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HomeMy WebLinkAboutDISCOVERY SCIENCE CENTER OF ORANGE COUNTY (2) - 2011City of Santa A 7-�;4t-701111 Clerk of the Council AGREEMENT TERMINATION FORM _-.-._-._-.-. COTC Office Use Only 2919 JUL I ---- - 2P!9 Julr 19 m Please complete this form when the attached agreement and all CITY OF SANTA ANA amendments (if any) are no longer in effect. CLERK OF COUNCIL CITY OF SAN Return form to the Clerk of the Council Office (M-30). CLERi OF CI Call 647-6520 if you have any questions. The agreement with No. N-2011-036 was completed on )9jL;;5'1jjI and final payment has been made. (List all amendments. Use space below if needed.) Q-a-o\\-016Le-©0- Revised 08-23-10 Department: ?9-12,gk Phone/Ext.: -153 I Signature: w` iOL Date: 7" f ig ?,(- 201 1 - 03(0- c?o1 MAYOR Miptrel A. PaMido MAYOR PRO TEM Claude C. IJvarez COUNCILMEMBERS Davfd BanavlOSs Carkrs B?mtamarMe Mk?ele C. Marthez Nlrks 3arrrYerNo 3M Tkrajero ?'?' ,.. . ??` •?_ ?w CITY MANAGER Uavld N. Ream CITY ATTORNEY Joseph W. Fblcher CLERK OF THE COUNCIL Merle D. Holzer February 29, 2012 CITY OF SANTA ANA 20 Civic Center Plaza • P.O. Box ? 988 Barrie Ana, CaNforMe 92702 DISCOVERY SCIENCE CENTER OF ORANGE COUNTY Janet Yamaguchi 2500 N Main Street Santa Ana, CA 92705 Re: Children's Summer Zoo Camp Program Dear Ms. Yamaguchi _ o ,__- _., ''?.:, c?. _ ?a ,.._ .. r=-.?- rV .- o This letter will confirm our agreement to extend the terms and conditions of Agreement N-2001- 036, dated March 9, 201 1 , between the Discovery Science Center and the City of Santa Ana. We have agreed that the Discovery Science Center will hold the following children's camps at the Santa Ana Zoo at Prentice Park during the summer of 2012: Maximum number of cam ers Age of campers Camp Week of 15 5-6 Zoo and You Jul 2 2012 30 5-6 Zoo and You Jul 9, 2012 30 7-10 Zoo Cam Jul 16, 2012 30 5-6 Zoo and You Jul 23, 2012 30 7-10 Zoo Cam Jul 30, 2012 30 7-1 O Zoo Cam Au 6, 2012 30 7-1 O Zoo Cam Au 13, 2012 30 5-6 Zoo and You Au 20, 2012 Discovery Science Center shall be responsible to set programming for each camp, in consultation with Zoo staff. Zoo staff shall designate, in writing, any limitations on the use of any portion of the Zoo. The terms and conditions of Agreement N-2011-036 shall remain in full force and effect through the extended termination date of December 31 , 2012. If you have any questions, please feel free to contact Zoo Manager, Kent Yamaguchi, at 714-647-6575. Sincerely Gerardo Mouet Executive Director - PRCSA -?---1 ,. :. .. _._ '; I'?C,VKL?.'?f. _??I .. ..'. _DATE (MWDDIYYY17... __. ,.,_ CERTI,FICA. TE :OF. LIABILITY ._ S .NCE ____.__>arls,zo,;o>.__..___ -"Tf'IIS.CERjIFIGAT.E IS .I,SSUED.AS-A Mi4TTER"AF,?INFORMAT(Ofy??(?L.Y F." RIGHTS UPON ?THECERTIFICATE?HOLDER.-THIS - CERTIFICATE [jOES NOT AFFIRMATIVELY: OR IVEGlRTIVELY gMEIY b, ND 'OR ALTER71iE COVERAGE AFFQRDED BY THE POLICIES BELOW. ,THIS.CERTt FICATEOF.INSURANCE DOES-NOT CONSTITUTE A?CONTRACT BE7?I?IE?I. THE.,'.IS$WNG?INSURER(S); AUTHORIZED REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOL.DE - ? _" ? ,--,'. I - ? - " ? ? ? - - - - -" IMPORTANTe IT the certificate holder Is an ADOtT10NAL INSURE Cy(iea).mt?? e;aenitb ed. If SVBROGATION IS WAIVED, subject to the terms and eondiUtxls of the policy, certain policies may require ?1?eriLyEfibemeht A afatement on this certificate does not confer rights to the certificate holder In Ilea of such endorsements . PRODUCER N A Marsh Commercial BuBiaess Center PHONE g88-591-1954 F?Iy _ 210-737-3584 a Service of Seahury & Smith EMAIL 9830 Colonnade Hivd. #400 E PO Hox 659520 PRODU 202560 San Ant OniO TX 75265-9520 INSVRER AFFORd NG COVERAGE NAICi INSURED L \ ?O?`_ O? INSURERA: TRAVELERS PROP CAS CO OF AM&R Discovery Science Center tv INSURERS: TRAVELER8 PROP CASUALTY INS CO 2500 North Main Street INSURERC: PENNSYLVANIA MFGRS ASSN INS Santa Ana, CA 92705 tatsuRER D: TRAVELERS CASUALTY & SURETY CO INSURER E - - INSURER F COVERAGES CERTIFICATE NUMBER. REVISION NLIMHF Re THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.- -NOTWITHSTANDINCa ANY RE QUIREMENT. TERM OR CONDITION OF ANY.CONTRACT OR OTHER DOCUME NT .WITH-RESPECT-TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.'THE?fNSURAN CE AFFORDED BY. THE POLICIES DESCRIBED FEREIN ?IS: SUBJECT TO ALL THE 'TERMS' EXCLUSIONS AND.CONOITIONS OF SUCH . , POLICIES. LIMITS SHOWN MAV HAVE BEEN'REDIJCED BY'PAID'CL-AIMSi ' ""' ? ''' ' -?` ?' ? '? " '-° ' - -+- ?. LTR ._ __"_.TYP6'OF-INSURANCE:........ _..._ ,_ ._, -..... _ ..... .... ., ., .' LI -EFF POLICY EXP _ ._. _ POLICY NUMBER.. .._ .-t'..: L. _.-._''?__. ?".'.:.`LIMBS .••: _ _ A._? GENERAL LUIBILITY '-?-; _ .. '--' 68002321.64$ '. --.-?-? 12/15/3010' 12y15/201b'Fgp1000URRENCE $`1, 000000 - ? X -'COMMF_RGwL GENERAL LIABILITY - 5-100.,.000 ..?^-. ? CI.AIMSMADE O OCCVR bED EXP An ore rson 5 5, 000 PERSONALS ADV INJURY 8 1 000,000 GENERAL AGGREGATE S 2.000,000 GENT AGGREGATE LIMIT APPLlE3 PER: PRODUCTS-COMPgP AGO $ 2.000,000 X PODCY PRO. LOG S H AUT X OMOBILE LwBILJTT O 820329D0533 12/15/2010 12/15/2011 COMBINED SINGLE LIMIT (E9 aoC30e0t) g 1,000,000 ANY AUT BODILY IWURY (Per peledl) $ ALL OWNED AUTOS BODILY IWURY der eoYdenl) $ SCIiEDULED AUTOS ?GE 5 HIRED AUTOS Ctltle,It NON4WNED AUTOS $ E H X UMBRELLA LIAR X OCCUR PSMCUP329D0809 12/15/2010 12/15/2011 EACi-I OCCVRREIICE S EXCESS UAB CLAInns-MADE - AGGREGATE 3 10, 000, 000 DEDVGTBLE $ NTION S C WO AND RKERS COI?ENSATION EMP LOYERS'LIABILRY 201001-17-94-96-5 oa/O3/solo Da/Ol/2011 WO STATU- OTI+ YIN AIVI'PROPRIETOR/PARTNER/E)fECUTNE OFFICERIMEMBER EXGLUDEDI O N/A EL. EACH ACCIDENT S 1, 000, 000 (ManaMbOrybNH) EL DISEASE-EA EMPLOYE $ 1 000,000 I/ yyeeaas? dBBOibB Llldaf DESCPoPffON OF OPFRATI E.L. 013EASE-POLICY DMIT $ 1 000 O DESCRIPTiOiL OF OPERATIONS / LOCATONS /VEHICLES (Attach ACORD 101, Atl4ltlonal Remsrka 8chsdula. H more apace m requ Vad) City Of Saa[a Ana, its oE£icera, agents, employees, repree0ntativae, and VOl YIICeeiB ai'G r0009aiLea a9 AddiCiOaal Ia6YCGa9 OSi General Liability ae reQUired by vrittea contract. IE RTI FICATE HOLDER - -- ?? _ `" -"'? CANCELLATION ity of Santa Ana ? 1 Salvador Community Cr3LC8?' ? - ??-?? - -' _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN .t t. T tl S l.1 4 .? 1 CG (I y ACCORDANCE WITH THE POLICY PROVISIONS. 825 w Civic Center Dr ?? *.?.,larsl City Al,orney ante Ana, CA 2703 AUTNORIZEDiREPRESENTATyE ®'1988-2009 ACORD CORPORATION. All rights reserved 4CORD 25 (2009/09) The ACORD name and logo are registered merits of ACORD TRAVELERSJ? CHANGE EFFECTIVE GATE: 01-27-11 CHANGE ENDORSEMENT NUMBER: 0005 Ona Tower Square, Hartford, Connecticut 06183 CHANGE ENDORSEMENT Named 2naured: DISCOVERY SCIENCE CENTER Policy Number: P-630-0232L645-TCT-10 Policy Effective Date: 12/15/10 Issue Date: 02/28/11 Additional Premium $ 941 INSURING COMPANY: THE TRAVELERS INDEMNITY COMPANY OF CONNECTICUT Effective from 01/27/11 at the time of day the policy becomes affective. THIS INSURANCE IS AMENDED AS FOLLOWS: THE COMMERCIAL GENERAL LIABILITY COVERAGE PART 2S AMENDED A3 FOLLOWS: AMENDING CG D4 11 04 OS - ADDL SNSD-DESIG PERSON OR ORGANIZATION AS PER ATTACHED. NAME AND ADDRESS OF AGENT OR BROKER: SEABURY & SMITH-CBC NPB (CHG22) PO SOX 659520 3AN ANTONIO, TX 782659520 COUNTERSIGNED BY: Authorized Representative DATE: IL TO 07 09 87 PAGE 1 OF 1 OFFICE: DIAMOND BAR TRAVELERS J? CHANGE EFFECTIVE DATE: 01-27-11 CHANGE ENDORSEMENT NUMBER: 0005 POLICY NUMBER: