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AC" CERTIFICATE OF LIABILITY INSURANCE FUATE(MM,°°IYYYY)
<br /> 16.. � 911112025
<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(fes) 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 /> Arthur J. Gallagher Risk Management Services, LLC PHONE FAX
<br /> 595 Market Street c E •415-546-9300 Arc Nu;415-536-8499
<br /> Suite 2100 ADDRESS:
<br /> San Francisco CA 94105 INSURERS AFFORDING COVERAGE NAIC#
<br /> License#m OD69293 INSURER A:AXA XL Insurance Company UK Limited
<br /> ENSURED FIREAGE-01 INSURER B:Safety National Casuait Cor oration 15105
<br /> Orange County Fire Authority
<br /> P O Box 57115 INSURER C:
<br /> Irvine, CA 9261 9-71 1 5 INSURER D:
<br /> INSURER E;
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER.544220355 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 SUER POLICY EFF POLICY EXP
<br /> LTR POLICYNUMBER IMMIDDIYYYYI (MMlDDIYYYY LIMITS
<br /> A X COMMERCIAL G ENE RAL LIABILITY Y Y B1262RT0219724 7/1/2024 7/112029 EACH OCCURRENCE $1,500,000
<br /> DAMAGE TO RENTE
<br /> CLAIMS-MADE X OCCUR PREMISES Ea occurrence)-_ $
<br /> MED EXP(Anyoneperson) $
<br /> PERSONAL&ADVINJURY $1,500,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $15,000,000
<br /> PRO-
<br /> POLICY YX JECT LOG PRODUCTS-COMPfOP AGG $
<br /> OTHER: Annual Public OfficialslEPL $1,600,000
<br /> A AUTOMOBILE LIABILITY Y Y B1262RT0219724 711/2024 7/1/2029 COMBINEDSINGLELIMIT $1,600,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY{Per person) $
<br /> OWNED
<br /> SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED f $
<br /> NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> B UMBRELLALIAB X IOCCUR Y Y XPR4068288 7/1/2025 7/1/2026 EAGHOCCURRENCE $5,000,000
<br /> X EXCESS LIAR CLAIMS-MADE AGGREGATE $5,voo,9ov
<br /> DED RETENTION$ $
<br /> WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $
<br /> OFFICERIMEMBEREXCLUDED? ❑ N I A
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Professional Liability B1262RT0219724 7/1/2024 7/1/2029 Limii $1,500,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES fACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> RE:Special Event Paramedic Services on 09/13-1412025
<br /> ADDITIONAL INSURED(S):City of Santa Ana,its City Council,its officers,officials,employees, agents,and volunteers are to be covered as additional
<br /> insureds, under Consultant's CGL and AL policies,with respect to any liability arising out of work or operations performed by or on behalf of the Consultant
<br /> including materials, parts,equipment,and personnel furnished in connection with such work or operations. Consultant's Insurance company(ies)agrees to
<br /> waive all rights of subrogation against City, its City Council, its officers,officials,employees,agents,and volunteers for losses paid under the terms of
<br /> Consultant's CGL and AL policies which arise from work performed by Consultant under this Agreement.
<br /> *Sexual Abuse/Molestation is not excluded from General Liability Dl9ltally5lyned
<br /> Tu Tra6lbyTuTran
<br /> 'Nguyen
<br /> CERTIFICATE HOLDER CANCELL TI 6157 09:32:43-07'00'
<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 /> Attn: Recreation&Community Services Agency
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATWE
<br /> P.O. Box 1988
<br /> Santa Ana CA 92702fn; ttGrr
<br /> O 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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