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<br />ORANCOU-19 VVXKUMAR3
<br />�� CERTIFICATE OF LIABILITY INSURANCE DA 2/11/2014
<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($), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT; If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 />INSURED
<br />INSURERS) AFFORDING COVERAGE I RAID If
<br />INsuRERA.Great American insurance Company 16691
<br />--
<br />Itis, IRFR e . Nonprofits United
<br />Orange County Conservation Corps INSURER
<br />1853 N. Raymond Ave. INsu REE
<br />Anaheim, CA 92801 INSURER
<br />COVERAGES CERTIFICATE NUMBER:
<br />REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW
<br />HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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
<br />BEEN REDUCED BY PAID CLAIMS.
<br />INSR ADDL SU
<br />I
<br />LTR TYPE OF INSURANCE ,t S +V POLICY NUMBER
<br />POLICY EFF POEAGY EXP
<br />MMiD47YYYY jMMt0D7Y`rYY Llh11T,5
<br />L LIABILITY
<br />EACH OCCURRENCE $ 11000,00 t
<br />MMERCIAL GENERAL LIABILITY X PACS154680.08
<br />712012013 712012014 PREMISES Eaaccurenca S 100,00
<br />CLAIM&MADE � OCCUR
<br />MED EXP (Any one person) $ 5,000
<br />fessional SIM
<br />PERSONAL &ADV INJURY $ 1,000,000
<br />xL Abuse$1M
<br />?GEN'LAGGREGArp.
<br />GENERALAGGREGATE $ 3,000,000
<br />LIMITAPPLIES PER:
<br />PRODUCTS-COMP/OPAGG $ 3,000,000
<br />ICY
<br />$
<br />LIABILITY
<br />COMBINED SINGLE LIMIBILE
<br />Ea accidanf 5,000,000
<br />B X ANYAUTO 1888
<br />71112013 7/1/2014 BOOILOYI'll(P., person) $
<br />ALLGWNED SCHEDULED
<br />BODILY INJURY(Peraccitlenl) $
<br />AUTOS AUTOS
<br />X NON -OWNED
<br />..
<br />PROPERTY DAMAGE $
<br />X HIRED AUTOS AUTOS
<br />$
<br />SRELLA LIAR X OCCUR
<br />EACH=-URRENCE $ 1,000,00 I
<br />A cess uAa CLUMS_MADE UMB560379506
<br />i:xc
<br />811712013 811712014 AGGREGATE $ 1,000,00
<br />X RETENTION$ 10,000.
<br />_D
<br />$
<br />WORKERS COMPENSATION
<br />WC STAT11 Ol'H-
<br />TORY LIMIT
<br />AND EMPLOYERS' LIABILITY
<br />B ANY PROPRIETORIPARTNEftIE%ECUTIVE YIN NPU-WCG 001-2014
<br />1/1/2014 11112015 EL. EACH ACCIDENT $ 1,000,000
<br />OFFICER/MEMBER EXCLUDED? NIA
<br />(Mandatory In NH)
<br />E.L. DISEASE -EA EMPLOYE $ i 1,000,000
<br />If yes, describe antler
<br />DEA RIPTION OFOPERATIONS below
<br />EL.DISEASE - POLICY LIMIT' $ 1,000,000
<br />O..-..
<br />DESCRIPTION OF OPERATIONS l LOCATIONS I VEHICLES (Attach ACORD 101, Addi[lonal Remarks
<br />schedule, if more space Ix reyulred)
<br />The City of Santa Ana its officers, employees, agents, volunteers and representatives
<br />are named additional insured with respect to the operations of the
<br />named Insured. Endorsement to Follow. Workers Compensation coverage excluded,
<br />evidence only. Such Insurance is Primary and Non -Contributory.
<br />pyx�` 3
<br />CERTIFICATE HOLDER
<br />CANCELLATION ^'`- E.• S'vy1'1,e:`I
<br />SHOULD ANY OF THE ABOVE DEOC°MD POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />The City of Santa Ana
<br />20 Civic Center Plaza
<br />;
<br />_)Santa Ana, CA 92702_____,___
<br />O 1988-2010 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />EXHIBIT 1
<br />
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