P-630-0232L645-TCT-10 EFFECTIVE DATE: 12-15-10 ISSUE DATE: 02-26-11 LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBSRS THIS LISTING SHOWS THE NUMBER OF FORMS,, SCHEDULES AND ENDORSEMENTS BY LINE OF BUSINESS. IL TO 07 09 87 CHANGE ENDORSEMENT IL T8 O1 10 93 FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS COMMERCIAL GENERAL LIABILITY CG D4 11 04 08 ADDL IN3D-DSSIG PERSON OR ORGANIZATION IL TS 01 1 O 93 PAGE i 1 OF 1 COMMERCIAL GENERAL LIABILITY POLICY NUMBER; p_630-0232L645-TCT-10 ISSUE DATE: 02-28-11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance prov[ded under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s): THS CITY OF SANTA ANA, AND THE CITY OF SANTA ANA, LOCATED AT 20 CIVIC CENTER PLAZA, SANTA ANA, CA 92701 Section II -Who Is An Insured is amended to Include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily Injury", "property damage", "personal injury" or "advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations: or S. In connection with your premises owned by or rented to you. CG D4 11 04 OS ®2008 The Travelers Companies, inc. Page 'I Of 1 Includes the copyrighted malartal of Insurance Services Offtce, Inc. with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE -ADDITIONAL INSUREDS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV), Paragraph 4. (Other Insurance), is amended as follows: 1. The following is added to Paragraph a. Primary Insurance: However, if you specifically agree in a written con- tract or written agreement that the insurance pro- vided to an additional insured under this Coverage Part must apply on a primary basis, or a primary and non-contributory basis, this insur- ance is primary to other insurance that is avail- able to such additional insured which covers such additional insured as a named insured, and we will not share with that other insurance, provided that: b. The "personal injury" or "advertising injury" for which coverage is sought arises out of an of- fense committed subsequent to the signing and execution of that contract or agreement by you. 2. The first Subparagraph (2) of Paragraph b. Ex- cess Insurance regarding any other primary in- surance available to you is deleted. 3. The following is added to Paragraph b. Excess Insurance, as an additional subparagraph under Subparagraph (1): That is available to the insured when the insured is added as an additional insured under any other policy, including any umbrella or excess policy. a. The "bodily injury" or "property damage" for which coverage is sought occurs; and CG DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Page 1 of 1 DISCO-4 -`'?? °s CERTIFICATE OF LIABILITY INSURANCE °AT;;;ti o"?'n" THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATNELY OR NEGATNELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSV RER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If [he eartlfleate holder Is an ADDITIONAL INSURED, the policy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and eondltlons of the policy, certain pollelea may require an endorsement. A statement on this certlflcate does not confer rlghts to tfie cartlfleate holder In Ilea of such endorsemen s . PRODUCER AME• Commerdal Lines - (87 6) 464-9300 P ONE PAX Wells Fargo Insurance Services USA, Inc. - CA Lk:#: OD06408 Ea+/uL c Na : _„" D 75303 Ventura Boulevard, 71h Floor INSURERS AFFORDING COVERAGE NATO YJ Sherman Oaks, CA 9 7 403-3 7 97 INSURER A: PtI]Iadelphia Indemnity Insurance Company 76058 INSURED INSUweR s : Philadelphia Insurance Company 76058 Discovery Science Center INSURER c : EmplDyers Compensation Ins Co 2500 Norlh Maln Street INSURER D INSURER E Santa Ana, CA 92705 INSURER F COVERAGES C_FRTIFIf_ATF NI IMaGO• 4909A7R eca.crw . THIS IS TO CERTIFY THAT 7HE 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 INSURANCE POLICY NUMBER P? ICY EFF POLICY E%P DNI'r5 A GENERAL LIA91LnY PHPK805927 72/7 $?77 72/75/72 EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIA6ILITy PREMI nsn i 100.000 CWMS-MADE ? OCCUR MEO EXP Myone parson S 5,000 PERSONAL 6 ADV INJVRY S 1,000,000 GENERAL AGGREGATE S 2.000,000 GENL AGGREGATE LJMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2.000,000 X POLICY PRO- LOC i B AUT OMOBILE LIABILnY PHPKB05927 72/75/17 72/75/72 COMBI? I I L LIMI 1.000,000 X ANY AUTO BODILY INJURY (Par parson) i A 7703 NED ?OEDULED BODILY INJVRY (PBr eoddant) i X HIRED AUTOS X ?OSWNED PPROP RTY DAMA E i - i B UMBRELLA LlA9 X OOCUq PHUB367595 72/7$/77 72/75/72 EACH OCCURRENCE i 10,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE S 10,000,000 DED RETENTION i C AND EMEPLOYERS'LULBIT?mr . EIG7 4536 7 3-00 D4/07?72 D4/07H3 X M/C STATU- 07H- ? rN OFFICER/MEIMBER PEXftUDERO (ECIITIVE ? NIA E. L. EAU-IACCIDFJYT 1,000,000 i (MSntla NSy Mr NNI If ib d d E.L. d3EA3E - EA EMPLOYE S 1,000,000 tam aso e an s DESCRIPTION OF OPERATIONS helew E.L. p3EA3E -POLICY LIMIT i 1,000,000 OESCRIPTN]N OF OPERATONS / LOCATONS / VEHICLES (Attach ACORD 101, AdtllllonM RamerMa SoMtlula, q mere spaea la rapulnrd) The City of Santa Ana, Parks, Reaealior?a?glrfltlr,ll?r??ar f??T)cy)Ig(t7?1J?1(,r?d as Addlttonal Insured for General Llabllty as required by written contract. ?n ?,/ f 1 ,., ? I.. .v -?ti: I I. .1 ;. r y r?l >rnc?. IiMI`1liG LLI?i 1 Ivn City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Parks, Recreation and Community Services Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Silvia Cuevas 26 Civic Center Ptaza AtJTHORIZEO REPRESENTATVE Santa Ana CA 92707 9? -- The ACDRO Hama end logo era registered marlca of ACORD ®7988-201 O ACORD CORPORATION. All rlghts reserved. AcoHD zs tzo7oios) ma, a.rlle.. ?.d.e. -.racaex r.? a xana,m ADDITIONAL INSURED ENDORSEMENT Insurance Company: Philadelphia Indemnity Insurance Company This endorsement modifies such insurance as in afforded by the provisions of Policy # PHPK805 9 2 7 Relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701, officers, employees, agents and representatives are named as additional insured with regard to liability and defense of suits arising from the operations and uses performed by on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insured. _ 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insured, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty-30 days written notice has given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. Completion of the following, including countersignature, is required to make this endorsement effective. Effective December 15 , 2011 .this endorsement form as part of Policy # PHPK805927 Issued to Discovery Science Center / • /I Name Insured Countersigned by Title: Assistant Vice President 3/x$/17 Repi esentative ?-? .? 2?t069 ?"-?"r? CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YVYY) 12/1 l/20'12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE C ERTIFICATE 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 endorsement(s). PRODUCER CONTACT Commercial Lines - (81 B) 464 9300 NAME: - PHONE Fql( W ll F I A/C No e s argo nsurance Services USA, Inc. - CA Lic#: OD08408 E-MAIL ? ADORES 5303 Ventura Boulevard, 7th Floor Sh ' INSURER 5 AFFORDING COVERAGE NAIC # erman Oaks, CA 9 1403-3197 Phil d l h a e p ia Indemnity Insurance Company INSURER A: 18058 INSURED ? / /? Discove Science C nt Q INSURER B: Philadelphia Insurance Company 23850 e er / ? _ ? 1? :J ( / /? ??/ ? ? Em lo r C ti I ? .. 2500 N ? " rth M i St p ye s ompensa on ns Co INSURER c : 11512 o a n reet Santa A CA 927 INSURER D na, 05 INSURER E INSURER F - v..?l.