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CERTIFICATE OF LIABILITY INSURANCE F_4ATE(MMM
<br /> O
<br /> NYVY)
<br /> 4/23l2025
<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($), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If'the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the Polley,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 I CONTACT
<br /> (OC)Heffernan Insurance Brokers N ME:
<br /> 18004 Sky Park Circle,Suite 210 PHONE 949-771-3dOD PAx 849-771 3441
<br /> Irvine CA 92614 _Aq E•o IL - hibcenre uesi heffins,com
<br /> WSURERS AFFORDING COVERAGE NAICfI
<br /> 4 EE
<br /> uldeOne 8 eclalt Mutual Insurance Com an 14559INsuReo HUMAOPT-04Uidegne MutlJal insurance Corn an 15032
<br /> Human Options, Inc.
<br /> PO Box 53745 INSURER c:Houston Casualty CompanV 42374
<br /> Irvine CA 92619 INSURER D
<br /> INSURER E:
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER:649222484 REVISION NUMBER:
<br /> THIS IS TO CERTII Y 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 RY PAID CLAIMS.
<br /> INSR ADDL SUER
<br /> LTR TYPEOFINSURANCEINSD wynPOLIO NUMBER PMIb�EFF MI M6RLIC EXP mi LIMITS
<br /> B X COMMERCIAL GENERAL LIABILITY Y V Di-4{141-350
<br /> 9/2312024 9/2312025 EACHOCCURRENGE $1,000,000
<br /> CLAIMS-MADE I_X1 OCCUR DAMAGE TO RENTS
<br /> _PREMISES Ea occurrence $1,000,000
<br /> MED EXP(A ono arson) $20,000
<br /> PERSONAL&AOV INJURY— $1.000,000
<br /> GENT AGGREGATE LIMIT APPUES PER; GENERAL AGGREGATE $3,000,000
<br /> X POLICY❑JPEGT �LOG -
<br /> PRODUCTS-COMP/OPAGG $3,000,000
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY Y Y 01-0041-35'I 9123/2024 9/23f2025 COMBINED S NGLE LIMIT $1,000,D00
<br /> ANY AUTO Ea ace dent
<br /> CH
<br /> OWNED
<br /> BODILY INJURY(Per peraon) $
<br /> SE
<br /> AUTO$ONLY AUTODULED S BODILY INJURY(Per accident) $
<br /> X HIRED X NON-OWNEn PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY era denl $
<br /> A )( U6IBRELWiJAB X $
<br /> OCCUR 01.0041-352 9/23/2024 9/23/2025 EACH OCCURRENCE $5,000,000
<br /> EXCESS LIAR CLAIMS-MAOE
<br /> ADaREDATE $s,aoa,000
<br /> DIED I X" I RETENTION$ $
<br /> A AND 5MPLOYER 'LI A IONILFr Y 7 N Y 01-0037-245 4/112025 411 r2026 X 3T�ATtJ E � -
<br /> ANOEMPLOVERS'LIABILrrY
<br /> ANYPROPRIE70 JPARTNER/EXECUTIVE $1,O00,D00
<br /> OFFICERIMEMBEREXCLUDED? El NIA E.L.EACHACC1DENr
<br /> (Mandatory In Nil) E.L.DISEASE-EA EMPLOYE#f yes,describe under $1,000,OOD
<br /> DESCRIPTION OF OPERATIONS bolaW E.L.RISEASE-POLICY LIMIT $1,000,000
<br /> B Prolassloral Liability 01-0041-350
<br /> e Employee Dlshonasty 01-0041-350 9I231202d 9f23/2025 9/2312024 912312026Per lCncetla tilrr3i $1.000•000
<br /> O Cyberllablltty H24NGP210733.03 9/23/2024 9/23/2025 Each Claim Lfmlt $1 p6pflQ0
<br /> DESCRIPTION of OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedere,maybe attached if more apace le required)
<br /> Ro:As Per Contract or Agreement on File with Insured.City of Santa Ana,officers,agents,employees and volunteers are included as en additional insured
<br /> (primary and non-contributory)on General Liability policy and additional insured on Automobile Liability policy per the attached endorsements,If required.$5M
<br /> Umbrella policy goes over the underlying Genera liability,Automobile Liability,Workers'Compensation,and Sexual Misconduct Policies.Waivers Of
<br /> Subrogation are included on General Liability,Automobile Liability and Workers Compensation policies per the attached endorsements,if required.This
<br /> Certificate replaces and supersedes all previously issued certificates.
<br /> Diglta4y signed �]1
<br /> TU Tran byTtTran AI!Tran
<br /> RVEj
<br /> Nguyen
<br /> f\J g uye n Dice:202s.04.24
<br /> ,1.03,09.07'co By Nguyen at 11:02 am,Apr 24,2R25
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Chy of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Community Development Agency
<br /> 20 Civic Center Plaza, M-25 AUTHORITEDREPRESENTATIVE
<br /> Santa Ana,CA 92701
<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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