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�►coR©® CERTIFICATE OF LIABILITY INSURANCE r (MMiDDIYYYY)aTE 10/14/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy ies must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER NAME: Brandon Dempster JVRC Insurance Services PHONE. No,Ext: 81 873 5 7600 C. No): 818-69B-6401 5707 Corsa Ave ADDRESS: services@jvrcinsurance.com Ste 105 INSURER(S)AFFORDING COVERAGE NAIC p Westlake Village CA 91362 INSURER A: Ategrity Specialty Insurance Company 16427 INSURED INSURER B: Omaha National Casualty Company 32107 Anguiano Lawn Care Inc INSURER C PO Box 2849 INSURER D INSURER E Seal Beach CA 90740 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMlDDlYYYY) (MMIDDM'YY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �OCCUR PREMISES REMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A Y Y 01-C-PK-P20084995-02 08/25/2025 08/25/2026 PERSONAL BADVINJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICYLIII� JEt° LOC PRODUCTS-COMPlOPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMUINLU $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident AUTOS AUTOS ( ) $ PROPERTY DAMAG17- HIRED AUTOS NON-OWNED AUTOS (Peraccidenl) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORlPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 B OFFICERIMEMBEREXCLUDED? NIA Y ONCC11838-05 09/29/2025 09/29/2026 If In NH)and E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Santa Ana,its City Council,officers,officials,employees,agents,and Volunteers are named as additional insureds With respect to the general Digitallysi ed liability policy.Waiver of subrogation applies with respect to the general liability and workers'compensation policies. TU Tran by T.Tran Nguyen Nguyen Date:zaz5 0.17 I Q45:57-0'00' APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 10.44 am,Oct 17,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attention: CIP Engineering AUTHORIZED REPRESENTATIVE 20 Civic Center Plaza,M-36 Santa Ana CA 92701 �t� /� O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD