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ACC CERTIFICATE OF LIABILITY INSURANCE DATE[MMIDDIYYYYI
<br /> Ill 105r0612a25
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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 Daniel Benson
<br /> NAME:
<br /> Assured Partners Northeast,LLC. PHONE {914)761-9000 FAX, (914)761-3749
<br /> AIC No Ext: AINo
<br /> 445 Hamilton Avenue E-MAIL Daniel.Benson@assuredpartners.com
<br /> ADDRESS:
<br /> 1 Oth Floor INSURERIS)AFFORDING COVERAGE NAIC#
<br /> White Plains NY 10601 IN5URERA: Travelers Indemnity Company of Connecticut 25682
<br /> INSURED INSURER B: Travelers Property Casualty Company of America 25674
<br /> Pacific Traffic Control,LLC INSURER C: Admiral Insurance Company 24856
<br /> 2840 Lugo Street INSURER D:
<br /> INSURER E
<br /> Los Angeles CA 90023 INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: CL2541445612 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE 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 7YpB OF INSURANCE POLICY EFF POLICY EXP
<br /> LTR MSD WVD POLICYNUMBER MM1DDdYYYY MMIDDIYYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
<br /> S 1,000,000
<br /> CLAIMS-MADE OCCUR PREMISES Ea ,-re ccunce S 300,000
<br /> MED EXP(Any one person) S 5,000
<br /> A Y Y Y-630-5Y374343-TCT-25 04/14/2025 04/14/2026 PERSONAL&ADV INJURY S 1.000,000
<br /> GEN'L AGGREGATE LIMITAPPL€ES PER: GENERAL AGGREGATE S 2.000,000
<br /> POLICY X PRO PRODUCTS AGG $
<br /> JECT �LCC 2,000,000
<br /> OTHER: S
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea.accident
<br /> X ANYAUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED Y Y BA-5Y317895-25-14-G 04/14/2025 04/14/2026 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PRDPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> $
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> B EXCESS LIAS CLAIMS-MADF CUP-9X370586-25-14 04/14/2025 04/14/2026 AGGREGATE $ 5,01
<br /> DED I I RETENTION S $
<br /> WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE I ER
<br /> ANY PROPRIETORIPARTNERIEXECUTIVE ❑ N 1 A N/A
<br /> E.L.EACH ACCIDENT
<br /> D? $
<br /> OFFICERIMEMBER EXCLUDE
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S
<br /> Commercial Cyber and E&O Liability
<br /> General Aggregate $1,000,000
<br /> C E000002533-12 04/14/2025 04114/2026 Each Occurrence $1,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> The City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are included as Additional Insureds.Additional Insured status is
<br /> granted with respects to General Liability on a Primary&Non-Contributory basis,when required by written contract,per form CGD269 04116(copy
<br /> attached).Additional insured status is granted for Auto Liability,perform CAT353 02115(copy attached).
<br /> Waiver of Subrogation applies to General Liability and Auto Liability.
<br /> Tu Tran Digital€yslgnedby APPROVED
<br /> Tu Tran Nguyen R Tu Tran Nguyen at 7:2t1 am,May Date:zozs.os,rz YY 12,2025
<br /> N g uyen OT22 z7-07'00'
<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 Attention:Parks,Recreation,and Community Service ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza,
<br /> CA927fl1,M-23 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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