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Ro® CERTIFICATE OF LIA
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITL
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of t
<br />this certificate does not confer rights to the certificate holder in lieu of
<br />PRODUCER
<br />3S Insurance Services
<br />4425 Bayard St Ste, 122
<br />San Diego CA 92109
<br />INSURED
<br />Prime Tech Cabinets, Inc.
<br />2215 S Standard Ave Bldg A & B
<br />Santa Ana CA 92707-3036
<br />PRIMTEC-O'
<br />,BILITY INSURANCE DATE(MMfDDIYYYY)
<br />10/24/2025
<br />Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
<br />. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />TE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />1e policy, certain policies may require an endorsement. A statement on
<br />uch endorsement(s).
<br />CONTACT
<br />NAME: Amlr Filsoof
<br />PHONE
<br />WC.o E - 949-339-5037vc No 949-281-5541
<br />EMAIDL care 3sinsure.com ADRESS;
<br />INSURER S) AFFORDING COVERAGE NAIC #
<br />INSURERA: Pennsylvania Lumbermens Mutual Insurance 14974
<br />INSURER B: TechnologyInsurance Company 42376
<br />INSURER C :
<br />INSURER D :
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 13878194 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 />MISR ADDLSUBR
<br />LTR TYPE OF INSURANCEimqn wynPOLICY NUMBER MMIDDYNYYV MMIODIYYYPY
<br />A X MERCIALGENERALLIABILITY Y Y 04-PO23-01-25 1/1/2025 1/1/2026
<br />CLAIMS -MADE � OCCUR
<br />COM
<br />GEN'LAGGREGATE LIMIT APPLIES PER:
<br />POLICY � PRO- LOC
<br />A AUTOMOBILE LIABILITY
<br />X ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLYHX
<br />AUTOS
<br />X HIRED NON -OWNER
<br />AUTOS ONLYAUTOS ONLY
<br />Y I Y I04-PO23-02-25
<br />A rUMBRELLA LIAB X OCCUR Y Y 04-PO23-03-25
<br />EXCESS LIAB CLAIMS -MADE
<br />❑ED RETENTION $
<br />B WORKERS COMPENSATION Y TWC4548688
<br />AND EMPLOYERS' LIABILITY Y I N
<br />ANYPROPRIETORIPARTN EPJEXECUTIV E
<br />OFFICERIMEMBEREXCLUDED? Y NIA
<br />(Mandatary In NH)
<br />it yes, describe under
<br />DESCRIPTION OF OPERATIONS helnw
<br />1/1/2025 1 1 /112026
<br />111 /2025 1 111/2026
<br />1 /112025 1 1/112026
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached of more space is requil
<br />TE HOLDER
<br />CANC
<br />LIMITS
<br />EACH OCCURRENCE $1,004,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence) $ 1,000,000
<br />MED EXP (Any one person) $ 5,000
<br />PERSONAL & ADV INJURY $1,000,000
<br />GENERAL AGGREGATE $2,000,000
<br />PRODUCTS - COMP/OPAGG $2,000,000
<br />GLDeductitde $1,000
<br />COMBINED SINGLE LIMIT $ 1,000,000
<br />Ea accident
<br />BODILY INJURY (Per person) 3
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />Per accident
<br />S
<br />EACH OCCURRENCE $ 51000,000
<br />AGGREGATE 35.000,000
<br />$
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />Nguyen o95�20-08�002
<br />APPROVED
<br />By Tu Tran Nguyen at 9:56 am, Nov 12, 2025
<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 />Attention: Jaime Lopez
<br />801 W. Civic Center Drive, Suite 200 AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701 /
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />COVERAGES CERTIFICATE NUMBER: 13878194 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 />MISR ADDLSUBR
<br />LTR TYPE OF INSURANCEimqn wynPOLICY NUMBER MMIDDYNYYV MMIODIYYYPY
<br />A X MERCIALGENERALLIABILITY Y Y 04-PO23-01-25 1/1/2025 1/1/2026
<br />CLAIMS -MADE � OCCUR
<br />COM
<br />GEN'LAGGREGATE LIMIT APPLIES PER:
<br />POLICY � PRO- LOC
<br />A AUTOMOBILE LIABILITY
<br />X ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLYHX
<br />AUTOS
<br />X HIRED NON -OWNER
<br />AUTOS ONLYAUTOS ONLY
<br />Y I Y I04-PO23-02-25
<br />A rUMBRELLA LIAB X OCCUR Y Y 04-PO23-03-25
<br />EXCESS LIAB CLAIMS -MADE
<br />❑ED RETENTION $
<br />B WORKERS COMPENSATION Y TWC4548688
<br />AND EMPLOYERS' LIABILITY Y I N
<br />ANYPROPRIETORIPARTN EPJEXECUTIV E
<br />OFFICERIMEMBEREXCLUDED? Y NIA
<br />(Mandatary In NH)
<br />it yes, describe under
<br />DESCRIPTION OF OPERATIONS helnw
<br />1/1/2025 1 1 /112026
<br />111 /2025 1 111/2026
<br />1 /112025 1 1/112026
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached of more space is requil
<br />TE HOLDER
<br />CANC
<br />LIMITS
<br />EACH OCCURRENCE $1,004,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence) $ 1,000,000
<br />MED EXP (Any one person) $ 5,000
<br />PERSONAL & ADV INJURY $1,000,000
<br />GENERAL AGGREGATE $2,000,000
<br />PRODUCTS - COMP/OPAGG $2,000,000
<br />GLDeductitde $1,000
<br />COMBINED SINGLE LIMIT $ 1,000,000
<br />Ea accident
<br />BODILY INJURY (Per person) 3
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />Per accident
<br />S
<br />EACH OCCURRENCE $ 51000,000
<br />AGGREGATE 35.000,000
<br />$
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />Nguyen o95�20-08�002
<br />APPROVED
<br />By Tu Tran Nguyen at 9:56 am, