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A�® CERTIFICATE OF LIABILITY INSURANCE 70T,
<br /> E2/2026IYYYY)
<br /> /02/2026
<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 CONTACT
<br /> Marsh USA LLC NAME:
<br /> HONE FAX
<br /> 30 South 17th Street AIC_ Ext: A/C,No
<br /> Philadelphia,PA 19103 E-MAIL
<br /> Attn:NBCU.Certrequest@marsh.com Fax 212-948-5143 ADDRESS:
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> CN 101 608515-NBCU-GAWUW-25- wsURERA: ACE American Insurance Company 22667
<br /> INSURED INSURER B: Indemnity Ins Cc Of North America 43575
<br /> NBCUniversal Media,LLC
<br /> a fully owned subsidiary of Comcast Corporation INSURER C: ACE Property And Casualty Ins Cc 20699
<br /> 30 Rockefeller Plaza INSURER D: ACE Fire Underwriters Ins.Co. 20702
<br /> New York,NY 10112
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: CLE-006533573-24 REVISION NUMBER: 31
<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 ADDLSUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER
<br /> POLICY EFF POLICY EXP
<br /> LTR MM/DDIYYYYI iMMIDDIYYYYI LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY y y XSLG49368793 12/01/2025 12/01/2026 EACH OCCURRENCE $ 19,900,000
<br /> RENTEDDAMAGE TO
<br /> CLAIMS-MADE X� OCCUR FIR SES(Ea
<br /> occurre... $ 19,900,000
<br /> X SIR:$100,000 MED EXP(Any one person) $ 10,000
<br /> PERSONAL&ADV INJURY $ 19,900,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 60,000,000
<br /> POLICY❑ JECT PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 15,000,N
<br /> 000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY ISA H11361262 12/01/2025 12/01/2026 COMBINED SINGLE LIMIT $ 20,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTYDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> L $
<br /> C X UMBRELLALIAB X OCCUR XEU G27924840 011 12/01/2025 12/01/2026 EACH OCCURRENCE $ 10,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION y WLR C7280143A(AOS) 12/01/2025 12/01/2026 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> D YIN SCF C72801441(W) 12/01/2025 12/01/2026 2,000,000
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? N❑ NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000
<br /> If yes,describe under 2,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Excess Workers Compensation WCU C72801453(WA) 12/01/2025 12/01/2026 Ea Acc/Dis Employee/Dis Polic 2,000,000
<br /> SIR 5,000,000
<br /> Dlgitallysigned
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Nguyen
<br /> RE:Service Contract between SportsEngine Inc.-NCSI and City of Santa Ana,CA Nguyen Date:2026.01.06
<br /> 09:19:24-08'00'
<br /> NBCUniversal Media,LLC subsidiaries include,but are not limited to:SportsEngine Inc.dba National Center for Safety Initiatives LLC
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are included as additional insured(except workers'compensation)where required by written contract with the Named
<br /> Insured. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured and where required by written contract. Waiver of
<br /> subrogation is applicable where required by written contract. Please see attached for Notice of Cancellation endorsements.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 9:18 am,Jan 06,2 226
<br /> City of Santa Ana, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Attention:Human Resources Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 20 Civic Center Plaza CA 92701 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Santa Ana,CA 92701
<br /> AUTHORIZED REPRESENTATIVE
<br /> of Marsh USA LLC
<br /> @ 1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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