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ONE0000-01 KDOHMAN AFRO CERTIFICATE OF LIABILITY INSURANCE DAT DlYYYY) 3114/214l2025 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 have ADDITIONAL INSURED provisions or 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 endorsement(s). PRODUCER License#0757776 CONTACT Stephanie Lanzas NAME: HUB International Insurance Services Inc. PHONE o,Ext):(951 779-8562 FAX PO Box 5345 ) (A/C,No): Riverside,CA 92517 E-MAIL ste hanie.lanzas hubinternational.com ADDRESS: P INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B: OneOC INSURER C: 1901 E.Fourth Street,Suite 100 INSURER D: Santa Ana,CA 92705 - 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 j ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER D MIDD LIMITS A I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S _ 1,000,00d CLAIMS-MADE OCCUR PRSE TO aoccueEMIES(E occurrence) S 100,000 MED EXP(Any oneperson) S _ 5,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,OOf),000 X POLICY PRO- LOC 3,000,000 JECT PRODUCTS $ OTHER: A IIAUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ ANY AUTO X PHPK2631419-009 1/15/2025 1/1512026 BODILY INJURY Perperson) $ OWNED SCHEDULED --- AUTOS ONLY X AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE'. I,AGGREGATE $ DED RETENTION$ is WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY Y 1 N STATUTE FIR _ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N!A E.L.EACH ACCIDENT S (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S A Abusive Conduct PHPK2631419.009 1/15/2025 1/1512026 Each Cond:$1M;Agg: 2,000,000 Tu Tran Train Ngu en DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule may be attached If more space is required) N g uye n O�:a2:03-o7 0zo ' RE:GREEN MPNA and Orange County Environmental Justice Education Fund(OCEJ) City of Santa Ana,its City Council,its officers,officials,employees,agents,and volunteers are Additional Insured with regard to General Liability when required by written contract per the attached endorsement form,attached-Waiver of Subrogation applies. Notice of Cancellation will be provided in accordance with policy provisions attached. APPROVED By Tu Tran Nguyen at 7:41 am,May 20, 2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Division 20 Civic Center Plaza Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE .�z'lL�rl-E�.GrrdL_ ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD