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Digitally signed by <br />11 yAngie Acevedo <br />Y4924.07.15 <br />STILLIAICevedo 4.11111 0�0ak;:.!"t' Grance <br />14:09:09 -07'00' <br />Business Policy Number <br />BP4001633 <br />Account Number Risk Management Division <br />Policy Effective Date <br />05/04/2024 <br />Policy Expiration Date <br />05/04/2025 <br />Insured Business Name or DBA <br />Justin Phu Media <br />1103 Delpy View PT <br />Vista, CA 92084-4837 <br />Agency Certificate Date 05/14/2024 <br />Palush Insurance Services Inc <br />6950 Indiana Ave Ste 3 <br />Riverside, CA 92506-4162 <br />Insurer Providing Coverage <br />Stillwater Insurance Company <br />NAIC Number 25180 <br />PO Box 45126 <br />Jacksonville, FL32232-5126 <br />Certificate Holder <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />Type of Insurance <br />Limits <br />X <br />General Liability <br />General Liability - per occurrence <br />$2,000,000 <br />General Liability -aggregate <br />$4,000,000 <br />Products - Completed Operations <br />$4,000,000 <br />X <br />Personal & Advertising Injury <br />Limits included within General Liability limits above <br />Included <br />NA <br />Hired Auto & Non -Owned Auto <br />Limits not included within General Liability limits above <br />No Coverage <br />NA <br />Professional Liability <br />Limits not included within General Liability limits above <br />No Coverage <br />X <br />Medical Expense <br />Medical Expense - any one person <br />$10,000 <br />NA <br />Employment Practices <br />Liability - aggregate, with 3rd party coverage <br />No Coverage <br />NA <br />Cyber Suite Enhanced <br />Liability - aggregate, with 3rd party data, network and electronic media <br />compromise <br />No Coverage <br />X <br />Damages to Premises Rented to You <br />Liability - aggregate <br />$100,000 <br />SPECIAL PROVISION <br />The City of Santa Ana, its officers, officials, employees, and volunteers <br />EVENT OR ACTIVITY <br />THIS CERTIFICATE OF INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE, TERMS, EXCLUSIONS AND CONDITIONS AFFORDED BY <br />THE POLICIES REFERENCED HEREIN. CERTIFICATE HOLDER IS GRANTED NO RIGHTS BY THIS FORM. <br />WE CERTIFY AS OF CERTIFICATE'S DATE, DESCRIBED POLICY WAS ISSUED TO INSURED <br />NAMED FOR THE INDICATED POLICY PERIOD. INSURANCE IS SUBJECT TO ALL POLICY_-- <br />TERMS, EXCLUSIONS AND CONDITIONS. <br />AUTHORIZED REPRESENTATIVE <br />SB DS 04 10 20 <br />Risk MougCNumt DMslcrn <br />°K REVIEWED & APPROVED BY. <br />o � <br />Ai je Acevd <br />Risk Management Specialist <br />