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<br /> ATE(MMIDOIYYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 0312,112025
<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 /> d
<br /> PRODUCER CONTACT T}
<br /> NAME:
<br /> Aon Risk Services Northeast, Inc.
<br /> New York NY Office (AC.N.Eatk (866) 283-7122 (T1A`XC.No.): C00) 363-0105 n
<br /> One Liberty Plaza E-MAIL =
<br /> 165 Broadway, Suite 3201 ADDRESS:
<br /> New York NY 10006 USA
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURED INSURERA: Underwriters at Lloyds 32727
<br /> WOOlpert Inc. INSURERS: The charter Oak Fire Insurance Company 25615
<br /> 4454 Suitei100a [enter Boulevard INSURERC; The Phoenix insurance Company 25623
<br /> Dayton OH 45430 USA INSURERD: Travelers Property Cas Co of America 25674
<br /> INSURER E: Endurance American Specialty Ins Co. 41718
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 570111688666 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 INDICATED.
<br /> NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY
<br /> PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY
<br /> HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> Limits shown are as requested
<br /> INSR ADOL SUBIR POLICY EFF POLICY EXP
<br /> L7R TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYYYYI IMMIODNYYYI LIMITS
<br /> n X COMMERCIAL GENERAL LIABILITY P630OR56138000F25 03/01/2025 03/01 2 226 EACH OCCURRENCE $1,000,000
<br /> CLAIMSMADE El OCCUR PREMISES(Eao cursencey $1,GOO,000
<br /> MED EXP(Any one person) s1s,000
<br /> PERSONAL&AUV INJURY $1,000,000 Ct
<br /> GEll]'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 4fl
<br /> �I m
<br /> POLICY I XIPE� LOG PRODUCTSCOMPlOP AGG $2,000,000
<br /> OTHER:
<br /> 0
<br /> n
<br /> r AUTOMOBILE LIABILITY 810-2w2O6561-25-43-G 03/01/2025 03/01/2026 COMBINED SINGLE LIMIT rn
<br /> (Ea accident) $1,000,000
<br /> x ANY AUTO HOMILY INJURY{Per person)
<br /> O
<br /> SCHEDULED
<br /> OWNED BODILY INJURY{Per accident) Z
<br /> ADTDS
<br /> AUTOS ONLY N
<br /> HIREDAUTOS NON-OWNED PROPERTY DAMAGE ;y
<br /> ONLY AUTOSONLY (Peraxidentl O
<br /> L=
<br /> X Cull&Cum Cad t,WU
<br /> U
<br /> D X UMBRELLA LIAR OCCUR
<br /> CUP2w73426525NF 03/01/2025 03/01/2026 EACH OCCURRENCE $10,000,060 V X
<br /> EXCESS UAB CLAIMS-MADE AGGREGATE $10,000,00
<br /> DED I x IRETENTION $10,000
<br /> C WORKERS C EMPLOYER SOMAPBELSAION AND UB4w7689952543E 03/01/2025 03/01/2026, X PER STATUTE CTIi-
<br /> ITY YiN ER
<br /> ANY PROPRIETOR PARTNER!EXECUTIVE EL.EACH ACCIDENT $1 000,000
<br /> OFFICERIMEMBER EXCLUDED? N NIA
<br /> (Mandatory In NHj E_L DISEASE-EA EMPLOYEE $1,ow,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> A E&O - Professional Liability PSDFF2501124 03/01/2055 03/01/202(i Per Claim/Aggregate $5,000,000_
<br /> Primary Clms Mid - Prof/Pollution Deductible $750,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached it more space is required)
<br /> RE: PR03 #78392 - REP #17-101. City of Santa Ana, its City council, officers, officials, employees, agents and volunteers an
<br /> representatives are included as Additional insured in accordance with the policy provisions of the General Liability,
<br /> Automobile Liability and Professional Liability policies. 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. A7
<br /> waiver of Subrogation is granted in favor of City of Santa Ana, its City Council, officers, officials, employees, agents and
<br /> volunteers and representatives in accordance with the policy previsions of the General Liability, Automobile Liability,
<br /> Professional Liability and workers' compensation policies. Should General Liability, Automobile Liability, Umbrella Liability
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By TO Tram Nguyen at 3:42 pin,Mar 24,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br /> DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCURDANCE WITH THE POLICY PROVISIONS.
<br /> Digitally sign
<br /> City of Santa And Tu Tr
<br /> bYTuTan AUTHORIZED REPRESENTATIVE
<br /> Risk Management Division, 4th Floor N4,1Rn Sri
<br /> 20 civic Center Plaza Nguyen nalkaDzs➢ a
<br /> Santa Ana CA 92702 USA ts:42;41-o71 o' r1a
<br /> Cfi` J -SIZ_
<br /> OO 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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