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a CERTIFICATE OF LIABILITY INSURANCE r <br /> ATE(MMIDDIYYYY) <br /> 2/4/2025 <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 <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 CONTNAMEAC7 Account Manager <br /> Spectrum Risk Management PHONE g49-756-5730 u <br /> 74 Discovery 1PJC.N Not: 949-756-5740 <br /> E MA <br /> Irvine, CA 92618 ADDRESS: offlce@spertrumrisk.com <br /> INSURERS AFFORDING COVERAGE NAIClf <br /> vww,spectrumrisk.com OC77485 INSURER A: Travelers Property Casualty Co of America 25674 <br /> INSURED INSURER B: Travelers Indemnity Co of Connecticut 25682 <br /> TSCM Corp INSURER C: Insurance Company of the West 27847 <br /> 17791 Jamestown Lane <br /> Huntington Beach CA 92647 INSURERD: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 83828803 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 ADDL SUER POLICY EFF POLICY EXP <br /> LTR POLICY NUMBER MMIDD!YYW MMIDD[YYYY LIMITS <br /> A ✓ COMMERCIAL GENERAL LIABILITY ✓ 630-2W697831 1/1/2025 1/1/2026 EACH OCCURRENCE S1000000 <br /> CLAIMS-MADE OCCUR OAMAGETO RENTEDPREMISES Ea occurrencel $300,000 <br /> ✓ Deductible-$0 MED EXP(Any one person) $5 000 <br /> ✓ Contractual Liability PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> POLICY I v I jRb ❑ LOC PRODUCTS-COMPIOP AGG $2,000,000 <br /> OTHER: $ <br /> B AUTOMOBILE LIABILITY BA-2W698028 1/1/2025 111/2026✓ COMBINEDSINGLELIMIT S✓ Ea accident 1 t)QQ 000 <br /> ✓ ANY AUTO BODILY INJURY(Per person) S <br /> OWNED AUTOS SCHEDULED BODILY INJURY Per accident $ <br /> AUTOS ONLY AUTOS ( ) <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLY Per accident S <br /> / Deductible-0 $ <br /> A ✓ UMBRELLA LIAB ✓ OCCUR CUP-2W698182 1/112025 111/2026 EACH OCCURRENCE $5000000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $5 000 000 <br /> DEC) I ✓ RETENTION$() $ <br /> C WORKERS PER <br /> AND EMPLOYOERS�IABILIITY YIN ✓NSATION WSD 5056095 04 7/1/2024 7/1/2025 `/ STATUTE OERH <br /> ANYPROPRIETOFJPARTNEPJEXFCUTIVE E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? N i A <br /> (Mandatory in NH) <br /> If yes,describe under E,L.DISEASE-EA EMPLOYEE $ Q <br /> ,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 51 000 QGQ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Santa Ana its officers,employees,agents,volunteers and representatives are additional insured with respect to the general liability <br /> and auto liability when required by written contract per the attached forms.Primary and non-contributory wording applies per the attached carrier <br /> form.Waiver of subrogation applies to the auto liability and employers liability per the attached carrier form. <br /> APPROVED <br /> By Tu Tran Nguyen at 3:08 pm,Feb 04, 2025 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Attention: (PWA: Parks, Fleet& Facilities) ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 20 Civic Center Plaza, M-11 <br /> Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE <br /> Jim Waterhouse <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Tu Tram Digitallysignedby Tu <br /> Train Nguyen <br /> 83828803 I 2025 PKG + 2024 We I Sara Lee 2/4/2025 9:28:37 AM WST} I Page 1 of I9 Lt �n Date:20Z5.02,04 <br /> 9 S 15:09:15.08'00' <br />