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TOWNPUB-01 SKURUBA
<br />,dâ–ºcoRO CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />9/24/2025
<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 License # 0757776
<br />CONTACT Sara Scheuneman
<br />NAME:
<br />PHONE FAX
<br />(A/C, No, Ext): (951) 779-8534 No):(951) 231-2572
<br />HUB International Insurance Services Inc.
<br />PO Box 5345
<br />Riverside, CA 92517
<br />E-MAIL-ADDRESS: Cal-CPU@Hubinternational.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA:Continental Casualty Company
<br />20443
<br />INSURED
<br />INSURER B: United Financial Casualty Company
<br />11770
<br />INSURERC:Oak River Insurance Company
<br />34630
<br />Townsend Public Affairs, Inc.
<br />INSURER D: Lloyd's Syndicate #2623/623
<br />1401 Dove St, Ste 430
<br />Newport Beach, CA 92660-2420
<br />INSURER E
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMRFR- REVISION NUMRFR-
<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
<br />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 />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$
<br />1,000,000
<br />rl
<br />CLAIMS -MADE X OCCUR
<br />X
<br />X
<br />8034762328
<br />8/31/2025
<br />8/31/2026
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$
<br />1,000,000
<br />MED EXP (Any oneperson)
<br />$
<br />10,000
<br />PERSONAL & ADV INJURY
<br />$
<br />1,000,000
<br />GENT
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$
<br />2,000,000
<br />X
<br />POLICY PRO LOC
<br />PRODUCTS-COMP/OPAGG
<br />$
<br />2,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$
<br />1,000 000
<br />BODILY INJURY Perperson)
<br />$
<br />ANY AUTO
<br />X
<br />862859129
<br />8/28/2025
<br />2/28/2026
<br />OWNED SCHEDULED
<br />AUTOS ONLY X AUTOS
<br />BODILY INJURY Per accident
<br />$
<br />PROPERTY DAMAGE
<br />ccident
<br />Per accident)
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$
<br />5,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />8034762331
<br />8/31/2025
<br />8/31/2026
<br />AGGREGATE
<br />$
<br />5,000,000
<br />DED X RETENTION $ 10,000
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/ R/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />EXCLU
<br />(Mandatory in NH)
<br />N / A
<br />X
<br />TOWC635486
<br />8/31/2025
<br />8/31/2026
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$
<br />1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$
<br />1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$
<br />1,000,000
<br />D
<br />Professional Liab.
<br />W301DF240401
<br />8/31/2024
<br />9/30/2025
<br />Ret: $5k; EA. Claim
<br />2,000,000
<br />D
<br />Professional Liab.
<br />W301DF240401
<br />8/31/2024
<br />9/30/2025
<br />Aggregate
<br />4,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Revised 09/24/2025: This certificate rescinds and supersedes any and all prior certificates issued on behalf of the Named Insured.
<br />City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers are Additional Insured with regard to the General Liability policy,
<br />when required by written contract, per the attached endorsement form SB146932G 10/19, Waiver of Subrogation included. Waiver of Subrogation applies to
<br />the Auto Liability policy, when required by written contract, per the attached endorsement form 2367 06/10. Waiver of Subrogation applies to
<br />the Workers
<br />Compensation policy, when required by written contract, per the attached endorsement form WC990410C 01/19.
<br />CERTIFICATE HOLDER APPROVED CANCELLATION
<br />By Tu Tran Nguyen at 9:28 am, Sep 29, 2025
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana TU Tran Digitally signed by THE EXPIRATION DATE THEREOF, NOTICE WILL BE
<br />Y TuTranNguyen ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attention: PWA - Water Resources Date: 2025.09.29
<br />220 S Daisy Ave N g u ye n 09:29:07-07'00'
<br />DELIVERED IN
<br />Santa Ana, CA 92703 AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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