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DATE(MMIDDIYYYY)
<br /> A� �� CERTIFICATE OF LIABILITY INSURANCE
<br /> OSl192025
<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(les)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:
<br /> Next First Insurance Agency,Inc. PH ON o (855)222-5919e No
<br /> IX
<br /> PO Box 60787 EXII: (FA
<br /> Pala Alto,CA 94306 E-MAIL pp ADDRESS: support@rextinsurance.com
<br /> INSURERS AFFORDING COVERAGE NAIL#
<br /> INSURER A: State National Insurance Company,Inc. 12831
<br /> INSURED INSURER B:
<br /> Brian Peterson Art Inc
<br /> 2522 Chambers Rd Ste V-116 INSURER C:
<br /> Tustin,CA 92780 INSURER D:
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:443901727 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 /> EXP
<br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM DDPOLICYIYYYY MMIDD EFF YfYYYY I LIMITS
<br /> LTR
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00
<br /> CLAIMS-MADE XI OCCUR DAMAGE TO RENTED l00,000.00
<br /> PREMISES Ea occurrence $
<br /> MED EXP(Any one person) $15,000.00
<br /> A X X NXTXKDWVFL-02-GL 01/2012025 01/20/2026 PERSONAL&ADV INJURY $1,000,000.00
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000.00
<br /> POLICY PRO O LOG PRODUCTS-COMPIOPAGO $2,000,000.00
<br /> X RI-
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTYDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> UMBRELLA.LIAR OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE $
<br /> DEQ I I RETENTION$ $
<br /> WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANYPROPRIETORYPARTNEPJEXECUTIVE ❑ EL EACH ACCIDENT $
<br /> OFFICERIMEMBEREXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS beluw E.L.DISEASE-POLICY LIMIT S
<br /> Each Occurrerce, $1,000,000.00
<br /> A Professional Liability X NXTXKDWVFL-02-GL 01/20/2025 01/20/2026 Aggregate: $2,000,D00,00
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,,may be attached if more space is required)
<br /> The Certificate Holder is City of Santa Ana.A General Liability Waiver of Subrogation applies in favor of this Certificate Holder.City of Santa Ana,its City Council,officers,
<br /> officials,employees,agents,and volunteer are Additional Insureds on the General Lia lity policy per the Additional Insured Automatic Status Endorsement.All Certificate
<br /> Holder privileges apply only if required by written agreement between the Certificate Holder and the insured,and are subject to policy terms and conditions.
<br /> Digitally signed
<br /> Tu Tran Nguy—an
<br /> Nguyen APPROVED
<br /> Nguyen Mte:202s0a.2s
<br /> 07:42:06-07'00' ,By Tu Tran Nguyen at 7:46 am,Aug 25,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Santa Ana LIVE CERTIFICATE
<br /> Attn:Executive Director,Community Development Agency SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 20 Civic Center PI7 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Santa Ana,CA 92701 r + ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> ° AUTHORIZED REPRESENTATIVE
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