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72/26/2025
<br /> (MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE
<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: Carrie Mulhern
<br /> Acrisure SouthWest Partners Insurance Services, LLC PHONE FAX
<br /> 4000 Westerly Place A/C No EXt: 909-726-7371 A/c,No):
<br /> Suite 110 ADDRESS: cmulhern@acrisure.com
<br /> Newport Beach CA 92660 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:OG18344 INSURERA: California Automobile Insurance Company 38342
<br /> INSURED DAVITAU-01 INSURERB:Starstone National Insurance Company 25496
<br /> DTA Public Finance, Inc.
<br /> 18201 Von Karman Ave, Suite 220 INSURERC: Hartford Casualty Insurance Company 29424
<br /> Irvine CA 92612 INSURERD: Philadelphia Indemnity Insurance Company 18058
<br /> INSURER E: Hartford Fire Insurance Company 19682
<br /> INSURERF: Hartford Underwriters Insurance Company 30104
<br /> COVERAGES CERTIFICATE NUMBER:2139643291 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 I POLICY NUMBER MM/DD/YYYY MM/DDIYYYY
<br /> F X COMMERCIAL GENERAL LIABILITY Y 72SBABJ3H19 2/24/2025 2/24/2026 EACH OCCURRENCE $2,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea or
<br /> $1,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
<br /> PRO-
<br /> POLICY� ECT1:1 LOC PRODUCTS-COMP/OPAGG $4,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY BAD40000030599 12/19/2024 12/19/2025 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> X 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 /> B X UMBRELLA LIAB X OCCUR 85717R252ALI 2/24/2025 2/24/2026 EACH OCCURRENCE $5,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000
<br /> DED RETENTION$ $
<br /> C WORKERS COMPENSATION 72WECEU2873 9/1/2024 9/1/2025 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> ❑
<br /> OFFICER/MEMBER EXCLUDED? NIA
<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 /> D Prof.Liab/CLAIMS PHSD1835820015 11/1/2024 11/1/2025 Agg/Per Claim Limit 2,000,000
<br /> E Crime 72 BDD HP8140 6/14/2024 6/14/2025 Limit 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> KDowns@santa-ana.org
<br /> -Cyber Liability coverage with State National Insurance Company,Inc.-Policy#EHJ-ADN02027372 Eff:7/22/24-7/22/25. Limit$2,000,000
<br /> —Excess follows form over General Liability,Automobile Liability,and Employers Liability
<br /> CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED. -A/I ATTACHED.
<br /> Digitallysigned APPROVED
<br /> Tu Tran N uyenT. an
<br /> N
<br /> Nguyen Dguyen
<br /> ale:2025.03.04
<br /> 09:5723-08'00' By Tu Tran Nguyen at 9:56 am,Mar 04, 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 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 CIVIC CENTER PLAZA
<br /> Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE
<br /> USA
<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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