<br />EACH OCCURRENCE
<br />S''
<br />x
<br />CLAMS -MADE OCCUR
<br />PREMISES (Eaoccurrenue)._
<br />S 1,000,000
<br />MED EXP (Any one pprscn)
<br />- , I'll __
<br />I S . ............... . ... . .... 5,000
<br />PERSONAL & ADV INJURY
<br />i S 1,000,000
<br />GEN'[
<br />AGGRIEGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />2,000,000
<br />x
<br />PRO,
<br />� POLICY JE.CJ LOC
<br />PRODUCTS - COMPtOP AG G
<br />S 2,000,000
<br />I
<br />OIHFR:
<br />Sexual AlbuselMoleslation
<br />Included
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />PHPK1590101
<br />12/1512016
<br />7/112018
<br />COMB INF. D SINGLE LIMI I
<br />JE'�Lguci 11
<br />1,000,000
<br />X
<br />ANY AUTO
<br />� __991
<br />BODILY INJURY (Per porsor)
<br />OWNED 'CHEDULED
<br />AUTOS ONLY AUTOS
<br />.... .. . ... ... .
<br />BODILY INJURY SPerarcidenl)
<br />S
<br />x
<br />HIRED NON -OWNED
<br />rytA0
<br />AUTOS ONLY AUTOS ONLY
<br />(Per acciderl)
<br />A
<br />-,.X---
<br />UMBRELLALIAB X OCCUR
<br />PHUB567098
<br />12115/2016
<br />7/1/2018
<br />EACH OCCURRENCE
<br />S 11 000,000
<br />EXCESS LIAR CLAIMS -MADE
<br />AGGREGATE
<br />11,000000
<br />UFO RETENTIONS
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />PJUB3J26338517
<br />04101/17
<br />04/01/18
<br />iPER OTH"
<br />__.�jaT , TE ER
<br />mm.m
<br />Ymm
<br />ANYPROPRIETOR/PARTNERi'EXECOTIVE
<br />'N
<br />L EACH ACCIDENT $ 1,000,000
<br />OFFICERIMEMBER EXCLUDED? [:N:
<br />I A
<br />E.L. DISEASE - EA EMPLOYEE 3 1,000,000
<br />(Mandatory in NH)
<br />If yes, describc, ondor
<br />-
<br />E.L. DISEASE - POLICY LIMIT 3 1,000,000
<br />DESCRIPTION OF OPERATIONS below
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required),
<br />The City of Santa Ana, Parks, Recreation and Cornrnunity Services Agency is included
<br />as Additional Insured for Genera I Liabl ity as f y written
<br />contract.
<br />X�
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />City of Santa Aria, its officers, agents, and employees
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL -LED BEFORE
<br />Parks, Recreation and Community Services Agency
<br />THE EXPIRATION DATE THEREOF, NIOTIICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />Santa Ana CA 92701
<br />AUTHORIZED REPRESENTATIVE
<br />The ACORD name and logo are registered marks of ACORD @ 1988-2015 ACCIRD CORPORATION, All rights reserved,
<br />ACORD 25 (2016103) I11111110 I11111111 I I110
<br />II1111111111111111 11��l Ike1111
<br />
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