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/ A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/13/2024 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 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Julie Bushinger NAME: North Risk Partners PHONE (763)536-8006 FAx A/C No Exf : A/C, No): P.O. Box 64016 E-MAIL ) ger@ p ulie.bushin northrisk artners.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # St Paul MN 55164 INSURERA: Great Northern Insurance Company 20303 INSURED INSURER B: Federal Insurance Company 20281 Clifton LarsonAllen LLP INSURERC: Chubb Indemnity Insurance Company 12777 220 South 6th Street INSURER D : Suite 300 INSURER E : Minneapolis MN 55402-1436 INSURER F : COVERAGES CERTIFICATE NUMBER: 24/25 Cert#3 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ® DAMAGE TO RENTED 1,000,000 CLAIMS -MADE OCCUR REMSES Ea o.urrrence $ -PREMISES MED EXP (Any one person) $ 10,000 1,000,000 A 35983569 12/31/2024 12/31/2025 PERSONAL &ADV INJURY $ LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- ElPRO ® POLICY JECT LOC MOTHER PRODUCTS-COMP/OPAGG $Included Combined Total $ 10,000,000 : AUTOMOBILE LIABILITY Cf;31*BB1�DSINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED 73572825 12/31/2024 12/31/2025 BODI LY I NJ U RY(Pe r accide nt) $ AUTOS ONLY AUTOS PROPERTY DAMAGE $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 50,000,000 AGGREGATE $ 50,000,000 B EXCESS LAB CLAIMS -MADE 79880747 12/31/2024 12/31/2025 DED I RETENTION $ 0 $ WORKERS COMPENSATION PER OTH- I AND EMPLOYERS' LIABILITY Y / N STATUTE I ER E.L. EACH ACCIDENT $ 1,000,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE N/A 71749276 12/31/2024 12/31/2025 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) [Job #: A169766 Job Type: ] The City, its officers, employees, agents, volunteers and representatives are included as additional insureds on General Liability per form 80-02-2367 Rev 5-07 and on Automobile per form 16-02-0292 Ed 4-11 when required in prior written contract. General Liability is primary and non-contributory per form 80-02-2367 Rev 5-07 and Auto Liability is primary per form 16-02-0292 Ed 4-11 when required in prior written contract. Waiver of Subrogation included on General Liability per form 80-02-2000 & on Auto per form 16-02-0292 when required in prior written contract. General Liability & Auto Policies have been endorsed to provide 30 days notice of cancellation, with the exception of 10 days notice of cancellation for non-payment of premium per form 80-02-9779 and 16-02-0306 respectively. Umbrella Policy is follow form. Waiver of Subrogation is included on Workers' Compensation Policies for all states except APPROVED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVEMESCIUMD POETCTES BE CAtJCELLED BIEF THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza, 4th FI Santa Ana CA 92701.. /56 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD