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A"Rv CERTIFICATE OF LIABILITY INSURANCE DAT8�2Z�2o2'�"Y)
<br /> THIS CERTIFICATE 1S 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: Kimb®rl Leonardo
<br /> The Baldwin Group Mid-Atlantic LLC PHONE Pax
<br /> 20 South King Street N •703-777-2341 Arc No):703-771-1852
<br /> Leesburg VA 20175 E-MAIL kim.leonardo@baidwin.com
<br /> INSURERS)AFFORDING COVERAGE NAIC#
<br /> License#:CA#0658748 INSURER A:Twin City Fire Insurance Coma 29459
<br /> INSURED KABOGMD-01 INSURERB:Trumbull Insurance Company 27120
<br /> KABOOM!, Inc. INSURER c:Hartford!Pool 9i4
<br /> 7200 Wisconsin Avenue Suite 400
<br /> Bethesda MD 20814 INSURER D:Evanston Insurance Company 35378
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:2108014856 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 OFF POLICY EXP
<br /> LTR POLICYNUMBER MMIDDIYYYY MMIDDIYYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 42UUNAY6W07 11112025 11112026 EACH OCCURRENCE 31,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea occurrence $300,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY S1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY❑PRO ❑ LOC
<br /> JECT PRODUCTS-COMPIOPAGG $0
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY Y Y 42UENAE6588 111/2025 11112026 COMUINED SINGLE LIMIT S 1,000,000
<br /> Ea accident _
<br /> IxANY AUTO BOOILY INJURY(Per person) S
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) S
<br /> AUTOS ONLY AUTOS
<br /> HIRED IX
<br /> NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE S
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE S
<br /> DED RETENTION$ S
<br /> C WORKERS COMPENSATION Y 42WEEL9110 111/2025 111/2026 X I STATUTE 01RH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANYPROPRIETOPJPARTNERIEXECUTIVE E.L.EACH ACCIDENT s 1,000,000
<br /> OFFICERIMEMBEREXCLUDED? El EXCLUDED? -
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,0001000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT 5 1,G00,000
<br /> D Products Liability MKLV2PBC002331 1/1/2025 111/2026 Each Oec-51.000,000 2,G00,000 AGG
<br /> Deductible 5,000
<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,it's City Council,it's officers,officials,employees,agents,are included as an Additional Insured with respects to General Liability and Auto
<br /> Liability if required by written contract and subject to terms,conditions,and exclusions of the policy. A Waiver of Subrogation applies to General Liability, Auto
<br /> Liability and Workers Compensation if required by written contract,and subject to terms,conditions,and exclusions of the policy.
<br /> Tu Tra n Digitally signed by
<br /> Tu Tran Nguyen
<br /> #a2025.0902Nguyen APPROVED
<br /> 4:55: By To Tran Nguyen at 2.54 pm,Sep 02, 2025
<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 /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Parks, Recreation and Community Services, M-23
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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