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DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 09/03/2025
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
<br /> THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
<br /> POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
<br /> AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED,
<br /> subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not
<br /> confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> NUTMEG INS AGENCY INC/PHS NAME:
<br /> 76210775 PHONE (888)925-3137 FAX
<br /> (A/C,No,Ext): (A/C,No):
<br /> The Hartford Business Service Center
<br /> 3600 Wiseman Blvd E-MAIL
<br /> San Antonio,TX 78251 ADDRESS:
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURED INSURERA: Hartford Underwriters Insurance Company 30104
<br /> Hera Property Registry,LLC INSURER B: Hartford Fire Insurance Company 19682
<br /> 1917 S HARBOR CITY BLVD INSURERC:
<br /> MELBOURNE FL 32901-4747
<br /> INSURER D
<br /> INSURER E:
<br /> 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
<br /> TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSR WVD MM/DD/YYYY MM/DD/YYYY
<br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED $1,000,000
<br /> PREMISES Ea occurrence
<br /> X General Liability MED EXP(Any one person) $10,000
<br /> A X X 76 SBU AY9R14 07/12/2025 07/12/2026 PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> X JECT LOC PRODUCTS-COMP/OPAGG $2,000,000
<br /> POLICY❑PRO- ❑
<br /> OTHER:
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person)
<br /> A ALL OWNED SCHEDULED 76 SBU AY9R14 07/12/2025 07/12/2026 BODILY INJURY(Per accident)
<br /> AUTOS AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS X AUTOS (Per accident)
<br /> X UMBRELLA LAB X OCCUR EACH OCCURRENCE $1,000,000
<br /> EXCESS LAB CLAIMS- AGGREGATE $1,000,000
<br /> A MADE 76 SBU AY9R14 07/12/2025 07/12/2026
<br /> DED RETENTION$ 10,000
<br /> WORKERS COMPENSATION PER I OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> ANY Y/N E.L.EACH ACCIDENT
<br /> PROPRIETOR/PARTNER/EXECUTIVE N/A
<br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE
<br /> (Mandatory in NH)
<br /> If yes,describe under E.L.DISEASE-POLICY LIMIT
<br /> DESCRIPTION OF OPERATIONS below
<br /> FailSafe Technology Errors or Each Wrongful Act $1,000,000
<br /> B 76 SBU AY9R14 07/12/2025 07/12/2026 Omissions Liability Aggregate A re ate Limit $1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Those usual to the Insured's Operations.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Santa Ana, its City Council, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
<br /> officers,off icia Is,employees,agents, & BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED
<br /> volunteers;Planning and Building Agency IN ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 CIVIC CENTER PLZ AUTHORIZED REPRESENTATIVE
<br /> SANTA ANA CA 92701
<br /> ©1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br /> Tu Tran T�Tallysigne by APPROVED
<br /> Date:2025.09.03 By Tu Tran Nguyen at 2:46 pm,Sep 03,2025
<br /> Nguyen 14:4723-07'00'
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