MINI EXPRESS, THE (SUPER BIRTHDAY, INC.)

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A� o® CERTIFICATE OF LIABILITY INSURANCE DATE 11 MI 2D"YYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER CONTACT NAME: Thomas Plouffe Specialty Insurance, LTD, P.O. Box 16901 PHON INC, NoEat. 203-931-7095 FAX Na:203-931-0682 E-MAIL ADDRESS: V P Y Certificates@/�@ ecialt insuranceltd.com INSURERS AFFORDING COVERAGE NAIC # West Haven, CT 06516 INSURERA: Lexington Insurance Company 19437 INSURED Super Birthday, Inc 1941 California Ave # 77591 Corona, CA 92877 INSURER B INSURERC: INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF ABBEUBR POLICY NUMBER POLICY EFF MMIDDIYYYY) POUCYEXP (MMIDDIYYYYI LIMITS A X COMMERCIALGENERALLIABILITY CL-M AIMSADE � OCCUR x x 018558000-02 1/24/25 1/24/26 EACH OCCURRENCE $ 1,000,000 DAMAGE PREMISES Eaolccurence $ 50,000 MED EXP (Any oneperson) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ PRJECT O- 1-1LOG GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Par person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS (Per accident BODILY INJURY P ( 1 $ HIRED AUTOS NON-0WNED AUTOS PROPERTY DAMAGE Per amid m $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LUIB CLAIMS -MADE DED I I RETENTION$ $ WORNERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNER/ ECUTIVE OFFICERIMEMBER EXCLUDED? N/A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) H yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Santa Ana, its officers, officials, employees, agents, and volunteers are added as an additional insured but only with respects to the operations of the named insured during the policy period. The general liability policy is primary and non-contributory. A Waiver of Subrogation applies. Tu Tran ** T """ APPROVED Trackless Train Insurance Coverage Nguyen By Tu Tran Nguyen at 10:08 am, Feb 25, 2025 City of Santa Ana Attention: Library Services Department 20 Civic Center Plaza, M-42 Santa Ana, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE —� © 1988-2014 ACORD CORPORATION_ All rinhts ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD