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<br /> V CERTIFICATE OF LIABILITY INSURANCE Darz012025
<br /> or2oz5
<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 ondorsoment(s).
<br /> PRODUCER CONTACT
<br /> Marsh USA LLC NAME:
<br /> 30 South 17th Street PHCN o t- AJ Not:
<br /> Philadelphia,PA 19103 EMAIL
<br /> Attn:NBCU.Cedrequest@marsh.com Fax 212-948-5143 ADDRESS:
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> CNI41608515-NBCU-GAWUW-24- INSURER A: ACE American Insurance Company 22667
<br /> INSURED NBCUniversal Media,LLC INSURER B: Indemnil Ins CO Of North America 43575
<br /> a fully owned subsidiary of Comoasl Corporation INSURER C A�,E E[gperty And Casualty ins Co 20699
<br /> 30 Rockefeller Plaza
<br /> New York,NY 10112 INSURER o ACE Fire.Underwrilers Ins.Co. 24702
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: CLE-007389440-02 REVISION NUMBER: 4
<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 AODL 5UBR
<br /> POLICY EFF POLICY EXP
<br /> LTR POLICY NUMBER MMIDDIYYYY MM1DDr(YYY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY XSL G4893044A 12/0112024 12/01/2025 EACH OCCURRENCE $ 19,900,000
<br /> E �OCCUR DAMAGE (RENTED
<br /> CLAIMS-MAD
<br /> PREMISES Ea occurrence 5 19,940,000
<br /> X SIR:S100.1000 MED EXP(Any one person) S 10,1100
<br /> PERSONAL&ADV INJURY S 19,900.000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 60,000,ODO
<br /> X POLICY a PROJECT ❑ LOG PRODUCTS-COMPIOP AGG $ 15,D00,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY ISA H11352637 1210112024 12/0112025 Ea OBI E1,1itSINGLE LIMIT $ 20,000,400
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTYOAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> $
<br /> C X UMBRELLA LIAB X OCCUR XEU G27924840 010 1210112024 121D112425 EACH OCCURRENCE $ 10,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,0011,404
<br /> ❑E❑ RETENTION$ $
<br /> B WORKERS COMPENSATION WLR C72613363(ADS( 12JO112024 1210112025 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> A YIN WHIRI �C72613405 CA.MA 1210112024 12Ja112425
<br /> ANYPROPRIETORIPARTNER7EXECUTIVE N f A E.L.EACH ACCIDENT $ 2,000,440
<br /> D OFFICERrMEMBEREXCLUDED? SCFC7261348A IM 1210112024 1210112025
<br /> (Mandatory in NH) ( ) E.L.DISEASE-EA EMPLOYEE S 2,000,000
<br /> If yes,describe under 2,000,440
<br /> DESCRIPTION OF OPERATIONS below E.L.❑ISEASE-POLICY LIMIT S
<br /> A Excess Workers Compensation WCU C72613442(WA) 12/01/2024 1210112025 Ea AcclDis EmpiuyeelDis Police 2,000,00D
<br /> SIR 5,000,GOD
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Parks,Recreation&Community Services Agency City of Santa Ana are included as additional insured(except workers`compensation)where required by written contract with the Named Insured. This insurance is
<br /> Primary&Nan-Contributory with any other insurance available to the Certificate Holder. NBCU is self-insured for auto physical damage. NBCUniversal Media,LLC subsidiaries include,but are not limited to:
<br /> Estrella Communication,LLC as operator of KVEA TV,100 Universal City Plaza,Universal City,CA 91608;NBCUniversal Media,LLC its parents and its subsidiaries.30 Rockefeller Plaza,New York,NY 10112
<br /> Tu Tran by uaTrangned
<br /> Nguyen APPROVED
<br /> Nguyen 2W5.n8.22
<br /> en By Tu Trun Nguyen at 8:55 am,Aug 22,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Parks,Recreation&Community Services SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Agency City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Santa Ana,CA 92701
<br /> AUTHORIZED REPRESENTATIVE
<br /> O 1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(213161(33) The ACORD name and logo are registered marks of ACORD
<br />
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