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® DATE(MM/DD/YYYY) <br /> ACC OR" <br /> � CERTIFICATE OF LIABILITY INSURANCE 1/7/2026 <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: FirstMark Insurance Group,Inc. <br /> FirstMark Insurance Group,Inc. PHONE 425-582-9037 ) (425)-608-9187 <br /> p A/C,No,Ext: ( ) (A/C,No <br /> Agent:Dan Fortune ADDRESS: commercial@firstmarkinsurance.com <br /> 12918 Mukilteo Speedway Suite C23,PMB 603 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Lynnwood, WA 98087 INSURER A: Mount Vernon Fire Insurance Company 26522 <br /> INSURED INSURER B: <br /> BAY SPROUTS LLC DBA BEAN SPROUTS CAFE INSURER C: <br /> 3902 Milwaukee St,Unit#14725 INSURER D: <br /> INSURER E: <br /> MADISON, WI 53708 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 /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> ETT— <br /> CLAIMS-MADE ❑OCCUR PREMISES(Ea occurrence) $ <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY ❑PRO ❑ <br /> JECT LOC PRODUCTS-COMP/OP AGG $ <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY (Ea accident) $ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED HKUHEK I Y DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY (Per accident) <br /> UMBRELLA LAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LAB HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> ORKERS COMPENSATION - <br /> PER 1R— <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> Each Common Cause 1,000,000 <br /> A LIQUOR LIABILITY LQ2016356A 11/13/2025 11/13/2026 Aggregate 2,000,000 <br /> D7 hall si nedb <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) D,rrao Ng°Ye" <br /> Dace:202e.01.07 <br /> Re:Agreement:A-2024-026.Cafe Services at Zoo 1801 E Chestnut Ave,Santa Ana,CA 92701 Nguyen 1214:08-08'00' <br /> Evidence of Insurance <br /> APPROVED <br /> By Tu Tran Nguyen at 12:13 pm,Jan 07,2026 <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 /> Santa Ana Zoo AUTHORIZED REPRESENTATIVE <br /> 1801 E Chestnut Ave. Marv_LQr,­ <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 <br />