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711/17/2025
<br /> E(MM/DD/YYYY)
<br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br /> 'Ill
<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
<br /> NAME: Walnut Creek AMS Team
<br /> (WC) Heffernan Insurance Brokers PHONE FAX
<br /> 1350 Carlback Avenue vC No Ext: 925-934-8500 A/c,No):925-934-8278
<br /> E-MWalnut Creek CA 94596 ADDRESS: WalnutCreekAMS@HeffINS.Com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:0564249 INSURERA:Valley Forge Insurance Company 20508
<br /> INSURED VISIINT-02 INSURERB:Transportation Insurance Company 20494
<br /> Meridian Knowledge Solutions, LLC INSURERC: Continental Insurance Company 35289
<br /> 80 Iron Point Circle, Suite 100
<br /> Folsom CA 95630 INSURERD: National Fire Insurance Company of Hartford 20478
<br /> INSURERS:At-Bay Specialty Insurance Company 19607
<br /> INSURERF: Federal Insurance Company 20281
<br /> COVERAGES CERTIFICATE NUMBER:1755883194 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 SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICYNUMBER MM/DD MM/DD
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 7094828100 10/15/2025 10/15/2026 EACH OCCURRENCE $1,000,000
<br /> DAMAGES( RENTED
<br /> CLAIMS-MADE OCCUR
<br /> PREMISES Ea occurrence)
<br /> ccurrence) $1,000,000
<br /> MED EXP(Any one person) $15,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY� ECT � LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY BUA 7094828095 10/15/2025 10/15/2026 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> C X UMBRELLA LAB X OCCUR CUE 7094828128 10/15/2025 10/15/2026 EACH OCCURRENCE $10,000,000
<br /> EXCESS LAB CLAIMS-MADE AGGREGATE $10,000,000
<br /> DED X RETENTION$n $
<br /> D WORKERS COMPENSATION Y WC 7 94828114 10/15/2025 10/15/2026 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? ❑ N/A
<br /> (Mandatory in NH) E.L.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 /> E TECH E&O Retro 11/14/24 AB-6636808-02 10/15/2025 10/15/2026 LIMIT/RETENTION $5M/$25K
<br /> F CRIME 8264-5216 10/15/2025 10/15/2026 LIMT/DEDUCTIBLE $1M/$25k
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> Re:As Per Contract or Agreement on File with the Insured. City of Santa Ana, its officers,officials,employees,and volunteers are included as an additional
<br /> insured(primary and non-contributory)on General Liability policy per the attached endorsement,if required.Waivers of Subrogation are included on General
<br /> Liability and Workers Compensation policies per the attached endorsements,if required. Cancellation notice endorsement for the General Liability policy is
<br /> attached,if required.This Certificate replaces and supersedes all previously issued certificates.
<br /> Digitally signed
<br /> Tu Tran byTuTran
<br /> Nguyen
<br /> Nguyen Date 2 20-08 00 9 APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 12:42 pm,Dec 09,2025
<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 /> Human Resource Department
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<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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