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AC" CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDOfYYYY)
<br /> 07/16/2025
<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 CONTACT NAME: SiIVI EUnSUfI Choi
<br /> NEW TOWN INSURANCE AGENCY PHONE (213)365-2800 FAX No): (213)674-2319
<br /> 1458 S San Pedro St#212 E-MAIL ADDRESS: irifo@newtins.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC N
<br /> Los Angeles CA 90015 INSURER A: ATLANTIC CASUALTY INS CO
<br /> INSURED INSURER B: UNITED FINANCIAL CASUALTY COMPANY 11770
<br /> Xanadu Service System,Inc C/o Bruce Hwang INSURER C: SCOTTSDALE INSURANCE COMPANY
<br /> 752 S.Windsor Blvd INSURER D: EMPLOYERS PREFERRED INS CO
<br /> INSURER E:
<br /> Los Angeles CA 90005 INSURER F:
<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 EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INsn wyn POLICY NUMBER lMMIDDfYYYYI MM1DDfYYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED
<br /> PREMISES Es occurrence $ 100,000
<br /> MFD FXP(Any one person) $ 5,000
<br /> A x x L227001123-1 09/15/2024 09/1512025 PERSONAL&ADVINJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 2,000,000
<br /> POLICY E PO-
<br /> JEC LOC PRODUCTS-COMP/OP AGG $ INCLUDED
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT
<br /> Ea accident $ 1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED 995750193 04107/2025 10/07/2025 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> L — I —UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000,000
<br /> C X EXCESSLIAB CLAIMS-MADE CXS4052898 05/19/2026 09115/2025 AGGREGATE $ 1,000,000
<br /> DFD RETENTION$ $
<br /> WORKERS COMPENSATION X STATLfTE OE
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANY PROPRIGTORlPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000.000
<br /> D oFFICERIMEMBER EXCLUDED? 0 N f A EIG5218309-02 04/02/2025 04/02/2026
<br /> (Mandatory in NH) ELL DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 191,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana,officers,agents,employees,and volunteers are named as additionally insured on this policy pursuant to written contract,agreement,or memorandum of
<br /> understanding.Such insurance as is afforded by this policy shall be primary,and any insurance carried by City shall be excess and noncontributory,"City of Santa Ana,its City
<br /> Council,officers,officials,employees,agents,and volunteers"
<br /> This Policy may be canceled by the Company by giving to the insured and the additional insureds indicated on the certificates of insurance issued during the term of this policy at
<br /> least thirty(30)days written notice of cancellation or in the case of non-payment of premium,at least ten(10)days written notice of cancellation"
<br /> Sexual Abuse or Molestation Liability added to the policy.
<br /> CERTIFICATE HOLDER TtI Troll DigitAFl Igned CANCELLATION
<br /> an
<br /> Nguyen
<br /> Nguyen Date 2025.07�4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana, PWA-Parks,Fleet&Facilities, I03R29-07'00' THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 20 Civic Center PIZ,M-11 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Santa Ana, Ca 92701
<br /> �APPR,OVED AUTHORIZED REPRESENTATIVE
<br /> By Tu Tran Nguyen at 10:29 am,Ju!24,2025
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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