COAST LIVE OAK SCHOOL (2) - 2014

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r , .„, l .t 1, ,,, DATE (MM/DD.fYYYY) q+ct�► n CERTIFICATE OF LIABILITY INSURANCE 9/22/2015 THIS CERTIFICATE, IS ISSUED AS A MATTER OF INFORMATIONONLY AND CONFERS NO RIGHTS UPON' THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain Policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Wood Gutmann & Bogart License #0679263 15901 Red Hill Ave., Suite 100 CONTACT Seliler-I lynn _ PHONE FAX 714-505-7000 (ALC_Noi 714-573-1770 �I�O�`Iss..'�yWgbib.com INSURERS AFFORDING COVERAGE NAIC q Tustin CA 92780 INSURER A : Philadelphia In emnity Ins Co. INSURED CO.AST66 ' INSURER B Coast Live Oak School 6 EMk dgewood Road 113 -ill), 1 _k _1 INSURER C : INSURERD: INSURER E : Santa Ana CA 92706 INSURER F : COVERAGES CERTIFICATE Nt1MRFR- 15479060,47 REV!S!0N !4 IfuR=0r THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT' TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR LTR TYPE OF INSURANCEIN D WVD POLICY' NUMBER POLICY EFF MMIDD POLICY E%P DOfYYYY - LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE l .1 OCCUR. PHPK1220574 9/22/2015 912212D16 EACH OCCURRENCE $1,000,000 F PREMISES Ea occurr n j $100„000 MED EXP (Any one person) $5,000 PERSONAL .&ADVINJURY $1,000„000 GEN1 . AGGREGATE LIMIT APPLIES PER: POLICY =. JECO'T � LOC I 1 GENERAL AGGREGATE $2,004,000 PRODUCTS - COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY .. t9. . a aRINF k SINGLE ANY AUTO - BODILY INJURY IPer person)' $ ALL8WNED SCHEDULED N-OAUT S AUTOS HIRED AUTOS AUTOS NED ' AUTOS F � N _;,� �>� - � � BODILY INJURY (Per & ) $ ER Y AMAG Peraccldenl� S _ $ .,..� UMBRELLA LIAR. OCCUR EACH OCCURRENCE $ -- EXCESS LIAR CLAIMS -BADE \e r�I� AGGREGATE $ DED I I RETENTIONS $ COMPENSATION S' AND EMPLOYERLIA9ILITY YIN ANDEROPRIErOER EAR NEERE XECUTNVE; OFF❑. NIA + ,! '( �a STATUTE H.KERS E.L... EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE: $ (Mandatary In NH) If yes, describe under N ISEASE -POLICY LIMIT ''.. S ''.. DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of Santa Ana, its officers„ agents and employees are named as additional insured on the General Liability per attached PI GLD VS 01 08, Cancellation verbiage as per IL0017 11 98 attached. Primary and Non -Contributory applies on the General Liability per attached PI G'LD VS 01 08, Ttil'S CERTIFICATE SUPERCEDES ANY PREVIOUSLY ISSUED. _1_ 11C 'VM 1 G N'14/4..WQFX t.J4V1%.r_LLA I IUN City of Santa Ana; Parks, Recreation and Community Services Agency Attn: Carmen Acosta 1825 W. Civic Center Drive Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE24 . 1 "" & @ 1988-2014 ACORD CORPORATION. All right's reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD