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ACC DATE (MNrLDm'-'YI ACOW" OF LIABILITY INSURANCE 03/13/2024 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(ios) 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 STATE FARM INSURANCE NAmE; GARY BLACKBURN GARY BLACKBURN, AGENT L1C# 0490552 PHONE9 94��s1-off_ _ FAX.Noi:949..5�� E-MAIL 23881 VIA FABRICANTE, STE 506 ADDRESS. GARY.BLACKBURN BBCZOSTATEFARM.COM �� MISSION VIEJO, CA 92691 INSURERIS) AFFORDING COVERAGE NAICa INSURER A: State Farm Mutual Automobile Insurance Comaan r INSURERB: ___ 25178 INSURED DIVERSIFIED WATERSCAPES, INC 27324 CAMINO CAPISTRANO STE_ 213 LAGUNA NIGUEL, CA 92677 INSURER C: INSURER D. INSURER E INSURER F : COVERAGES rIPPTIFICATF NI uUll vo. APvI¢Int',t hu tnnul=o• 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; L1R TYPE OF INSURANCE ADD L BRA POLICY NUMBER POLICY EFF MMMDIYYYYI POLICY EXP immiDDlYYYY T_ I LIMITS GENERAL LIABILITY OOMMERCIAL GENERAL UABILITY CLAIMS -MADE ❑ OCCUR II I EACH OCCURRENCE PE I S E W PREMISES Ea accurrancs $ $ MED EXP (Any one person) $ PERSONAL & AOV INJURY _ $ T GENERAL AGGREGATE S -Y— GFFNE'L AGGREGATE LIMIT APPLIES PER s POLICY PRO LOC PRODUCTS - COMP/OP AGG $ $ A � AUTOMOBILE LIABILITY ANY AUTO ALLOWNED AUTC"SULED AUTOS I x AUTOS NON-OANED HIRED AUTOS x AUTOS Y Y 3321267-E05 75L 828 360T-E09-7SH 1i10512023 11108f2Ci23 t1lU5l2024 11I09}2ii24 CE® a6 NED SINGLE LIMIT nli $ I BODILY INJURY (Per Parson) S 1.000,000 BODILY INJURY (PeraccidenC) $ 1,000,000 PROPERTY DAMAGE - Psractident) __„ 5 1,fl00,1300 S UMBRELLA LIAR OCCUR EXCESS LIAR CLAIMS -MADE' EACH OCCURRENCE AGGREGATE $ ]� DED RETENTION $ $ i WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PRCPRIEYIN TORQARTNERIEXECUnVE j OFFICEIM EMBER FXCLU DED? ❑ (Mandatary In NH) 11 yes, de under rvw NIA WC ST.ATU- I OTH- ,-IMITS' E.L. EACH. ACCIDENT ' 5 E.L. O€SFA$E - EA FMPLOYE -- $ E.L. DISEASE- POLICY LIMIT S lI f DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES (Attach ACORD 10i, Additional Remarks Schedule, It mote space Is required) THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS AND REPRESENTATIVES ARE ADDITIONAL INSUREDS. 628 3607-EO9-75H IS AN ENOL POLICY 332 1267-EO5-75L IS A 2006 TOYOTA TUNDRA CERTIFICATE OFF INSURANCE SHALL PROVIDE THIRTY (30) DAY PRIOR WRITTEN NOTICE OF CANCELLATION FICATE HOLDER CITY OF SANTA ANA RISK MANAGEMENT 20 CIVIC CENTER PLAZA, 4TH FLOOR SANTA ANA, CA 92701 ACORD 25 (2010105) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE. EXPIRATION GATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE 0 1988-2010 C( The ACORD name and logo are registered marks of ACORD oR,N F Risk MougmumtDivisian REVIEWED & APPROVED BY: o, z A Aav44 Risk Management Specialist