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A C 0® DATE(MMIDOIYYYY)
<br /> �- CERTIFICATE OF LIABILITY INSURANCE 08/06/2024
<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. Q
<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). c
<br /> CONTACT W
<br /> PRODUCER V
<br /> AOn Risk Services Central, Inc. NAME:
<br /> Chicago IL Office PHONE
<br /> (ac.No.Et): (966) 283-7122 FAX
<br /> (800) 363-0105
<br /> Digitally signed by Angi'a=
<br /> 200 East Randolph Ange i E-MAIL
<br /> Chicago IL 60601 USA ADDRESS:
<br /> [�/�N\SUREQCR(S AFFORDI G COVERAGE NAIC t!
<br /> INSURED INSURER A: ‘'1r I Crl—ARfe I �CO 16535
<br /> New Tangram, LLC INSURER B: Th' ont�•n©enta7�Ij� �d nf�e�p an 35289
<br /> 9200 Sorensen Ave Lia'le 'Vr� 1�iWP Pi 9
<br /> Santa Fe Springs CA 9067 64 INSURERC: Na ,n i �i r h 19445
<br /> l� � e o INSURER'.
<br /> INTUUR .4E: 10.19.29 -07'00'
<br /> N'./RER F:
<br /> COVERAGES CERTIFICATE NUMBER: 570107533920 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 /> Limits shown are as requested
<br /> INSR ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY V GL0550321711 04/01/2024 04/01/2025 EACHOCCURRENCE $2,000,000
<br /> CLAIMS-MADE [7 OCCUR PREMSl RENTED
<br /> PREMISES(Ea occurrence) $SOO,OOO
<br /> MED EXP(Any one person) $10,000
<br /> _- PERSONAL&ADV INJURY $2,000,000 p
<br /> GEN'L AGGREGATE LIMIT APPLIES I�PER GENERAL AGGREGATE $4,000,000 F.,,,,POLICY I X poi I l LOC PRODUCTS-COMP/OPAGG S4,000,000 r
<br /> OTHER: 1111 0
<br /> _ E.
<br /> A AUTOMOBILE LIABILITY BAP 5503218-11 04/01/2024 04/01/2025 COMBINED SINGLE LIMIT to
<br /> (Ea accident) $2,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) ••
<br /> O
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) Z
<br /> AUTOS ONLY AUTOSclt
<br /> HIRED AUTOS
<br /> NON-OWNED PROPERTY DAMAGE CO
<br /> ONLY AUTOS ONLY (Per accident) 0
<br /> a
<br /> B X UMBRELLA LIAB X OCCUR 7037028874 04/01/2024 04/01/2025 EACH OCCURRENCE $15,000,000 V
<br /> SIR applies per policy terms & conditions
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000,000
<br /> OED X RETENTION
<br /> A WORKERS COMPENSATION AND WC550321611 04/01/2024 04/01/2025 PERSTATUTE IOTH- ,
<br /> EMPLOYERS'LIABILITY x ER
<br /> YIN •
<br /> ANY PROPRIETOR/PARTNER! I N E.L.EACH ACCIDENT $1,000,000
<br /> EXECUTIVE OFFICER/MEMBER N/A
<br /> (Mandatory in NH) E L DISEASE-EA EMPLOYEE $1,000,000
<br /> II yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> C Miscellaneous Liability Cover; 048251777 04/01/2024 04/01/2025 Each Occurrence $10,000,000
<br /> Aggregate $10,000,000=
<br /> 0
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD ICH.Additional Remarks Schedule,may be attached it more space is required)
<br /> ada—
<br /> The City of Santa Ana, its officers, officials, employees, and volunteers are included as Additional insured in accordance with
<br /> the policy provisions of the General Liability policy. General Liability policy evidenced herein is Primary and
<br /> Non-Contributory to other insurance available to Additional Insured, but only in accordance with the policy's provisions.
<br /> 5.1
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br /> DATE THEREOF.NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. _
<br /> City of Santa And AUTHORIZED REPRESENTATIVE
<br /> Risk Management Division \ I
<br /> 20 Civic Center Plaza �1 �c e� RleltMawagmnentDiislon
<br /> Santa Ana CA 92702 USA fY/ M.4. !�� REVIEWED&APPROVED BY:
<br /> eXXOya Z G sou w °'ile ii � sti+f a Aacvak
<br /> ' Risk Management Specialist
<br /> ©1988-2015 ACORD CORP/
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACO
<br />
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