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ATE IMWDDIYYYY) A`O/2E7® CERTIFICATE ©F LIABILITY INSURANCE D06/18/2026 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: GARY BLACKBURN GARY BLACKBURN, AGENT LIC#0490552 PH CNMo.E .949-581-0800 FAX No:949-581-1400 E-MAIL 23881 VIA FABRICANTE, STE 506 ADDRESS:GARY.BLACKBURN.B8CZ STATEFARM.COM I $MISSION VIEJO, CA92691 INSURER AFFORDING COVERAGE NAIL INSURER A:State Farm Mutual Automobile Insurance Company 51 INSURED SIMMSGEIGER, MARIA& PATRICK AND INSURERB: DIVERSIFIED WATERSCAPES, INC INSURERC: 27324 CAMINO 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. ILTR TYPE OF INSURANCE POLICY NUMBER MM)DO EFF MWDR EXP LIMITS GENERAL LIABILITY EACH OCC-1 RENTED URRENCE $ COMMERCIAL GENERAL LIABILSTY PREMISES Ea occurrence $ CLAIMS-MADE71 OCCUR MED EXP(Any one.person) $ PERSONAL$ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LMi1T APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY F1 PRO- LOC --- dOSINGLEIMI aA AUTOMOBILE LIABILITY _ci8nt $ ANYAUTO Y $ _ 3321267-E05-75Y 05/05/2026 11/05/2026 OODILY INJURY(Per person) $ 1,000,000 ALL OWNED Ix SCHEDULED BODILY INJURY(Per accident) $ 1,000AUTOS 000 628 3607-E09-75W 05/09/2026 111091202ENON-OWNED PROPERTY DAMAGE1,000,000 X HIRED AUTOS AUTOS Peraccident $ E UMBRELLA UAS OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ _ DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN T RY LI }TS ER ANY PROPRIETORIPARTNER!EXECUTIVE ❑ NIA❑ E.L.EACH ACCIDENT $ OFFICE/MEMBER EXCLUDED? (Mandatory In NH) E-L-DISEASE-EA EMPLOYE $ If yes,describe under _ E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) THE CITY OF SANTA ANA,ITS OFFICERS,EMPLOYEES,AGENTS AND REPRESENTATIVES ARE ADDITIONAL INSUREDS. 628 3607-ED9-75S 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 CANCELLATION -:[APPROVED By Tu Tran Nguyen at 3:14 pm,Jun 18,2026 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 REPRES TINE SANTA ANA,CA 92701 O 8- A O RPORATION. Ali rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of CO 1001486 132849.E 11-15-2010