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EVIDENCE OF COVERAGE <br />D12/19/2017Y) <br />12/19/2017 <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 the coverage afforded by the memoranda listed below. <br />MEMORANDUM NUMBER: 77 <br />JOINT POWERS AUTHORITY (JPA) <br />Alliance of Schools for Cooperative Insurance Programs <br />16550 Bloomfield Avenue <br />Cerritos, CA 90703 <br />www.ASCIP.org <br />CONTACTNAME: Mr. Fritz J. Heirich, Chief Executive Officer <br />PHONE: (562) 404-8029 <br />JPA MEMBER <br />Rancho Santiago Community College District <br />2323 North Broadwayy <br />Santa Ana CA 92706 <br />%J -020 f7 'a �D(Q <br />This is to certify that the Alliance of Schools for Cooperative Insurance Programs (ASCIP) Memorandum of Coverages on insurance listed 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 <br />ADDL <br />INSR <br />MEMORANDUM NUMBER (MOC) (MMIDDIYYYY) <br />POLICY EFF <br />POLICY EXP <br />12:01a.m. <br />LIMIT OF LIABILITY/COVERAGE <br />GENERALLIABILITY <br />OCCURRENCE <br />Personal Injury <br />V <br />MOC #77 <br />7/1/2017 <br />7/1/2018 <br />COMBINED SINGLE LIMIT PER OCCURRENCE <br />$ $5.000,000 <br />AGGREGATE <br />$ N/A <br />$ <br />Errors & Omission <br />$ <br />Employment Practices <br />$ <br />AUTOMOBILE <br />LIABILITY <br />AUTOMOTIVE PHYSICAL DAMAGE <br />COMPREHENSIVE / COLLISION <br />ANYAUTO <br />COMBINED SINGLE LIMIT PER OCCURRENCE <br />$ <br />ACTUAL CASH VALUE <br />$ <br />$ <br />PROPERTY <br />BUILDING / CONTENTS <br />FIRE, THEFT, RENTAL INTERRUPTION <br />REPLACEMENT COST SUBJECT TO POLICY LIMITS, <br />AND CONDITIONS <br />TERMS, <br />$ <br />$ <br />WORKERSCOMPENSATION <br />AND EMPLOYERS' LIABILITY <br />WC STATUTORY LIMITS <br />NIA <br />EACH ACCIDENT <br />$ <br />PER EMPLOYEE <br />$ <br />POLICY LIMIT <br />$ <br />OTHER <br />EMPLOYEE DISHONESTY (CRIME) <br />SUBJECT TO POLICY LIMITS, TERMS, AND CONDITIONS <br />$ <br />S <br />ADDITIONAL REMARKS: y <br />As respects to Seeds of Trees 2/5/18 - 6/1118 <br />e �a5 <br />e •c <br />CERTIFICATE HOLDER <br />City of Santa Ana <br />Attn: Ed Rayya <br />PO Box 1988 <br />Santa Ana CA 92702 <br />CANCELLATION r)f.IN <br />Should any of the above coverages for Wgiw3 a changed or withdrawn prior <br />to the expiration date issued ab A 30 days written notice to the <br />Certificate Holder, but failure t ail such all impose no obligation or liability of <br />any kind upon ASCIP, its agents, or represen dives. <br />V v <br />AUTHORIZED REPRESENTATIVE: Fritz J. Helrlch <br />*ASCIP is ajoint powers authority pursuant to Article 1(commencing with Section 6500)Chapter 5 of Division 7 of Title l ofthe Government Code and Sections 39603 and 81603 ofthe EducationCode. Rev 5-97 <br />39333269 1 77 117/18 A11 Types WC I Nancy Lopez 112/19/2017 9:28:42 AN (PST) I Page 1 of 2 <br />