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76/30/2025
<br /> E(MM/DDYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE /Y
<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
<br /> Risk Strategies Company PHONE FAX
<br /> 500 N Brand Ste. 1600 A/C No Ext: 818-857-5010 A/C No):
<br /> 818-274-0325
<br /> Glendale, CA 91203 ADDRESS:
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> www.risk-strategies.com INSURERA: Palomar Excess and Surplus Insurance Co 16754
<br /> INSURED INSURERB: Palomar Specialty Insurance Company 20338
<br /> Aspen Environmental Group INSURERC: Insurance Company of the West 27847
<br /> 5020 Chesebro Rd., Suite 200
<br /> Agoura H Ills CA 91301 INSURER D: The Hanover American Insurance Company 36064
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 86055180 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 POLICYNUMBER MM/DD MM/DD
<br /> A / COMMERCIAL GENERAL LIABILITY / / CEEPP-25-0000356-00 7/1/2025 7/1/2026 EACH OCCURRENCE $1,000,000
<br /> Am
<br /> CLAIMS-MADE Iv] OCCUR PREM SESOEa occurrDence $500,000
<br /> MED EXP(Any one person) $25,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000
<br /> POLICY ✓� ECT �✓ LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> 1� PRO-
<br /> OTHER: Deductible $2,500
<br /> B AUTOMOBILE LIABILITY CPEAP-25-0000358-00 7/1/2025 7/1/2026 (CEO,acccidentSINGLE LIMIT $1,000,000
<br /> ✓ ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY ✓ AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> ✓ AUTOS ONLY ✓ AUTOS ONLY Per accident
<br /> V Comp ded$1, QD Collision ded$ ,000 $
<br /> A UMBRELLA LAB / OCCUR CEEXP-25-0000357-00 7/1/2025 7/1/2026 EACH OCCURRENCE $4,000,000
<br /> ,/ EXCESS LAB CLAIMS-MADE AGGREGATE $4,000,000
<br /> ✓ DED RETENTION$ $
<br /> C WORKERS COMPENSATION ✓ WVE 5056103 05 7/1/2025 7/1/2026 �/ STATUTE EERH
<br /> AND EMPLOYERS'LIABILITY Y/N
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? Fy] N/A
<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 /> A Professional Liab.Retro Date:7-27-95 CEEPP-25-0000356-00 7/1/2025 7/1/2026 1,000,000 Per Claim Ded$25,000
<br /> A Pollution CEEPP-25-0000356-00 7/1/2025 7/1/2026 1,000,000 per occurrence Ded$2,500
<br /> D Business Personal Property FZ3 J410328 02 7/1/2025 7/1/2026 Limit:$734,184 Ded:$1,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> Project Name: City of Santa Ana On Call
<br /> Project Number: 3627
<br /> The City,its officers,officials,employees,and volunteers are to be covered as additional insureds on the CGL policy when required by written
<br /> contract with respect to liability arising out of work or operations performed by or on behalf of the Consultant including materials, parts,or
<br /> equipment furnished in connection with such work or operations. TU Tldn Digital ned by
<br /> Tu Tran Nguyen
<br /> Nguyen 1 z 01-0 00- APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 2:26 pm,Jul 16,2025
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Planning and Building A ency ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza (M-20)
<br /> PO Box 1988
<br /> Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE
<br /> Ile
<br /> RSC Insurance Brokerage
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br /> 86055180 125-26 GL, Auto, Umbl, Prof. Liab & WC I Irma Cortez 16/30/2025 6:03:22 PM (PDT) I Page 1 of 10
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