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DATE(MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE 4/30/2026
<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 /> NAME: Certificate Team
<br /> Inszone Insurance Services, LLC PHONE FAX
<br /> 2721 Citrus Road, Suite A A/C No Ext: 877-308-9663 A/c,No):916-400-2625
<br /> E-MRancho Cordova, CA 95742 ADDRESS: certs@inszoneins.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:OF827641 INSURERA: BERKLEY ASSURANCE COMPANY 39462
<br /> INSURED J&LOONS-02 INSURER B: Evanston Insurance Company 35378
<br /> J & L Constructors, Inc.
<br /> 10062 Cynthia Drive INsuRERc: State Compensation Ins Fund 35076
<br /> Huntington Beach, CA 92646 INSURERD:
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1750633048 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 INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICYNUMBER MM/DD MM/DD
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y VUMA0310933 4/27/2026 4/27/2027 EACH OCCURRENCE $1,000,000
<br /> DAMAGES( RENTED
<br /> CLAIMS-MADE OCCUR
<br /> PREMISES Ea Occurrence)
<br /> ccurrence) $100,000
<br /> MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY❑ PRO ❑
<br /> JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> X
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> B UMBRELLA LAB X OCCUR EZXS3243140 4/27/2026 4/27/2027 EACH OCCURRENCE $3,000,000
<br /> X EXCESS LAB CLAIMS-MADE AGGREGATE $3,000,000
<br /> DED RETENTION$ $
<br /> C WORKERS COMPENSATION Y 9170623-2025 12/3/2025 12/3/2026 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? ❑ N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Pollution Liability CPLMOL137611 2/11/2026 2/11/2027 Aggregate $10,000,000
<br /> B Pollution Liability CPLMOL137611 2/11/2026 2/11/2027 Each Occurrence $5,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Additional Insured on the General Liability. Primary and Non-Contributory on the General Liability.Waiver of Subrogation on the General Liability and Workers
<br /> Compensation. Excess follows form,subject to the terms and conditions of the policy.
<br /> The aforementioned coverage is provided to the extent in the attached forms for:The City of Santa Ana, its City Council,officers,officials,employees,agents
<br /> and volunteers
<br /> APPROVED
<br /> By Tu Tran Nguyen at 4:48 pm,May 06,2026
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Public Works Agency Water Resources Division
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana, CA 92701 `
<br /> @ 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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