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CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 04/30/2024 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: It 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 Hiscox Inc. d/b/a/ Hiscox Insurance Agency in CA NAME: PNONE (ggg) 202-3007 ac No 5 Concourse Parkway E-MAIL Suite 2150 AD ss: conn'tIIct@hiscox. m Atlanta GA, 30328 A Y1 �y �� D I .T RDING COVERAGE NAIC# INSURED — — — Swim Brayv 5701 Santa Catalina Gard Acevedo Garden Grove, CA 928 COVERAGES CERTIFICATE NUV317A: Inc :7 AT 169 P7 7. I I Lfi I l l A iDYDDI 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 TYPEDFINSURANCE ADDLSUBR INSD wvo POLICYNUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDO LIMITS X COMMERCUILGENERAL LIABILITY EACH OCCURRENCE $ 1,000000 CLAIMS -MADE AIMS -MADE FIOCCUR DAMAGETO S(RENTED PREMISES Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 A Y Y P102.732.064.3 05/10/2024 05/10/2025 BERL AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY JEC �LOC PRODUCTS - COMP/OP AGG $SIT Gen. Agg. $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident)$ NON-0WNED HIRED AUTOS AUTOS PROPERTYDAMAGE Par accident $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DIED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANYPROPRIETORIPARTNEWEXECUTIVE ❑NIA OFFICERIMEMBEREXCLUDED? E.L. DISEASE -EA EMPLOYE $ (Mandatary In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be abashed if more space is required) City of Santa Ana Risk Management Divisions be covered as additional insured on the Commercial General Liability with respect to liability arising out of work or operations performed by or on behalf of the premity including materials parts or equipment furnished in connection with such work or operation City of Santa Ana Risk Management Divisions 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC @ 1988-2015 ACORD g., Risk MmugtmmtDhislan ry ge REviEWED&APPROVEDB/Y.- Risk Management Spedalist 00 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD