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DAVITAU-01 LBU RRI LL <br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)8/29/2024 <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 CONTACT Lisa Burrill <br />NAME: _ <br />Acrisure Southwest Partners Insuran Services, LLC • PHONE ea/uv <br />4000 Westerly Place (A/C, No Ext) n <br />Suite 110 E-MAILngie liburri acrisur .com <br />Newport Beach, CA 92660 <br />NAIC # <br />- Ant <br />Jr I I I goo V %-%040 <br />INSURED <br />David Taussig & Associ s Inc. <br />dba DTA <br />18201 Von Karman Av <br />Suite 220 <br />Newport Beach, CA 92612 <br />riiri11/ =I -7•rrl �S <br />INSURF i A Sentiner Insurance Company, Ltd 11000 <br />INSU- .ER BVa <br />i A I n man 38342 <br />JRF::..N a&Ya s Y M e C an y 25496 <br />.SURER D : o I Ins an 29424 <br />INSURER E : it d ni I s e Com an 18058 <br />INSURER F : Hartford Fire Insurance Company 19682 <br />R1=\/ICI[1N NI IMRFR• <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 <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 />I COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 290009000 <br />CLAIMS -MADE F_X OCCUR <br />X <br />72SBAAP5439 <br />2/24/2024 <br />2/24/2025 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />190009000 <br />$ <br />MED EXP (Any oneperson) <br />$ 109000 <br />PERSONAL & ADV INJURY <br />$ 290009000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 490009000 <br />POLICY a JERC LOC <br />PRODUCTS - COMP/OP AGG <br />$ 490009000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />190009000 <br />$ <br />BODILY INJURY Perperson) <br />$ <br />X ANY AUTO <br />BA040000030599 <br />12/19/2023 <br />12/19/2024 <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY Per accident <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />C <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 530009000 <br />AGGREGATE <br />$ 590009000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />85717R241 ALI <br />2/24/2024 <br />2/24/2025 <br />DED I I RETENTION $ <br />$ <br />D <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? HN/A <br />(Mandatory in NH) <br />72WECEU2873 <br />9/1/2024 <br />9/1/2025 <br />X PER I 1OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 190009000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />190009000 <br />$ <br />E <br />Prof. Liab./Claims <br />PHSD1835820 <br />11 /1 /2023 <br />11 /1 /2024 <br />Limit <br />290009000 <br />F <br />Crime <br />72 BDD HP8140 <br />6/14/2024 <br />6/14/2025 <br />190009000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />cityclerk@santa-ana.org; FVillareal@santa-ana.org <br />—Cyber Liability coverage with State National Insurance Company, Inc. - Policy #EHJ-ADN02027372 Eff: 7/22/24 - 7/22/25. Limit $2,000,000 <br />Excess follows form over General Liability, Automobile Liability, and Employers Liability <br />"THIS IS A WC POLICY RENEWAL ONLY. ONLY WC ENDORSEMENTS WILL BE ATTACHED. <br />ALL PREVIOUSLY ISSUED GL, AUTO, AND PROF. LIAB. ENDORSEMENTS ARE STILL VALID AND WILL NOT BE ATTACHED. <br />SEE ATTACHED ACORD 101 <br />C_1=RTI1=IC_AT1= I-I[11 nl=P C_ANC_FI I ATI[1N <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />CITY OF SANTA ANA <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92701 <br />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 />