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ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br />16.�
<br />DATE(MM/DD/YYYY)
<br />1 06/03/2025
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />NAME: Mancela Aguirre
<br />HONE
<br />(PA/C./C. No. EAE: (714)779-6999 FAX , No): (714)779-6903
<br />McRae Associates Insurance Services
<br />1265 N. Manassero St Suite 303
<br />Anaheim, CA 92807
<br />E-MAIL
<br />maricela@mcraeinsurance. insure
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: Travelers Property Casualty Company of America
<br />25674
<br />INSURED
<br />INSURER B : TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
<br />25674
<br />INSURERC: GREAT AMERICAN INSURANCE COMPANY
<br />16691
<br />CROSSTOWN ELECTRICAL & DATA, INC.
<br />5454 DIAZ ST.
<br />INSURER D : St Paul Surplus Lines Insurance Company
<br />30481
<br />Irwindale, CA 91706
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 00001315-0 REVISION NUMBER: 750
<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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />I
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DDIYYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />DT22-CO-7W503833-TCT-25
<br />06/03/2025
<br />06/03/2026
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE X OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 3OO OOO
<br />X
<br />MED EXP (Any one person)
<br />$ 5,000
<br />Deductible $10,000
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4000000
<br />PRO -
<br />POLICY � ECT El LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 4,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILE LIABILITY
<br />Y
<br />Y
<br />810-7W449049-25-26-G
<br />06/03/2025
<br />06/03/2026
<br />COMBIB
<br />'aa acccideDtsINGLE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />X X
<br />AUTOS ONLY AUTOS ONLY
<br />C
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />TUE257205207
<br />06/03/2025
<br />06/03/2026
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION $ 0
<br />$
<br />A
<br />Y
<br />UB-7W504031-25-26-G
<br />06/03/2025
<br />06/03/2026
<br />X STATUTE EORH
<br />AND EMPLOYERS' LIABILITY
<br />AND EMPLOYERS'
<br />YERS' LIABTIONILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />N
<br />N I A
<br />E.L. DISEASE- EA EMPLOYEE
<br />$ 1,000,000
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE- POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />2nd Tier Umb. Policy
<br />Y
<br />Y
<br />EX-B4831416-25-NF
<br />06/03/2025
<br />06/0312026
<br />Each Occ/ Gene Agg
<br />$5,000,000
<br />D
<br />Prof. & Poll. Liab.
<br />Y
<br />Y
<br />ZCE-16P95095
<br />10/10/2024
<br />10/10/2025
<br />Each Occ/ Gen Agg
<br />$2 mill/ $4 mill
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />RE: ATMS AND COMMUNICATION SYSTEMS, ON CALL REPAIR SERVICES, JOB#4775-22
<br />THE CITY OF SANTA ANA ALONG WITH THEIR OFFICERS, OFFICIALS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED
<br />AS ADDITIONAL INSURED WITH RESPECTS TO THE ABOVE -MENTIONED POLICIES PER ATTACHED ENDORSEMENT(S).
<br />COVERAGE IS PRIMARY & NON-CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT, PER ATTACHED ENDORSEMENT
<br />FORMS. WAIVER OF SUBROGATION APPLIES, IF REQUIRED BY WRITTEN CONTRACT.
<br />continued on ACORD 101 Additional Remarks Schedule APPROVED
<br />CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 3:16 pm, Jun 10, 2025
<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 />DigitallyPisi dby
<br />20 CIVIC CENTER PLAZA M-30 Tu Tran
<br />,,my
<br />SANTA ANA, CA 92702 AUTHORIZED REPRESENTATIVE Date: 2025.06,10
<br />Nguyen
<br />15:16:45-07'00'
<br />(MAG)
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by MAG on 06/03/2025 at 08:54AM
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