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EVIDENCE OF COVERAGE aA?AI�NnorYYYY, —) <br />I L�1A!/trla rt <br />LJ1-7GV I G <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 AUTHORrrY (JPA) <br />JPA WEIMBER <br />Alliance of Schools for Cooperative Insurance Programs <br />Rancho Santiago Community College District <br />16550 Bloomfield Avenue <br />2323 North Broadway <br />Cerritos, CA 90703 <br />Santa Ana CA 92706 <br />www.ASCIP.org <br />CONTACTNAms: Mr. Fritz Heirich, Chief Executive Officer <br />PHONE: (562) 404 -6029 <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 COVc'-RAGE <br />ADDL <br />iNSR <br />MEMORANDUM NUMBER (MOC) <br />POLICY EFF <br />(MMrDp/YYYY) <br />POLICY EXP <br />12;01a,m. <br />LIMIT OF LIABILITY! COVERAGE <br />GENERALLIABILITY <br />COMBINED SINGLE LIMIT PER OCCURRENCE <br />4 $5,000,000 <br />OCCURRENCE <br />(HOC #77 <br />7/1/2012 <br />7/1/2013 <br />AGGREGATE <br />$ NIA <br />Personal iniury <br />$ <br />Errors & Cm(ssion <br />s <br />Employment Practices <br />s <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT PER OCCURRENCE <br />$ <br />AUTOMOTIVE PHYSICAL DAMAGE <br />ACTUALCASH VALUE <br />$ <br />COMPREHENSIVE/ COLLISION <br />S <br />AMY AUTO <br />S <br />S <br />4 <br />PROPERTY <br />REPLACEMENT COST SUBJECT TO POUCY LIMITS, <br />AND CQNDITIDNS <br />TERMS, <br />BUILDING 1 CONTENTS <br />FIRE, THEFT, RENTAL INTERRUPTION <br />$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' UABIUTY <br />WA <br />EACHACCtDENT <br />PER EMPLOYEE <br />g <br />F] WC STATUTORY LIMITS <br />_ <br />POUCY LIMIT <br />$ <br />OTHER <br />SUBJECTTO POLICY LIMITS, TERMS, AND CONDITIONS <br />EMPLOYEE DISHONESTY (CRIME) <br />TT7��J 7/�" .ji/7 <br />✓_._.bbl' <br />E <br />ADDITIONAL REMARKS: <br />� City pttor'ney <br />As respects to Vocational Classes PSSISt aVI <br />CERTIFICATE HOLDER <br />CANCELLATION <br />Should any of the Nbove coverages for the Covered Party be changed or withdrawn prior <br />to the expiration date issued above, ASCIP will mail 30 days written notice to the <br />City of Santa Aria <br />Certificate Holder, but failure to mail such notice shall impose no obligation or liability of <br />Attn: .,vlle Castro - Cardenas <br />any kind upon ASCIP, Its agents, or representatives, <br />1000 E. Santa Ana Blvd., Suite 200 <br />Santa Ana CA 92701 <br />f' `fJ / � ✓� - "�'" <br />AUTHGR¢ED REPRE$ENTATM : FMZ Heirich <br />*AMP !s a joint powers authority pursuant to hrtide i (c rnmendna wkh Sectfor, 65001 Chapters of Division 7 of T'die l of the Gower ment Code and Sectlons 39603 and 81603 of the Education Code. 0" 5 -97 <br />C_"T 10.1 13143650 CYnNT COOS: 77 Nancy Lopez 6/f/2012 7.59:30 F24 Sege 2 of 2 <br />19F -164 <br />