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HOWRGEN-02
<br /> ACVROaDATE(MMIDDNYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE
<br /> 8/6/2025
<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 iiiiii
<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 /> ................................. ................................................. ........
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(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 endorsemeni
<br /> ............ ...........
<br /> mm
<br /> PRODUCER CONTACT
<br /> NAME:
<br /> MG Skinner&Associates CONTACT
<br /> FAX
<br /> 1666 20th St Ste 200 (A/C,No,Ext):(310)478-5041 (A/C,
<br /> No):(310)479-8707
<br /> Santa Monica,CA 90404-3827 E-MAIL
<br /> ADDRESS:
<br /> INSURERgS]AFFORDING COVERAGE NAIC#
<br /> INSURER A:Toklo Marine Specialty Insurance Company 23850
<br /> INSURED INSURERB:Ace American Ins Co 22667
<br /> The Act I Group,Inc.,dba ATIMS INSURER C:
<br /> P.O.Box 29048 INSURER D:-
<br /> Glendale,CA 91209-9048 INSURER E
<br /> r11S1RER F:
<br /> ............. —------ ........................
<br /> COVERAGES ............. CERTIFICATE NUMBER: .................—----- 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! ADDL SUBR[ POLICY NUMBER POLICY EFF POLICY EXP
<br /> OF INSURANCE -,............. N D. LIMITS
<br /> -—--------- In
<br /> W 11L-v�; VLY xn....................... ......... ... .............. ............................
<br /> A X COMMERCIAL GENERAL LIABILITY j I EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE 1, X'OCCUR DAMAGE TO RENTED 100,000
<br /> I X PHPK2679926-002 411/2025 '1 411/2026 PREWSES(-Faoccurrence), $
<br /> X Contractors Lialb. MED_EXP(Any,one personi $ 5,000
<br /> PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: ..GENERAL AGGREGATE. I$ 4,000,000
<br /> X POLICY LX.1 PRO-
<br /> JECT XLOC PRODUCTS-COMP/OP AGG 1$ 4,000,000
<br /> OTHER: 1$
<br /> .................. ...................——------------- . ............................. ..... ..............................................
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> I (Ea accident)__ $
<br /> X ANY AUTO X �PHPK2679926-002 4/1/2025 411/2026 BODILY INJURY(Per person) $
<br /> OWNED F SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accidentl $
<br /> X HIRED X I NO,P60WN D PROPERTY DAMAGE S O,�
<br /> AUTOS ONLY A LY �Per accident,�
<br /> i --- '--""'-""-''-" "I'll, I'll �....... -111111111-1.......... .... . ........
<br /> .. ..........................
<br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 1$ 10,000,000
<br /> EXCESS LIAB CLAIMS-MADE� 1PUB909174-002 4/1/2025 4/11/2026 10,000,000
<br /> AGGREGATE-
<br /> DEC) I X ' RETENTION$ 10,0001 1
<br /> ............................. ...... ......................1000 .w
<br /> ...............
<br /> B WORKERS COMPENSATION X PER OTH
<br /> AND EMPLOYERS'LIABILITY STATuTE-L—L1i5R-
<br /> ANY PROPRIETORIPARTNERIEXECUTIVE Y/P! NIA X WLRC726110192 41112025 4/1/2026 E.L.EACH ACCIDENT 1$ , ,000
<br /> .O Ey
<br /> F'CEP'MEMBER EXCLUDED?
<br /> (Mandatory
<br /> in NH) E.L.DISEASE-FA EMPLOYEE!$ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> • Crime(3rd Party) P H P K 2 679926-002 41 1 1 202 5 I 411/2026 1Occurrence/Aggregate 66,666
<br /> • E&O/Prof.Liab. X ';PHPK2679926-002 41112025 4/l/2026 Occurrence/Aggregate 3,000,000
<br /> ................. .............- ........................."-'....................................................... ------------ ................................................... ...------
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more spare is eju red)
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are additional insu4e s. Primary and Non-Contributory is included as
<br /> per the terms and conditions of the policies. Separation of Insureds/Cross Liability clause applies under the General Liability policy. Cyberl-lability:
<br /> Travelers Excess&Surplus Lines Insurance Company (Corvus)and Landmark American Insurance Company-Policy Number-CYB-107947188-01-Policy
<br /> Term:4/1125 to 411/26-Total Limit:$2M.Waiver of Subrogation included under the Workers Compensation policy. Notice of Cancellation under General
<br /> Liability: 30 days 110 days for non-payment of premium.
<br /> Tu Tran Dig11,11,signed by
<br /> Tu Tran Nguyen
<br /> Me 2025.08.07
<br /> Nguyen081513-07'00'
<br /> ........................... —�By
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ................ .......... TtiTianNgityenatB:14aniAttgO7,2025
<br /> ---------------------------------------------------------------------------
<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 /> Attn:Santa Ana Police Department—Jail
<br /> 62CivicCenter Plaza ................—-—-------"'........... ------- ...........................
<br /> Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE
<br /> Ve-
<br /> ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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