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<br /> A`oRo° CERTIFICATE OF LIABILITY INSURANCE 7OT4
<br /> 0/202DIYYYY)
<br /> 0/20 2 6
<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 CONTACT
<br /> Marsh Risk&Insurance Services NAME:
<br /> PHONE FAX
<br /> 17901 Von Karman Avenue,Suite 1100 (A/C,No Ext: A/C,No):
<br /> (949)399-5800;License#0437153 E-MAIL
<br /> Irvine,CA 92614 ADDRESS:
<br /> Attn:NewportBeach.CertRequest@marsh.com/F:212-948-4323 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> CN102166416-STND-GAWUP-26- INSURERA: Hartford Fire Insurance Company 19682
<br /> INSURED INSURER B: N/A N/A
<br /> Griswold Industries,Cla-Val Company
<br /> 1701 Placentia Avenue INSURER C: Twin City Fire Insurance Company 29459
<br /> Costa Mesa,CA 92627-4475 INSURER D: NIA N/A
<br /> INSURER E: Hartford Fire Insurance Company 19682
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: LOS-002267646-41 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 ADDLSUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER
<br /> POLICY EFF POLICY EXP
<br /> LTR MM/DDIYYYYI iMMIDDIYYYYI LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY 72ECSOFOBP5 04/01/2026 04/01/2027 EACH OCCURRENCE $ 1,000,000
<br /> RENTEDDAMAGE TO
<br /> CLAIMS-MADE X� OCCUR FIR SES Ea occurre... $ 300,000
<br /> X $1,000,000 SIR MED EXP(Any one person) $
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY❑ JECT PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,N
<br /> 000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY 72UENUM3154 04/01/2026 04/01/2027 COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTYDAMAGE
<br /> X AUTOS ONLY L
<br /> AUTOS ONLY Per accident) $
<br /> UMBRELLALIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ $
<br /> E WORKERS COMPENSATION 72WNC931 00(CA) 04/01/2026 04/01/2027 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> C YIN 72WEHO3564 AOS 04/01/2026 04/01/2027 1,000,000
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE ( ) E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? N❑ NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are included as additional insured where required by written contract with respect to General Liability and Auto Liability.
<br /> Waiver of subrogation is applicable where required by written contract and subject to policy terms and conditions.
<br /> APPROVED
<br /> By Tu Tran Nguyen at 7:30 am,Apr 13,2026
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Attn:Heidi Chou(M-85) THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 215 S.Center St. ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Santa Ana,CA 92703
<br /> AUTHORIZED REPRESENTATIVE
<br /> of Marsh Risk&Insurance Services
<br /> @ 1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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