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ACOCERTIFICATE OF LIABILITY INSURANCE `� DDIYYY) OA1103/2023 1/03/2RO® THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on is certificatedoes not confer rights to the certigca:_a h i ). V (/�� /+ NA : ex st s�If.� c1ey, Inc. A CeVe.JO PO Box 6078je/ A Acevedo Palo Alta, CA 943D6 Date:20 PHONE (855)222-5919 F A/c No), E-MAIL$. sUppert@DEXLIDSGfdnce.Com INGCOVERAGE NAIC# INSURERA: State National Insurance Company, Inc, 12831 edo_ INSURED _07INSURER Real Mini Diggers LLC 41 Oak Tree Ln B INSURERC: INSURER O: INlne, CA 92612 INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: 155335472 REVISION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DD/VY POLICY EXP MWDO LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR ETCH OCCURRENCE $1,000,000.00 DAM T TED PREMISES Ea occurrence $100,000.00 MED EXP Any one person) $15,000.00 PERSONAL& ADV INJURY .00 A X X NXTKTBRCRM-02-GL 08/16/2023 08/16/2024 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE .00 GEN'L X POLICY JET LOC PRODUCTS - COMP/OP AGO.00 OTHER AUTOMOBILELIABILITY COMBINED SINGLE LIMIT Ea accident V00 BODILY INJURY (Per person) ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Par (a )HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Peraccidenl UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE LED I I RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE IER E.L.EACH ACCIDENT $ ANYPROPRIETORIPARTNEWEXECUTIVE OFFICER/MEMBEREXCLUDEDT NIA E.L. DISEASE -EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS bull. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addillonal Remarks Schedule, may be allsched if more space Is required) The Certificate Holder is City Of Santa Ana Public Works Agency. A Waiver of Subrogation applies in favor of this Certificate Holder on the following policies: General Liability. This Certificate Holder is an Additional Insured on the General Liabilitypolicy on a prima and non-contributory basis. All Certificate Holder privileges apply only if required by written agreement between the Certificate Holder and the insured, and are subject to po Icy terms and conditions. Santa Ana Public Works Agency . Center Piz # M-21 ,na, CA 92701 LIVE CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC 62, © 1988.2015 ACORD Risk otQ;w o�l�rycPr°. I&TflEwE SAPPRc^vE�O�BIY' j ' q" f�4ra/so , ® Risk Management Specialist ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD