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EVIDENCE OF COVERAGE <br />D6/22/ <br />015 <br />6!22/2015 <br />This Evidence of Coverage is used as a matter o4+rifgqrlrlation only and confers no rights upon the Certificate Holder. This Evidence Of Coverage does not <br />amend, extend, or altgf G}1G copPTf.,a ffol`,ded tis}th@ in emcranda listed below, <br />MEMORANDUM NUMBER: 77 P <br />JOINT POWERS AUTHORIT�.{jP )V r J,�1 +' tr'S, <br />1 { li{ <br />Alliance of Scholl f r qQ, �r2five ln`stJrande Programs <br />16550 Bloomfield Eu'� <br />Cerritos, CA 90703 <br />JPA MEMBER <br />Rancho Santiago Community College District <br />2323 North Broadway <br />Santa Ana CA 92706 <br />www.ASCIP.org <br />CONTACT NAME: Mr. Fritz Heldch, Chief Executive Officer <br />PHONE: (562) 404-8029 <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 COVERAGE <br />DDL <br />MEMORANDUM NUMBERtMOC) (m,� <br />°Ymml <br />POLICY E P <br />LIMIT OF LIABILIN I COVERAGE <br />GENERALLIASILITY <br />COMBINED SINGLE LIMIT PEH OCCURRENCE <br />$ $5,000,000 <br />OCCURRENCE <br />MOC #77 <br />71112015 <br />7/1/2016 <br />AGGREGATE <br />s N/A <br />Personal ln iury <br />$ <br />Errors & Omission <br />$ <br />Employment Practices <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT PER OCCURRENCE <br />$ $5,000,000 <br />AUTOMOTIVE PHYSICAL DAMAGE <br />MOC #77 <br />7/112015 <br />71112016 <br />ACTUAL CASH VALUE <br />COMPREHENSIVE /COLLISION <br />$ <br />ANYAUTO <br />awned Auto <br />$ <br />Hired Auto <br />$ <br />PROPERTY <br />AND CONDITION CN COST SUBJECT TO POLICY LIMITS, <br />TERMS, <br />BUILDING I CONTENTS <br />+ <br />FIRE, THEFT, RENTAL INTERRUPTION <br />$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIASILRY <br />NIA <br />EACH ACCIDENT <br />$ <br />PER EMPLOYEE <br />$ <br />E] WC STATUTORY LIMITS <br />POLICY LIMIT <br />$ <br />OTHER <br />EMPLOYEE DISHONESTY (CRIME) <br />SUBJECT TO POLICY LIMITS, TERMS, AND CONDITIONS <br />C—) J <br />$ <br />V <br />E�t� <br />$ <br />—__- <br />etl <br />$ <br />$ <br />ADDITIONAL REMARKS: p.,a <br />As respects to Bridge t0 Engineering Program <br />= <br />CERTIFICATE HOLDER <br />CANCELLATION - _ OJ <br />Should any of the above 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 Ana <br />Clerk of the City Council <br />20 Civic Center Plaza (M -73, M -30) <br />Santa Ana CA 92702 <br />Certificate Holder, but failure to mail such notice shall impose no obligation or liability of <br />any kind upon ASCIP, Its agents, or representatives. <br />AUTHORIZEDREPRESENTAI "IVE: Fritz Helrich <br />'ASCIP is ajointpowers authority pursuanttn Adoe I(mmmeragg with 5e60n 6500) Chapters ofowsion7orule3 of the Governrnem Code and SWio0s 39603 and 81603 ofthe Education Code. Rev 5.97 <br />25196912 1 77 1 15/16 411 Types WC I Percy 1ppez 1 6/22/2015 7:15:50 M: (Pn1') I Page 1 of 2 <br />