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CERTIFICATE OF LIABILITY INSURANCE °07/17/20225 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 INSURERS), 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 STATE FARM INSURANCE NAME: GARYBLACKBURN GARY BLACKBURN, AGENT LIC#0490552 we N t 949-581-0800 NE arc No)-949-581-1400 23881 VIA FABRICANTE, STE 506 ADOA�ss:GARY.BLACKBURN.B8CZ STATEFARM.COM MISSION VIEJO, CA 92691 INSURERS AFFORDING COVERAGE NAIC# ` INSURER A:State Farm Mutual Automobile Insurance Company 25178 INSURED SIMMSGEIGER, MARIA& PATRICK AND INSURERB: DIVERSIFIED WATERSCAPES, INC INSURERC: 27324 GAMING CAPISTRANO STE. 213 INSURERD: LAGUNA NIGUEL, CA 92677 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFF MNOGOOrr YY LTR LIMITS GENERAL LIABILITY ❑❑ EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ _ CLAIMS-MADE n OCCUR MED EXP(Any one person) $ PERSONAL B,ADVINJURY $ GENERALAGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- LOC $ A AUTOMOBILE LIABILITY Y Y a aBIGdeDt SINGLE L1M€T $ 332 1267-E05-76U 11/05/2025 11/05/2026 BODILY MJURY(Per person) ANYAUTD $ 1,000,000 ALL OS X SCHEDULED BODILY INJURY(Peraccideal) $ 1,000,000 AU T PROPERTY DAMAGE Per accident AUTOS NON-OWNED 628 3607-E09-75S 05/09/2025 05/0912026 1,000,000 X HIRED AUTOS )( $ AUTOS _ $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LUAS CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS'LIABILITY YPN� TORY L MITS ER ---- ANY PROPRIETOR/PARTNER/EXECUTIVE IJ NIA E.L.EACH ACCIDENT $ OFFICE/MEMBER EXCLUDED? (Mandatory In NHI E.L.DISEASE-EA EMPLOYEd $ If yes,describe under E.L.DISEASE-POLICY LIMIT I $ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,AddlUonal Remarks Schedule,it more apace Is required) THE CITY OF SANTA ANA, ITS OFFICERS,EMPLOYEES,AGENTS AND REPRESENTATIVES ARE ADDITIONAL INSUREDS. 628 3607-E09-75S IS AN ENOL POLICY 332 1267-E05-75U IS A 2006 TOYOTA TUNDRA CERTIFICATE OF INSURANCE SHALL PROVIDE THIRTY(30)DAY PRIOR WRITTEN NOTICE OF CANCELLATION CERTIFICATE HOLDER APPROVED CANCELLATION By Tu Tran Nguyen at 4:21 pm,Mar 20,2026 CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RISK MANAGEMENT ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA,4TH FLOOR AUTHORIZED REPRE5E7 SANTA ANA, CA 92701 O 1988-2010,(CpRff CORPORATION. Ali rights reserved. ACORD 25(2010106) The ACORD name and logo are registered marks of AC t5l 1001486 132849.6 11-15-2010