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271069
<br />.4C�/2 y 0
<br />AC"RV CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMIDD/YYYY)
<br />7/3/2018
<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 policy(ies) 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 endorsement(s).
<br />PRODUCER
<br />Commercial Lines - 213-253-6700
<br />USI Insurance Services National, Inc. - CA Lic#: OD08408E-MAIL
<br />777 South Fig ueora St, Ste 2100
<br />CONTACT NAME: NOrah.JaCObO
<br />PHONE FAX
<br />A/C No Ext : A/C No):
<br />ADDRESS: Norah.Jacobo@usi.com
<br />INSURER(S)AFFORDING COVERAGE
<br />NAIC#
<br />Los Angeles, CA 90017
<br />INSURERA; Philadelphia Indemnity Insurance Company
<br />18058
<br />INSURED
<br />Discovery Science Center of Orange County
<br />INSURERS: Travelers Property Casualty Cc of America
<br />25674
<br />INSURER C :
<br />2500 North Main Street
<br />INSURER 0:
<br />INSURER E
<br />........................_....................................._........._..........................................................._,...................................................-......-..........
<br />Santa Ana, CA 92705
<br />.._
<br />INSURER F :
<br />.......,..
<br />COVERAGES
<br />CERTIFICATE NUMBER: 13274250
<br />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 ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />- --. _._....................._.....__..._.....__......_......_....._...__....... .. _......................_.,.. _..._........._....--,................_..._...__.....__.....,........._..__....._.
<br />ILTR TYPE OF INSURANCE INSO WVD POLICY NUMBER MM DDl YYY MMIDDI YYY LIMITS_
<br />A
<br />X
<br />COMMERCIALGENERALLIABILITY
<br />X
<br />CLAIMS -MADE OCCUR
<br />X
<br />PHPK1843692
<br />7/1/2018
<br />7/1/2019
<br />EACH OCCURRENCE
<br />..[DAMAGE'1`Z5"rf�NT�.D.........__..._
<br />PREMISES„{Ea uccurrenc�)_......._w
<br />$ 1,000,000
<br />..........................._.......,.....................,,.
<br />.......................__. 100,000
<br />.............................
<br />MED EXP (Any one person)....._. .
<br />$ ......................__. 5,000
<br />........................
<br />PERSONAL & A_DV INJURY
<br />$ 1,000,000
<br />AGGREGATE LIM IT APPLIES PER:
<br />G EN'L
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />X
<br />PRO-
<br />POLICY1:1 JE07 LOG
<br />------------
<br />PRODUCTS-COMP/OPAGG
<br />...................... .—.1-- ............
<br />-----------------
<br />$ 2,000,000
<br />OTHER:
<br />Sexual Abuse/Molestation
<br />$ Included
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />PHPK1843692
<br />7/1/2018
<br />7/1/2019
<br />COMBINED SINGLE LIMIT
<br />fEa accidenU
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X
<br />AINY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY _ AUTOS
<br />BODILY INJURY (Per accident)
<br />5 ._. __.__-4YNV4VLL---
<br />PROPERTY DAMAGE
<br />Per accident
<br />X
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />A
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />PHUB567098
<br />7/1/2018
<br />7/1/2019
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS'LIABILITY YIN
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? C
<br />(Mandatory In NH)
<br />N/A
<br />UB003K35535418
<br />04/01/18
<br />04/01/01/19
<br />OTH-
<br />X STATUTE_ ER
<br />_
<br />E.L. EACH ACCIDENT
<br />$ 1.000,000
<br />— —NT _
<br />E,L, DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE • POLICY LIMIT
<br />$ 1,000,000
<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 is Included as named as additional insured as it relates t0 general liability in accordance with the terms and conditions of the policy.
<br />Umbrella follows form as it relates to additional insureds.
<br />REVIEWED BY EUNICE FIEREOI _ PG (OF
<br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Public Works Agency, M 21 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />y ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />P O BOX 1988 AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92702 5'e10
<br />�
<br />The ACORD name and logo are registered marks of ACORD ©1988.2015 ACORD CORPORATION, All rights reserved,
<br />ACORD 25 (2016/03)
<br />
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