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<br /> A� CERTIFICATE OF LIABILITY INSURANCE DATE8/21/2025 Y)
<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 pollcy(tes)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: Sarah Field
<br /> (HD)Heffernan Insurance Brokers PWONE g25-934-8500 FAX No;925 934-8278
<br /> 1350 Carlback Avenue EMAIL
<br /> Walnut Creek CA 94596 DDREss• Sarahf@hefrins.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> L'ce se -0564249 INSURERA:Hudson Excess Insurance Company 14484
<br /> INSURED CALBUIL01 INSURER B:National Casualty Company 11991
<br /> Cal Building Systems, INSURERC:Ohio SecurityInsurance Company 24082
<br /> U c.
<br /> 3900 Prospect Avenue,, Unit B
<br /> Yorba Linda CA 92886 INSURERD:Hudson Insurance Company 25054
<br /> INSURER E:SiriusPoint Specialty Insurance Corporation 16820
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER:1684983189 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 /> INTR TYPE OF INSURANCE INSD WVD ADDLSUBR POLICY NUMBER MMIDDmYI' MMIDDNYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y ALM10505-00 7/15/2025 7/15/2026 EACH OCCURRENCE $1,000.000
<br /> CLAIMS-MADE M OCCUR DAMAGE TO(RENTED
<br /> PREMISES Ea occurrence) $100,000
<br /> MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> 3X1POLICY JECT1:1 LOC [PRODUCTS-COMPIOPAGG $2,000,000
<br /> OTHER: Contractual Llab 1 $
<br /> D AUTOMOBILE LIABILITY Y Y FSAR-000009-01 7/15/2025 7/15/2026 COMBINED S(EnINGLE LIMIT' $1,000,000
<br /> B0
<br /> FSA-000009-01 7/15/2025 7/15/2026 accident
<br /> ANY AU70 ODILY INJURY(Per person) $
<br /> OWNED X SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Par accident
<br /> Medical Payments $5,000
<br /> UMBRELLA LIAB X OCCUR ALMU 10209-00 7115I2025 7/15/2026 EACH OCCURRENCE $5,000,000
<br /> X EXCESS LIAB TSX-001555-25 7/1512025 7/15/2026
<br /> CLAIMS-MADE AGGREGATE $5,000,000
<br /> 1ED 1 X I RETENTION$ EachlOccrAggregata $5,000,000
<br /> B WORKERS COMPENSATION Y WCC370286A-00 7115/2025 71151202fi X STA UTE ERH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANYPROPRIETOFUPARTNERlEXECUTIVE F—v-1 NIA E.L,EACH ACCIDENT $1,000,000
<br /> OFFICER)MEMBEREXCLUOEO9
<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 /> A Professional Liability ALM10505-00 7/16/2025 7/15/2026 Aggregate 2,000,000
<br /> C auslaess Property 13FS(26)66 47 76 22 7/15/2025 711512026 Limit 63,956
<br /> E 1st Layer Excess over primary TSX-001555-25 7/15/2025 711512026 $5M Aggregate $5M Occurence
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be atlachad if more space is required)
<br /> Total Excess Liability limit is$10,000,000
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are to be covered as additional insureds.Waiver of Subrogation is
<br /> included on the General Liability,Commercial Auto and Workers Compensation policies per the attached endorsement,if required.Cancellation notice
<br /> endorsement on the General Liability policy is attached.
<br /> This certificate supersedes and replaces any previously issued certiflcate.
<br /> Tu 11'dn Digitally signed by
<br /> Tu Tran Nguyen APPROVED
<br /> Dale:2025,08,?2 - '
<br /> Ng uyen ngr155,-0,'00' By Tu Tran Nguyen at9:14 am Aug 22 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 /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana PWA-Parks, Fleet& Facilities
<br /> 20 Civic Center Piz, M-11
<br /> Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE
<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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