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DATE(MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE 5/12/2025
<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 CONTACT
<br /> NAME: Lauren Mayer
<br /> McGriff Insurance Services LLC PHONE FAX
<br /> 2200 N. Commerce Parkway A/C No Ext: 954-385-6022 vc,No:866-802-8684
<br /> E-MSuite 200 ADDRESS: lauren.mayer@mcgriff.com
<br /> Weston FL 33326 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA: Berkshire Hathaway Homestate Ins Co 20044
<br /> INSURED 132SAFEBLLC INSURERB: Everest Indemnity Insurance Company 10851
<br /> Interwest Consulting Group, Inc. INSURERC: Everest Premier Insurance Company 16045
<br /> 444 N Cleveland Ave;
<br /> Loveland CO 80538 INSURERD: Bridgeway Insurance Company 12489
<br /> INSURERE: Great American E&S Insurance Company 37532
<br /> INSURER F: Great American E&S Insurance Company 37532
<br /> COVERAGES CERTIFICATE NUMBER:507503014 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 INSD WVD POLICY NUMBER MM/DD MM/DD
<br /> B X COMMERCIAL GENERAL LIABILITY Y Y CF3GL00415241 10/3/2024 10/3/2025 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE � OCCUR PREMISES DAMAGE TO
<br /> PREMISES Ea occurrence)
<br /> ccurrence $300,000
<br /> X 10,000 MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> X POLICY� PECOT- LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY Y Y CF3CA00337241 10/3/2024 10/3/2025 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED LX
<br /> NON-OWNED FIR ERTYDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> Excess per occ/agg $1,000,000
<br /> D UMBRELLA LIAB X OCCUR Y Y 8EA7XL000207903 10/3/2024 10/3/2025 EACH OCCURRENCE $10,000,000
<br /> E 011170903 10/3/2024 10/3/2025
<br /> X EXCESS LAB CLAIMS-MADE AGGREGATE $10,000,000
<br /> DED X RETENTION$n $
<br /> A WORKERS COMPENSATION Y SAWC666825 5/12/2025 5/12/2026 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE FN] N/A E.L.EACH ACCIDENT $1,000,000
<br /> OFFICE R/M EMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> F Professional Liability TER5325879 10/3/2024 10/3/2025 Each Claim/Aggregate 10,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> Excess policy#140002058 effective 10/03/2024-10/03/2025-QBE Ins Corp NAIC#39217-Limits-$5,000,000 part of$10,000,000 Excess of$5,000,000.
<br /> Crime coverage—Federal Insurance Company, NAIC 20281-Policy#J06767825 effective 10/3/24-10/3/25; Limit$1,000,000 DED$10,000.Technology Errors
<br /> &Omissions and Cyber Coverage-Coalition Insurance Company NAIC#29530-Policy#C4LRS025767CYBER effective 10/3/24-10/3/25. Each Claim/AGG
<br /> $3,000,000 DED$100,000.
<br /> City of Santa Ana, its City Council,officers,officials,employees,agents,and volunteers are additional insureds with respects to general and automobile
<br /> liability,with a written contract.Waiver of Subrogation applies for general and automobile liability and workers compensation in favor of the additional insured,
<br /> with a written contract. Coverage is primary and non-contributory in favor of the additional insured. Notice of Cancellation is 30 days,except 10 days for
<br /> non-payment.
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By Tu Tran Nguyen at 2:15 pm,Jun 09,2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Tu Tran Digitally signed by THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> DaTu te:
<br /> Nguyen ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana Nguyen D:15:54-07'0'
<br /> 20 Civic Center PI, M-93 4:75:54-07'00'
<br /> P.O. Box 1988,Attn:Emily Ho;PWA Dev Eng Mgmt Aide AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702 4J;4t
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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