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DATE(MM/DD/YYYY)
<br /> ACCOR" CERTIFICATE OF LIABILITY INSURANCE
<br /> 04/03/2025
<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 Sarah Sta Ana
<br /> NAME:
<br /> Calender-Robinson Company,Inc. a/cNr o Ext: (415)978-3800 a/c,No): (415)978-3825
<br /> 0267063 E-MAIL sstaana@calrob.com
<br /> ADDRESS:
<br /> 233 Sansome St.Ste 508 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> San Francisco CA 94104 INSURERA: WestAmerican Insurance Company 44393
<br /> INSURED INSURER B: Ohio Security Insurance Company 24082
<br /> METROPOLITAN PLANNING GROUP INSURERC: Evanston Insurance Company 35378
<br /> 307 ORCHARD CITY DRIVE INSURER D: Employers Preferred Insurance Company 10346
<br /> SUITE 100 INSURER E: Mount Vernon Fire Insurance Company 26522
<br /> CAMPBELL CA 95008 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: CL254342579 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP
<br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDrence $ 500,000
<br /> MED EXP(Any one person) $ 15,000
<br /> A Y Y BKS(26)56609535 04/09/2025 04/09/2026 PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 4'000'000
<br /> JECT
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> ANYAUTO BODILY INJURY(Per person) $
<br /> B OWNED SCHEDULED BAS(26)56609535 04/09/2025 04/09/2026 BODILY INJURY(Pe r accide nt) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED �/ NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY /� AUTOS ONLY Per accident
<br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000
<br /> C X EXCESS LAB CLAIMS-MADE EZXS3196630 04/09/2025 04/09/2026 AGGREGATE $ 2,000,000
<br /> DED I X1 RETENTION $ 0 $
<br /> WORKERS COMPENSATION ER/� STATUTE EORH
<br /> AND EMPLOYERS'LIABI LI TY YIN 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> D OFFICER/MEMBER EXCLUDED? NIA Y EIG5234889-02 04/09/2025 04/09/2026
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> E
<br /> Professional Liability ach Claim $3,000,000
<br /> D PT2000323E 04/09/2025 04/09/2026 Aggregate Limit $3,000,000
<br /> Deductible Each Claim $10,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Digitally si ned
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are included as additional insured subject to the policy terms, Tu Trd n byTuTran
<br /> Nguyen
<br /> conditions,and exclusions. Nguyen Date:202s 0.03
<br /> 14:33:55-0 '00'
<br /> APPROVED
<br /> By Tu Tran Nguyen at 2:33 pm,Oct 03,2025
<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 Planning and Building Agency ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza,M-20
<br /> AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702 �Qt,(:ih t 4, �
<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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