|
,a`oRo° CERTIFICATE OF LIABILITY INSURANCE
<br />/YYW)
<br />DATE 6(MM/DD(MMIDD5
<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
<br />Inszone Insurance Services, LLC
<br />2721 Citrus Road, Suite A
<br />Rancho Cordova, CA 95742
<br />CONTACT
<br />NAME: Certificate Team
<br />PHONE FAX
<br />A/C No EXt: 877-308-9663 A/c,No:916-400-2625
<br />ADDRESS: certs@inszoneins.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: CFC Underwriting
<br />12831
<br />License#:OF82764
<br />INSURED DENOVOP-01
<br />De Novo Planning Group, Inc.
<br />1020 Suncrest Lane, Suite 106
<br />INSURERB: United Financial Casualty Co.
<br />11770
<br />INSURERC: Starstone Specialty Insurance Co.
<br />44776
<br />INSURERD: Hartford Casualty Insurance Company
<br />29424
<br />El Dorado Hills, CA 95762
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER:740648433 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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />Y
<br />Y
<br />PSNO140348538
<br />4/29/2025
<br />4/29/2026
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE OCCUR
<br />PREMISES DAMAGE TO
<br />PREMISES Ea occurrence)
<br />ccurrence
<br />$ 250,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />POLICY PRO ❑ LOC
<br />JECT
<br />X
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />Hired & Non -owned
<br />$ 1,000,000
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />994357605
<br />3/15/2025
<br />9/15/2025
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED X SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />FIR ERTYDAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />C
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />CSX00090224P-02
<br />4/29/2025
<br />4/29/2026
<br />EACH OCCURRENCE
<br />$1,000,000
<br />X
<br />AGGREGATE
<br />$ 1,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />Y
<br />57WECZ03688
<br />4/29/2025
<br />4/29/2026
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICE R/MEMBER EXCLUDED? ❑
<br />N/A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />A
<br />Professional Liability
<br />PSNO140348538
<br />5/7/2025
<br />5/7/2026
<br />Aggregate/Each Claim
<br />$2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Additional Insured on the General Liability and Auto Liability. Primary and Non -Contributory on the General Liability and Auto Liability. Waiver of Subrogation on
<br />the General Liability, Auto Liability and Workers Compensation. Excess follows form, subject to the terms and conditions of the policy. Dlgitallysigned
<br />Tu Tran by Tu Tran
<br />The aforementioned coverage is provided to the extent in the attached forms for: City of Santa Ana. Ng°ye°
<br />9 p v Nguyen Date:2025.06.1
<br />11:13*55-07'00'
<br />APPROVED
<br />CERTIFICATE HOLDER
<br />CANCELLATION By Tu Tran Nguyen at 11:13 am, Jun 11, 2025
<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 />Planning and Building Agency
<br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92701 � f
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
|