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Docusign Envelope ID: F9ADF187-59B2-4BDA-A5A7-F368D43E4390 <br /> 706/27/2025 <br /> E(MMIDDIYYYY) <br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE <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 CONTACT David Aguirre <br /> Egloff Insurance Agency, Inc. AI°NN Ext: (818)992-5744 a/c,No): <br /> 20969 Ventura Boulevard Suite 225A E-MAIL i id ava urre e loff.com <br /> ADDRESS: d g @ g <br /> Woodland Hills,CA 91364 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A: QBE Insurance Corporation <br /> INSURED <br /> INSURER B <br /> Carpenter, Rothans&Dumont,LLP INSURER C: <br /> 500 S Grand Ave. 19th Floor INSURER D: <br /> Los Angeles CA 90071 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 CONTRACT OR 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 BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR IN SD WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED <br /> PREMISES Ea occurrence $ <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ <br /> JECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS Per accident <br /> UMBRELLA LAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? N I A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> Lawyers Professional Liability $2,000,000/$4,000,000 Limits <br /> A LAW-21318-04 04/01/2025 04/01/2026 $15,000 Deductible <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> APPROVED <br /> By Tu Tran Nguyen at 2:20 pm,Jun 27,2025 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Attention: City Attorney§Office ocu igne y: <br /> AUTHORIZED REPRESENTATIVE <br /> 20 Civic Center Plaza, M-29 � n <br /> David Aguirre U. <br /> Santa Ana,CA 92701 <br /> 631613CE8CB24C3... <br /> ©1988-2013 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2013/04) The ACORD name and logo are registered marks of ACORD <br />