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DATE(MM/DD/YYYY)
<br /> A`�" CERTIFICATE OF LIABILITY INSURANCE
<br /> 73/27/2025
<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 CN A O ME:NTACT
<br /> Gre ling COI Specialist
<br /> Edgewood Partners Insurance Center PHONE FAX
<br /> 3780 Mansell Rd. Suite 370 A/C No Ext: 770.552.4225 'C'No):
<br /> Alpharetta GA 30022 ADDRESS: greylingcerts@greyling.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA: National Union Fire Ins Cc of Pittsburg 19445
<br /> INSURED KIMLASS INSURERB:Allied World Assurance Co(U.S.)Inc. 19489
<br /> Kimley-Horn and Associates, Inc.
<br /> 421 Fayetteville Street, Suite 600 INSURERC: New Hampshire Insurance Company 23841
<br /> Raleigh, NC 27601 INSURER D: Lloyd's of London 85202
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:24041175 REVISION NUMBER:
<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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR I POLICY NUMBER MM/DD/YYYY MM/DDIYYYY
<br /> A X COMMERCIAL GENERAL LIABILITY GL5268169 4/1/2025 4/1/2026 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea occurrence $1,000,000
<br /> X Contractual Liab MED EXP(Any one person) $25,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> POLICY� ECT � LOC PRODUCTS-COMP/OPAGG $4,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY CA4489663 AOS 4/1/2025 4/1/2026 COMBINED SINGLE LIMIT $2,000,000
<br /> A ( ) Ea accident
<br /> X ANY AUTO CA2970071 (MA) 4/1/2025 4/1/2026 BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> B X UMBRELLALIAB X OCCUR 03127930 4/1/2025 4/1/2026 EACH OCCURRENCE $5,000,000
<br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
<br /> DED X RETENTION$1 n rIno $
<br /> C WORKERS COMPENSATION WC067961230(AOS) 4/1/2025 4/1/2026 X PER oTH-
<br /> C AND EMPLOYERS'LIABILITY YIN WC013711885(CA) 4/1/2025 4/1/2026 STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE [-W] E.L.EACH ACCIDENT $2,000,000
<br /> OFFICER/MEMBER EXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $2,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000
<br /> D Professional Liability B0146LDUSA2504949 4/1/2025 4/1/2026 Per Claim $2,000,000
<br /> Aggregate $2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Re: On call City of Santa Ana; Michael Ledbetter.The City of Santa Ana, its officers,employees,agents,volunteers&representatives are named as Additional
<br /> Insureds with respects to General Liability where required by written contract.The above referenced liability policies with the exception of workers
<br /> compensation&professional liability are primary&non-contributory where required by written contract.Should any of the above described policies be cancelled
<br /> by the issuing insurer before the expiration date thereof,30 days'written notice(except 10 days for nonpayment of premium)will be provided to the Certificate
<br /> Holder.Waiver of Subrogation in favor of Additional Insured(s)where required by written contract&allowed by law.
<br /> Tu Tran Digitally signed by Tu
<br /> Tran Nguyen APPROVED
<br /> Nguyen Date:2025.04.03
<br /> 09:00:42-07'00'
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 9:00 am,Apr 03,J20225
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana
<br /> 20 Civic Center Plaza, M-30; AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701-0000 4— J_
<br /> @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE
<br />
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