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® DATE(MM/DD/YYYY)
<br /> ACC OR"
<br /> � CERTIFICATE OF LIABILITY INSURANCE 5/29/2025
<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: Rachel Garciano
<br /> Chrysalis Insurance Agency(Incorporated) PHONE ,A/C,No,Ext: 714 464-8080 (A/C No) (714)464-8070
<br /> 3001 Red Hill Ave,Ste.2-226 ADDRESS: service@ciapro.net
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Costa Mesa CA 92626 INSURER A: ADMIRAL INS CO 24856
<br /> INSURED INSURER B: AMGUARD INS CO 42390
<br /> Sunny Hills Associates Inc.d/b/a SUNNY HILLS RESTORATION INSURER C: MIDWEST EMPLOYERS CAS CO 23612
<br /> 1999 RITCHEY ST INSURER D: OHIO SECURITY INS CO 24082
<br /> INSURER E:
<br /> SANTA ANA CA 92705-5100 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 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 /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
<br /> x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE �OCCUR PREETT-
<br /> MISES(Ea occurrence) $ 100,000
<br /> X POLLUTION LIABILITY MED EXP(Any one person) $ 5,000
<br /> A X PROFESSIONAL LIABILITY Y Y FEI-ECC-35209-02 05/15/2025 05/15/2026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> x POLICY ❑ECT ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY (Ea accident) $ 1,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> B OWNED SCHEDULED AUTOS ONLY AUTOS
<br /> Y Y SUAU659174 04/10/2025 04/10/2026 BODILY INJURY(Per accident) $
<br /> /�
<br /> HIRED NON-OWNED HF<UHEK I Y DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY (Per accident)
<br /> UMBRELLA LAB x OCCUR EACH OCCURRENCE $ 1,000,000
<br /> E EXCESS LAB CLAIMS-MADE Y Y FEI-EXS-45093-02 05/15/2025 05/15/2026 AGGREGATE $ 1,000,000
<br /> DED I I RETENTION$ PRODUCTS/COMPLETI $ 1,000,000
<br /> WORKERS COMPENSATION ^ STATUTE ER
<br /> AND EMPLOYERS'LIABILITY
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000
<br /> COFFICER/MEMBER EXCLUDED? Fy] N/A Y BNUWC0164042 11/14/2024 11/14/2025
<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 /> Misc Equipment $55,000
<br /> D Commercial Property&Inland Marine BKS61278353 4/7/2025 4/7/2026 Property of Others $302,575
<br /> Systems Breakdown $302,575
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> See ACORD 101
<br /> TU Tra n e yT�aT�a�' APPROVED
<br /> Nguyen g Tu Tran Nguyen at 3:29 m,May 29,2025
<br /> Nguyen�ate:2025.05.29 YP Y
<br /> 15:30:22-07'00'
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division AUTHORIZED REPRESENTATIVE
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92701
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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