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CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYYYY)
<br /> 04/0212025
<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(les)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 endorsements .
<br /> PRODUCER NAME: Vijay VOng50Ufy
<br /> McGdff,a Marsh&McLennan Agency LLC company PHONE 503-943-6621 FAX, 503-943 6622
<br /> 5400 SW Meadows Road,Suite 240 AIC No E AICNo
<br /> Lake Oswego,OR 97035 EMAIL
<br /> ADDRESS:Vilay.Vongsoury@mcgriff.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Bus Risk Retention Group 17324
<br /> INSURED INSURER B:AIU Insurance Company Greyhound Lines,Inc. 19399
<br /> PO Box 660632 INSURER c:National Union Fire Insurance Company of Pittsburgh,PA 19445
<br /> Dallas,TX 75266.0362
<br /> INSURER D;New Ham shire Insurance Company 23841
<br /> INSURER E
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER.,5HT4CDUU 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 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 TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP
<br /> LTR D wVD POLICY NUMBER MMIDDIYYYY) (MMII30IYYYYI LIMITS
<br /> A X COMMERCIAL ENERAL LIABILITY
<br /> GL-RRO-001023 01/01/2025 01/01/2026 EACH OCCURRENCE $ 10,OD0,000
<br /> G
<br /> D ED
<br /> X T
<br /> CLAIMS-MADE OCCUR PREMISES ER occurrence) $ 5,000,000
<br /> MED EXP(Any one person) $
<br /> PERSONAL&ADV INJ URY $ 10,000,000
<br /> GHN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 10,000,U00
<br /> PRO- 10,000,000
<br /> POLICY JECT LOC PRODUCTS-COMNOPAGG $
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY AL-RRG-OD 023 01/01/2025 01/01/2026 COMBINED SINGLE LIMIT
<br /> Ea accident 10,000,000
<br /> X ANY AUTO BODILY INJURY(Per parson) $
<br /> OWNHO SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Par accident $
<br /> UMBRELLA LIAB OCCUR
<br /> EACH OCCURRENCE $
<br /> EXCESS LIAR CLAIMS-MADE
<br /> AGGREGATE $
<br /> DED I I RETENTION$ $
<br /> D wORKERS COMPENSATION 62790879 AOS 04/01/2025 04/01/2026 PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN X STATUT (;
<br /> ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT3,000,000
<br /> OFFICERIMEM DER EXCLUDED? ❑ NIA $
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 3,000,000
<br /> tryes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 3,000,000
<br /> B Auto Liability AL7281073 AOS) 04/01/2025 04/01/2026 Combined Single Limit 10,100,000
<br /> C AL7281072(MA) $
<br /> $
<br /> $
<br /> $
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/Vt:H1CLrzS (ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required)
<br /> Contractual Liability coverage is included under the General LlabiHty policy,
<br /> RE:Leased Location:The Depot at Santa Ana;1000 East Santa Ana Boulevard,Santa Ana,CA.City of Santa Ana,its agents,officers,empioyees and volunteers are
<br /> included as Additional Insured in accordance with the policy provisions of the General Liability policy.General Liability policy evidenced herein is Primary and
<br /> Non-Contributory to other insurance available to an Additional Insured,but only in accordance with the policy's provisions.A Waiver of Subrogation is granted in favor of
<br /> Certificate Holder in accordance with the policy provisions of the Workers'Compensation policy.Should General Liability policy be cancelled before the expiration date
<br /> thereof,the policy provisions will govern how notice of canoelfation may be delivered to Certificate holders in accordance with the policy provisions,
<br /> nise�eysi9 edeyT-T—
<br /> Tu Train Nguyen Nguy"
<br /> D,lm202s.D4e216<56s1
<br /> -mroo APPROVED .
<br /> CERTIFICATE HOLDER CANCELLATION -By-Tu-Tran-NguyGn—at 4*5€-pin,-.Apr-02. 4g$
<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 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attention: PWA Facilities
<br /> 20 Civic Center PI,M11 AUTHORIZED REPRESENTATIVE
<br /> Santa Ana,CA 92701
<br /> USA � .
<br /> Page 1 of @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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