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CERTIFICATE OF Date: June 15, 2024 <br /> SELF-INSURANCE COVERAGE <br /> PRODUCEWINSURFO <br /> The Regents of the University of California This Certificate is issued as a matter of information only to authorized viewers for <br /> Office of the President their internal use only and confers no rights upon any viewer of this Certificate. <br /> Office of Risk Services The Certificate does not amend,extend or alter the coverage described below, <br /> 1111 Franklin St., 6th Floor This Certificate may only be copied, printed and distributed by an authorized <br /> Oakland, CA 94607-5200 viewer for its Internal use. Any other use, duplication or distribution of the <br /> 510-987-9832 Certificate without the written consent of the Regents of the University of California <br /> is prohibited. <br /> ENTITIES AFFORDING COVERAGE <br /> r � � PARTICIPATION <br /> COMPANY LETTEn. A-The ff!! ent5 Oft B University of California <br /> OVERAGES <br /> THIS IS TO CERTIFY THAT THE REGENTS OF THE UNIVERSITY OF CALIFORNIA IS A GOVERNMENTAL ENTITY THAT HAS A SELF-FUNDED <br /> RETENTION FOR LIABILITIES DESCRIBED BELOW, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY WRITTEN <br /> CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY PERTAIN. THIS SELF FUNDED PROGRAM IS <br /> SUBJECT"TO ALL PROVISIONS OF THE BYLAWS AND STANDING ORDERS OF THE REGENTS OF THE UNIVERSITY OF CALIFORNIA,WHICH <br /> DOES NOT PERMIT ANY ASSUMPTION OF LIABILITY WHICH DOES NOT RESULT FROM THE NEGLIGENT ACTS OR OMISSIONS OF ITS <br /> OFFICERS,AGENTS OR EMPLOYEES. <br /> CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE LIMITS <br /> LTR <br /> GENERAL LIABILITY GENERAL AGGREGATE Not applicable <br /> A X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMPIOP AGG $ 5,000,1300 <br /> CLAIMS MADE ]OCCURRENCE Self-Insured July 1,2024 July 1,2025 PERSONAL&AOV INJURY $ 5,000,000 <br /> CONTRACTUAL LIABILITY $ 5,000,000 <br /> —� EACH OCCURRENCE $ 5,000,000 <br /> c UTOMO SILE LIAB.tLITY M COMBINED SINGLE LIMIT S Not applicable <br /> ANYAUTO <br /> X ALL OWNED BODILY INJURY $ 2500.000 <br /> AUTOS (PER PERSON) <br /> SCHEDULED Self-Insured July 1,2024 July 1,2025 <br /> AUTOS <br /> X HIREDAUTOS BODILY INJURY $ 2,500,000 <br /> (PER ACCIDENT) <br /> X NON-OWNED <br /> AUTOS <br /> GARAGE LIABILITY PROPERTY DAMAGE $ 2,500,000 <br /> PROPERTY � EACH OCCURRENCE $ 10,000,000 <br /> A X FIRE&EXTENDED PERILS Self-Insured July 1,2024 July 1,2025 AGGREGATE $ Not applicable <br /> STATUTORY LIMITS <br /> nWORKERS'COMPENSATION AND Self-Insured July 1,2024 July 1,2025 EACH ACCIDENT As required by <br /> EMPLOYERS LIABILITY California Law <br /> DISEASE-POLICY LIMIT $ As required by <br /> California Law <br /> DISEASE-EACH EMPLOYEE: As required.by <br /> California Law <br /> DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPECIAL ITEMS <br /> ADDITION LCOVERED PARTY-AS REQUIRED BY WRITTEN CONTRACTOR AGREEMENT WITH RES PECIJQ-ENERAL LIA§ILU <br /> AND AUTOMOBILE LIABILITY <br /> LOSS P YEE-A5 E UIREC3 ICY W TT TRACT'OR AGREEMI NT'WITH RESPECT_7'C1 PROPE�tPj C�C7VFRA�E <br /> CERTIFICATE HOLDER CANCELLATION <br /> APPLICABLE PARTY AS REQUIRED BY WRITTEN CONTRACT SHOULD THE REGENTS ELECT TO DISCONTINUE SELF-INSURING ITS <br /> OR AGREEMENT LIABILITIES,THE REGENTS WILL UPDATE PROOF OF SELF-INSURANCE ON ITS <br /> EBSITE. THE REGENTS SHALL NOT BE OBLIGATED TO PROVIDE INDIVIDUAL <br /> NOTICE TO VENDORS OR OTHERS. <br /> By. _ _ M <br /> APIMOVED - - KEVIN COh1FE171, AVP & CHIEF RISK OFFICER <br /> By Tu Tran Nguyen of 10:70 am,AIqr_'04, 2025 TU Tra rl Digitally signed by <br /> .Tu Tran Nguyen <br /> NL7I11/PT1 _Date:2025.04.04 <br />