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ACC?Rbr CERTIFICATE OF LIABILITY INSURANCE
<br />�/
<br />DATE (MMIDD YYYY)
<br />02/28/2025
<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
<br />PAYCHEX INSURANCE AGENCY, INC.
<br />225 KENNETH DRIVE
<br />ROCHESTER, NY 14623
<br />CONTACT Pa chex Insurance
<br />NAME: Y Agency Inc
<br />PHONE 877-266-6850 AIC No: 585J89-7426
<br />E-MAIL cedsQpaychex.com
<br />ADDRESS:
<br />INSURERS AFFORDING COVERAGE
<br />NAIC It
<br />INSURER A: Sentinel Insurance Company, LTD
<br />INSURED
<br />PROUDCITY
<br />DBA PROUDCITY
<br />2219 DAMUTH ST
<br />OAKLAND, CA - 94602
<br />INSURER B: Sequoia Insurance Company
<br />INSURER: Hartford Fire Insurance Company
<br />INSURER D
<br />INSURER E:
<br />1 INSURER F:
<br />COVERAGES CERTIFICATE NUMBER: REVISION NHMRFR-
<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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />J=
<br />SUER
<br />MD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MM DDIYYYY
<br />POLICY EXP
<br />MM/DD/YYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />X� OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />RENTED
<br />-DAIVIAGCLAIMS-MADE
<br />PREMISES
<br />PREMISES Ea NI ED occurrence)
<br />$ 1,000,000
<br />MED UP (Any one person)
<br />$ 10,000
<br />A
<br />X
<br />X
<br />76SBMBC3ROR
<br />07/05/2024
<br />07/05/2025
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />AGGREGATE LIMIT APPLIES PER:
<br />POLICY PECTRO- ❑
<br />JLOC
<br />GENERALAGGREGATE
<br />$ 2,000,000
<br />GENT
<br />X
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />AUTOMOBILELIABILITY
<br />COMBINED SINGLE LIMB
<br />Ea ccid.
<br />afl
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />A
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />AUTOS
<br />HIRED NON -OWNED
<br />AUTOS ONLY X AUTOSS ONLY
<br />v
<br />/�
<br />v
<br />/�
<br />76SBMBC3ROR
<br />07/05/2024
<br />07/05/2025
<br />X
<br />BODILY INJURY (Par accident)
<br />$
<br />PROPERTYDAMAGE
<br />Per accident
<br />$
<br />UMBRELLA LIAR
<br />OCCUR
<br />EACHOCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I I RETENTION$
<br />$
<br />BAWPROPRIETOR/PARTNERIEXECUTIVE
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />OFFICERIMEMBEREXCLUDED7 N
<br />(Mandatory in NH)
<br />H ySCRIPcdbe antler
<br />DESCRIPTION OF OPERATIONS below
<br />NIA
<br />QWC1254445
<br />01/15/2024
<br />01/15/2025
<br />PER OTH-
<br />X STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 1,000,000
<br />E.L.DISEASE-POLICY LIMIT
<br />$ 1,000,000
<br />C
<br />FailSafe Technology Errors
<br />or Omissions Liability
<br />76SBMBC3ROR
<br />o7/05/202a
<br />07/o5/zozs
<br />Each Wrongful Act
<br />Aggregate Limit
<br />$1,000,000
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, AddlOonal Remarks Schedule, may be attached if more space Is required)
<br />City of Santa Ana, officers, agents, employees, and volunteers are additional insured per Additional Insured: Owners,
<br />Lessees, or Contractors; Scheduled Person or Organization Form SS4170 attached to this policy. Waiver of Subrogation
<br />applies in favor of the Certificate Holder per the Business Liability Coverage Form SL 00 00, attached to this policy and the
<br />Hired Auto and Non Owned Auto Endorsement SSO438 attached to this policy. Coverage is primary and noncontributory
<br />per the Business Liability Coverage Form SL 00 00, attached to this policy. Notice of Cancellation will be provided in
<br />accordance with Form SL9013 attached to this policy."
<br />City of Santa Ana
<br />Attn: Risk Management Division
<br />20 Civic Center PLZ
<br />Santa Ana, 92701-4058
<br />APPROVED
<br />By Tu Tran Nguyen at 11:48 am, Mar 03,. 2025
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Tu Tran
<br />og.i,iq,y��e I AUTHORIZED REPRESENTATREPRESENTATIVE�1 L/ � -P ��
<br />n.
<br />Nguyen
<br />01988-2016 ACC
<br />name and logo are registered marks of ACORD
<br />rights reserved.
<br />
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