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AC"" CERTIFICATE OF LIABILITY INSURANCE r AT JMMID25 YY) <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 endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: Mandy Guo <br /> AssuredPartners Design Professionals Insurance Services, LLC PHONE 510-272-1402 PAX <br /> No. <br /> 3697 Mt. Diablo Blvd Suite 230 E-MAILExfi- <br /> Lafayette CA 94549 ADDRESS: CertsDesignPro@AssuredPartners.com <br /> INSURERS AFFORDING COVERAGE NAIL# <br /> License#:6003745 INSURER A:XL Specialty Insurance Co. 37885 <br /> INSURED MARKTHO-03 INSURER B; <br /> Mark Thomas&Company, Inc. <br /> 2833 Junction Avenue, Suite 110 INSURER C; <br /> San Jose CA 95134 INSURER D <br /> INSURER E: <br /> INSURER F I <br /> COVERAGES CERTIFICATE NUMBER:1484911407 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 /> ILTR ADDL�SUB POLICYEXP <br /> TYPE OF INSURANCE INSD WVD P041CY NUMBER MM DDY!YYY MMIDDIYYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE ❑OCCUR DAMAGES(-RENTED <br /> PREMISES Ea occurrence $ <br /> MEP FXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY[J JERCT LOC PRODUCTS-COMP/OP AGG $ <br /> OTHER: I $ <br /> AUTOMOBILE LIABILITY COMBINEO SINGLELIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Par person} $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE 5 <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> ER S <br /> AND EMPLOYERS'LIABILITY Y J N TATJTE <br /> ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? El NIA <br /> (Mandatory in Ni E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> A Professional Liability& DPR5044784 711/2025 711l2026 Per Claim $2,000,000 <br /> Contr,Pollution Liab Included Aggregate Limit $2,000,000 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 161,Additional Remarks Schedule,may be attached if more space is required) <br /> Job Number: 21-00208-SAGS Grant Applications-- <br /> TU Tran Digitallysigned by <br /> 7u Tran Nguyen <br /> Nguyen °4:t,o?°�0�009 <br /> APPROVED <br /> By To Tran Nguyen at 2:09 pm,Jura 09,2025 <br /> CERTIFICATE HOLDER CANCELLATION 30 Day Notice of 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 <br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE <br /> Santa Ana CA 92702 <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />