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A("`C>R"® DATE(MMIDDIYI'YY)
<br /> �� CERTIFICATE OF LIABILITY INSURANCE 0511212025
<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 NAME, Julia Traughber,CISR,CLCS
<br /> Pacific Agents Alliance Insurance Agency; Julie Traughber Insurance Agenc PHONE (818)203-2209X Nm; (626)799-7051
<br /> 524 S Rosemead Blvd E-MML ADDRESS: julie@julletraughberins.com
<br /> INSURER 5 AFFORDING COVERAGE NAIC 9
<br /> Pasadena CA 91107 INSURERA: CONTINENTAL CASUALTY COMPANY 20443
<br /> INSURED _ ,.._._.-.----...._
<br /> INSURER B
<br /> Argo Enterprises,Inc.dba: UniShield INSURER C:
<br /> 599 4th St INSURER D _._-.-.
<br /> INSURER E
<br /> San Fernando CA 91340 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 TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF]NSURANGE ADDL SUBR -- 00LICY EFF POLICY EXP
<br /> LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE Q OCCUR DAMAGE TO RENTE➢ 300 000
<br /> PREMISES Ea occurrence) $
<br /> MED EXP(Any one person) $ 10,000
<br /> A X X B6024759005 03124/2025 03/24/2026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000„000
<br /> X POLICY F] PRO
<br /> JECT L- PRODUCTS-GOMPIOP AGG $ 2,000,000
<br /> LOC
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINEntD SINGLE LIMIT $
<br /> Ea accide
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> B OWNED SCHEDULED
<br /> AUTOS ONLY AUT O S BODILY INJURY(Per sc:cident) $
<br /> PROPERTY DAMAGE
<br /> HIREDL NOWOWNED $
<br /> AUTOS ONLY AUTOS ONLY Per acc denl
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 3,000,000
<br /> A EXCESS LIAB CLAIMS-MADE B6024759019 03124/2025 03/24/2026 AGGREGATE $ 3.000,000
<br /> DED I X I RETENTION 10,000 $
<br /> WORKERS COMPENSATION PER OTH-
<br /> STATUTE ER
<br /> AND EMPLOYERS'LIABILITY Y/N
<br /> ANY PROPRIETORIPARTNEWEXECUTIVE E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? N I A
<br /> (Maridalory In NH) E.L.DISEASE-EA EMPLOYE $
<br /> If yes,describe under -
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> Employee Dishonesty, $1,000 deductible $25,000
<br /> A Forgery and Alteration B6024759005 03124/2025 03/24/2026 $1,000 deductible $25,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> It is agreed that the City of Santa Ana,its officers,officials,employees and volunteers are named Additional Insureds with respect to liability arising out of work
<br /> or operations performed by or on behalf of the Contractor including materials,parts or equipment furnished in connection with such work or operations.
<br /> General Liability Form CG 2026(04113)is attached.This insurance is also Primary and Non-Contributory with respect to insurance or self-insurance programs
<br /> maintained by the City per Form No.CG2001 (01104)attached_ Any insurance or self-insurance maintained by the Entity,its officers,officials,employees or
<br /> volunteers shall be excess of the Contractors insurance and shall not contribute with it per CG2404(10193)attached. It is also agreed that 30 Days'Notice of
<br /> Cancellation with 10 Days'Notice for Non-Payment of Premium in accordance with the policy provisions. All coverages are subject to the terms and conditions
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By Tu Tran Nguyen at 9:47 am,Jun 09,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Dignauysigned ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana Tu Tran by T.T,an
<br /> Nguyen
<br /> Risk Management Division Nguyen Date.2025.06.09 09:48:56-07'00' AUTHORIZED REPRESENTATIVE
<br /> 20 Civic Center Plaza
<br /> � �
<br /> Santa Ana CA 92701
<br /> O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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