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ACQ® CERTIFICATE OF LIABILITY INSURANCE DATE[MM/DDIYYIY) 07/02/2025 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 CONTACT Baker, Romero &Associates Insurance Brokers, Inc. PrA1oe Kevin Lizarraga FAX PO BOX 736 n E t: (626)332-2258 4pic,No): (626)339-9921 La Mirada,CA 90637 E-MAIL E-MAIL ADDRESS: kevin@bakerromero.com License#: OG22790 INSURERS AFFORDING COVERAGE NAIC M INSURER A: Nonprofit Insurance Alliance of California INSURED INSURER : State.Compensation Insurance Fund Thrive Santa Ana, Inc. INSURERC: P.O. BOX 1935 INSURERD: Santa Ana,CA 92702 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00008709-0 REVISION NUMBER: 35 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDPOLI DIYCY E LTR YYY MMIOD1YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 2024-57335 10/2712024 10/2712026 EACH OCCURRENCE $ 1 000 000 CLAIMS-MADE F-V-1 DAMAGE TO RENTED n l OCCUR PREM SES(Ea accu ante) $ 500,000 MED EXP(Any one erson) $ 20,000 PERSONAL&ADV INJURY $ 1.000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY D jE O LOC PRODUCTS-COMPIOP AGG $ 1,000,000 OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY iPer accident $ UMBRELLA LIARpCi UR EACH OCCURRENCE $ EXCESS LIAB MS-MADE AGGREGATE $ DED RETENT $ B WORKERS COMPENSATION JN 9294435.2025 0311712025 03117/2026 X STATUTE LOTH AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YL�J E.L.EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDE[ N I A (Mandatory in NH) EL DISFASF-EA EMPLOYEE S 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I I I EL DISEASE-POLICY LIMIT S 1,000,000 A Liquor Liability 2024-57335 10/2712024 10/2712025 $1M Aggregate 1M Each Cause DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required), City of Santa Ana, its City Council,officers, officials,employees, agents,and volunteers are named as additional insured. Tu Tra n Dig'I�A{ly signed by Tu Tran Nguyen Nguyen °r4z2°2b APPROVED By Tu Tram Nguyen at 7:4f am,Jul 08,2025 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 Attn:Executive Director,Community Development Agency ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE KAL) ©1988-2015 ACORD CORPORATKW. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by KAL on 07/02/2025 at 04:54PM