+t. Ir a.an ocrc: See Delow 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 RESP ECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT T O ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL 5 POLICY NUMBER POLICY EFF MM DDNYYY POLICY E%P MMIDD/YWY LIMITS A GENERAL LIABILrrY X X PHPK953782 12/15/2012 12/15/2U13 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY D PREM SE Ee oc ur n S 300,000 CLAIMS-MADE O OCCUR MED EXP (An one person) $ 5.000 PERSONAL 8 ADV I NJURY $ 1.000,000 GENERAL A GGREGATE $ 2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO PRODUCTS -COMP/OP AGG $ 2,000,000 X POLICY LOC g A AUT OMOBILE LIABILITY PHPK953782 12/15/2012 12/15/2013 COMBINED SINGLE LIMIT E ccitlanl 1,000,000 X ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per parson) $ AUTOS AUTOS NON-OWNED BODILY INJURY (Per accident) $ X HIRED AUTOS X AUTOS PROPERTY DAMAGE $ Pe cci and $ _ B UMBRELLA LIAR X OCCUR PHU6404496 12/15/2012 12/15/2013 EACH OCCURRENCE $ 10.000,000 X EXCESS LIA6 CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION X WC STATU- OTH- ? ANO EMPLOYERS'LIABl LITY ?,/N EIG1453813-00 04/01/12 04/01/13 ANY PROPRIETOR/PARTN ER/EXECUTIVE OFFICER/MEMBER EXCLUDED'! ? N / A E.L. EACH ACCIDENT g 1,000,000 (Mantletory in NH) If es, tlescribe untler E.L. DISEASE - EA EMPLOYE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Atldltlonal Remarka Schetlula, If more apace la requlratl) ??++tt??''?? of Santa Ana Parks Recreation and Comm nit S i A i d , , u y erv ces gency s included as Additional Insured for General Liable reQMr by written contract AS E9 ? ?4?p ???c ? y ?? ?? tt F' P E? . `ty S V Clty Of Santa Ana SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Parks, Recreation and Community Services Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Silvia Cuevas 26 Civic Center Plaza AUTHORIZED REPRESENTATIVE '//°"t' Santa Ana CA 92701 (]? The ACORD name and logo are registered marks of ACORD ©1988-201 O ACORD CORPORATION- All rights rwc,w wart ACORD 25 (2010/05) 271069 ACORN CERTIFICATE OF LIABILITY INSURANCE DATE (MM/OD/YYYY) 12/11/20'12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 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 endorsement(s). PRODUCER CONTACT Co i l Li ' NAME: mmerc a nes -(8 18) 464-9300 PHONE FAX A/C No . Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 E-MAIL ' ADDRE 15303 Ventura Boulevard, 7th Floor INSURERS AFFORDING COVERAGE NAIL e Sherman Oaks, CA 9403-3'197 Phil d l hi ' a e p a Indemnity Insurance Company INSURERA: 18058 INSURED Di S i INSURER B : Philadelphia Insurance Company 23850 scovery c ence Center INSURER c : Employers Compensation Ins Co 1'15'12 2500 North Main Street INSURER D Santa Ana, CA 92705 INSURER E INSURER F JCC VtlIVW THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO I L CY 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. IN$R LTR TYPE OF IN6U RANGE VBR POLICY NUMBER POLICY EFF MM/DDKYYY POLICY E%P MM/DD/YYYY LIMITS A GENERAL LIABILITY X PHPK953782 t2/'I 5/20'12 12/15/203 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY A A N P E T E E rra ce $ 300,000 CLAIMS-MADE ? OCCUR MED EXP (An one person) $ 5,000 PERSONAL B ADV INJURY $ 1 000 000 , , GENERAL AGGREGATE $ 2 000 000 , , GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS -COMP/OP AGG $ 2,000,000 X POLICY PRO LOC g /.? AUT OMOBILE LIABILITY PHPK953782 t2/t 5/20'12 t2/t 5/2013 D SINGLE LIMIT e d I Ea s ct a 1,000,000 X ANY AUTO ALL OWNED CHE BODILY INJURY (Per parson) $ AUTOS S DULED AUTOS O W BODILY INJURY (Per accident) $ X HIRED AUTOS X NED AV TOS PROPERTY DAMAGE $ era ant $ B UMBRELLA LIAR X OCCUR PHLI6404496 12/15/2012 t2/?