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ORANCOU -19 VMXHAVERI
<br />4f; �°RO' CERTIFICATE OF LIABILITY INSURANCE
<br />DATE 14 )
<br />2/7/2014
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />Arthur J. Gallagher & Co. Insurance Brokers of CA., Inc.
<br />505 N Brand Blvd, Suite 600
<br />Glendale, CA 91203
<br />CONTACT
<br />NAME:
<br />PHONE FAx
<br />No Ea: (818) 539.2300 AIC,NO: (818) 539.2301
<br />E -MAIL
<br />ADDRESS,
<br />INSURERS) AFFORDING COVERAGE
<br />NAICN
<br />INSURER A: Great American Insurance Company
<br />16691
<br />INSURED
<br />INSURER B: Non Profits United
<br />INSURER C
<br />Orange County Conservation Corps
<br />INSURER o
<br />1853 N. Raymond Ave.
<br />Anaheim, CA 92801
<br />INSURER E
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 CONTRACTOR OTHER DOCUMENTWITH RESPECTTO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALLTHETERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBRI
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMdDO1YYYY
<br />POLICY EXP
<br />MWDO[YYYYI
<br />LIMITS
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />X
<br />PAC5154680.08
<br />712012013
<br />7/20/2014
<br />pREMSES Ea occurrence
<br />$ 100,000
<br />MED EXP(Any one person)
<br />$ 5,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />X Professional $1M
<br />X
<br />Sexual Abuse$1M
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />GENE AGGREGATE LIMIT APPLIES PER
<br />PRODUCTS- COMP /OPAGG
<br />$ 3,000,000
<br />POLICY PRO LOC
<br />LE
<br />$
<br />AUTOMOBILE
<br />LIABILITY
<br />_
<br />COMBINED SINGLE LIMIT
<br />(Ea accident
<br />5,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />B
<br />X
<br />ANYAUTO
<br />1888
<br />711/2013
<br />71112014
<br />X
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />BODILY INJURY(Peraccident)
<br />$
<br />PROPERTY DAMAGE
<br />PER ACCIDENT
<br />$
<br />UMBRELLA LIAR
<br />X
<br />I OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />X
<br />EXCESSLIAB
<br />CLAIMS -MADE
<br />UMB560379506
<br />8/1712013
<br />8/17/2014
<br />AGGREGATE
<br />$ 1,000,000
<br />DIED FX I RETENTION$ 10,000
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />ANDEMPLOYERS'LIABILITY
<br />ANY PROPRIETOWPARTNERIE XECUTIVE YIN
<br />OFFICERIMEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />NIA
<br />NPU -WCG 001.2014
<br />1/1/2014
<br />11112015
<br />WC STATU- OTH-
<br />TORYLIMITS ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />—
<br />E.L. DISEASE - EA EMPLOYEE
<br />--
<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 (Attach AC ORD 101, Additional Remarks Schedule, If more space Is req ulred)
<br />The City of Santa Ana Its officers, employees, agents, volunteers and representatives are named additional insured with respect to the operations of the
<br />named insured. Workers Compensation coverage excluded, evidence only.
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />The City of Santa Ana
<br />20 Civic Center Plaza
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 92701
<br />. - --
<br />AUTHORIZED REPRESENTATIVE
<br />�I
<br />© 1988 -2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
<br />EXHIBIT I
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