$/20t3 EACH OCCURRENCE $ 10,000.000 X E%CE33 LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYER3'LIABILITY ?./N EIG 1453813-00 04/0'1/12 04/01/13 ANY PROPRIETOWPARTNER/EXECUTIVE OFFICER/MEMBEft EXCLU DED? ? N / A E.L. EACH ACCIDENT $ 1,000.000 (Mantletory In NH) If es describe under E.L. DISEASE - EA EMPLOYE $ 1.000.000 , DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1.000,000 $ DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Addltlonal Ramarka Schedule, I! more apace Is raqulred) The City of Santa Ana, its officers, agents, employees, representatives antl volunteers are included as Additional Insureds for General Liability as required by written contract. FORM A? ?? ROVE? . A ?,p RcK ?VGLL/YIIV rY fir` - Ll?+' V c,tstar` Ci[y Of Santa Ana SHOULD ANY OF THE ABOVE D?SCf216ED POLICIES BE CANCELLED BEFORE EI SalVad Or COmmUnliy Center THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. '1825 W Civic Cen[er Dr Santa Ana CA 92703 AUTHORIZED REPRESENTATIVE '/r°"? 9? The ACORD name and logo are registered marks of ACORD ©'1988-20'10 ACORD CORPORATION- All rin Flfa rnsnrvori ACORD 25 (20'10/05) POLICY NUMBER: pHPK953782 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or O anization s City of Santa Ana, it's officers, employees, agents, and representatives ?.. Infonmatiort re wired to com fete this Schedule, if not shown above, will be shown in the Declarations. Section 11 -Who Is An Insured is amended to in- clude as an additional insured the person{s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. APPROVED AS TO FORM. L?/-??- ---- ?L?SA E. STUr«-rte Assistant City Attorney?? CG 20 26 07 04 ©ISO Properties, lnc., 2004 Page 1 of 1 O Pt-MANU-1 (01/00) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ lT CAREFULLY Additional Insd Automatic Status When Required by Written Contract (CG2026) Additional Insured Autcmatic Status When Required by Written Contract (CG 2U 26 wording) Any person or organization that you visit in the scope of your business operations is added as an Additional insured only when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or organization is an insured only with respect to liability For "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your operations when on and visiting their premises. A person's or organization's status as an additional insured under this endorsement ends when. their contract or agreement with you ends. With respect ?to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after you leave the premises. APPROVED FORM A!I other terms and conditions of this Policy remain unchanged. LISA E. STORCK Assistant City Attorney Page 1 of 1 I < / 2]1069 ACIORV® CERTIFICATE OF LIABILITY INSURANCE DATE(YYY) Y 1//81201 8/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY .,?[uIENDr EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT C'?IfU'I'E .A ?CyON1?RA(eT kTETWEEN 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 regUire an endorsement. A stateolant on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). I.;' PRODUCER CONTACT NAME: Commercial Lines - (818) 464-9300 BONN A C Ez / No : Wells Fargo Insurance Services USA, Inc. - CA Lic#: OD08408 EMAIL ADDRESS: 15303 Ventura Boulevard, 7th Floor INSURERS AFFORDING COVERAGE NAIC # Sherman Oaks, CA 91403-3197 INSURERA: Philadelphia Indemnity Insurance Company 18058 INSURED INSURERS: Philadelphia Insurance Company 23850 Discovery Science Center INSURERC: Employers Compensation Ins Cc 11512 2500 North Main Street INSURER D: Travelers Casualty & Surety Co. of America 31194 Santa Ana CA 92705 , INSURER E : //11 O T/ INSURER F: COVERAGES CERTIFICATE NUMBER: 5465122 REVISION NUMBER: See helew 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 Um TYPE OF INSURANCE ADDL INSR SUBR MD POLICY NUMBER POLICY EFF MMIODIVVYV POLICY EXP MMIDDNYYY LIMITS A GENERAL LIABILITY X PHPK953782 12/15/2012 12/15/2013 EACH OCCURRENCE _ $ 1,000,000 X COMMERCIAL GENERAL LIABILITY TO REN7ET PREMIESES S Ea Ea occurrence) PREMI $ 300,000 CLAIMS-MADE OCCUR MED EXP(Anyone person $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENLAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 X POLICY PRO LOO $ A AUT OMOBILE LIABILITY PHPK953782 12/15/2012 12/1512013 COMBINED SINGLE LIMIT Ea eacldent 1,896,893 ANY AUTO BODILY INJURY(Per parson) $ I ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY Per accident ( ) $ x HIRED AUTOS X NON-OWNED AUTOS PROPERTDADAMAGE Per accident B UMBRELLA LIAB X OCCUR PHUB404496 12/15/2012 12/15/2013 EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEO RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- C AND EMPLOYERS' LIABILITY EIG1453813-00 04/01/12 04101/13 TCRYL ER YIN ANY PROPRIETOWPARTNEWEXECUTIVE F E E B E N / N/A E.L. EACH ACCIDENT 1,000,000 $ OF IC R M M ER XCLUDED? (Mandatory in NH) E.L. DISEASE- EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONSbelow EL.DISEASE - POLICY LIMIT $ 1,000,000 D D&O, EPL, Fiduciary, Crime 105645707 0613012012 06/30/2013 sooo,ooo DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CG 20 26 07 04 The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701, its officers, employees, agents, volunteers and representatives are included as Additional Insureds for General Liability and defense of suits arising from the operations and uses performed by or on behalf of the Named Insured per the attached. Cancellation Notice to Scheduled Additional Insured also attached. The coverage is primary and non-contributory with other insurance held by the City. Separation of insureds applicable per the policy form. FORM, CERTIFICATE HOLDER CANCELLATION City of Santa Ana - O ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Risk Management j 7 titt Sjl THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Assist t City Attorney Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE 97 ? ACORD 25 (2010/05) the ACORD name and logo are registered marks of ACORD © 1988-2010 ACORD CORPORATION. All rights reserved. ITlIS -Iroale,epl- oerllnoe,ea mee 116 issued on I'W. t ,) ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company Philadelphia Indemnity Insurance Company This endorsement modifies such insurance as is afforded by the provisions of Policy # PHPK953782 relating to the following: I. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective December 15, 2012 this endorsement form as a part of Policy 4 PHPK953782 Issued to Discovery Science Center Named Insured Countersignedby ?G L? Can z, Authorized Representative POLICY NUMBER: PHPK953782 COMMERCIAL GENERAL LIABILITY CO 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE City of Santa Ana Attn: Risk Management 20 Civic Center Plaza Santa Ana CA 92701 The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701, its officers, employees, agents, volunteers and representatives are included as Additional Insureds for General Liability and defense of suits arising from the operations and uses performed by or on behalf of the Named Insured per the attached. Cancellation Notice to Scheduled Additional Insured also attached. The coverage is primary and non-contributory with other insurance held by the City. Separation of insureds applicable per the policy form. Section 11 - Who Is An Insured is amended to in- clude as an additional Insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising Injury" caused, in whole or In part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or S. In connection with your premises owned by or rented to you. CO 20 26 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 ? 211069 tC CERTIFICATE OF LIABILITY INSURANCE oAT3(MWOV1r3YY( THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENL EX'? ND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE bOEB?NOT'CON5 IT TE 4 CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is on ADDITIONAL INSURED, the pollcy(los) must be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, cartel fk.policies may require art o?l.d? ji6ent. A statement on this certificate does not confer rights to the certificate holder In lleu of such endorsement's.: :,,}L, PRODUCER CAOMP or Commercial Lines - (818) 464-9300 PHONE e.n• FAX 2c. Rol: Wells Fargo Insurance Services USA, Inc. - CA Lie#: 0008408 MAIL ADDRESS: 15303 Venture Boulevard, 7th Floor INSURER S AFFORDING COVERAGE NAIC k Sherman Oaks, CA 91403-3197 INSURERA; Philadelphia Indemnity Insurance Company 18058 INSURED INSURERB: Philadelphia Insurance Company. 23850 Discovery Science Center INSURER 0: Employers Compensation Ins Cc 11512 2500 North Main Street INSURER D: Travelers Casualty & Surety Co. of America 31194 Santa Ana, CA 92705 / . INSURER E: ? ? Dll 0?? ?n I w.,mcne. COVERAGES ocvrmnu Lu u.ao cm. ,. 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. ILTR TYPEOPINBURANCE DOL E OR POLICYNUMBER MO tln EFR PO OCOY EXP LIMnB A asN ERAL LIABILITY X PHPK953782 12/15/2012 12115/2013 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAVAOETO ENT D REMISES Ea coomenee $ 300,000 CWMS-MADE OCCUR MED EXP(Any one percent $ 6,000 PERSONAL B ADV INJURY S 1 000 000 , , GENERAL AGGREGATE $ 2 000 000 , , GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000.000 PRO- I X POLICY 1 E] $ A AUT OMOBILE LIABILITY PHPK953782 12115/2012 12115/2013 COMBINED SINGLE LIMIT _Ea 4gcld mt 1,000,000 % ANYAUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY Per adddani ( ) I$ X HIREDAUTO$ X NON OWNED PROPERTYDAMAGE $ AUTOS Peramdd,m $ B UMBRELLA LIAR x OCCUR PHUB404496 12!1512012 12(1512013 EACH OCCURRENCE $ 10,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $ OED RETENTION$ $ WORKERS COMPENSATION We STATU. OTH- X C AND EMPLOYERS' LIABILITY EfG1453813-01 04/01113 04101114 . Yin ANY PROPRIETOWPARTNERIEXECUTIVE OFFICERRAEMBEREXCLUDEDY O N/A E,L.EACH ACCIDENT If i,OW,000 fMandelon, In NH) H rib d I[ 01 E. L. DISEASE-EA EMPLOYE $ 1,001 Vyas esc e under M $ ,0un OPERATIONS below EA. DISEASE-POLICY LIMIT 1,000,OO0 $ D D&0, EPL, Fiduciary, Crime 105645707 06/3012012 06/3012013 3,ooo,op0 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ARach ACORD 101, Additional Remains Schedule, if more space Is required) CO 20 26 07 04 The City of Santa Ana, 20 CIVIC Center Plaza, Santa Ana, California 92701, its officers, employees, agents, volunteers and representatives are included as Additional Insureds for General Liability and defense of suits arising from the operations and uses performed by or on behalf of the Named Insured per the attached. Cancellation Notice to Scheduled Additional Insured also attached. The coverage is primary and non-contributory with other Insurance held by the City. Separation of Insureds applicable per the policy form. City of Santa Ana x3T 'O,/ .r2 O FORM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Alin: Risk Mana ement 00- THE EXPIRATION DATE THEREOF, NOTICE WILL HE DELIVERED IN 9 {?? ?JJ y ?4brC ?' 20 GIVIO Canter Plaza ACCORDANCE W17H THE POLICY PROVISIONS. Santa Ana CA 92701 : Ura Stitt Sheerly AUTHORIZED REPRESENTATIVE p ..,istant City Attorn?y/*M`(ytA4 The ACORD name and logo are registered marks of ACORD 01988.2010 ACORD CORPORATION. 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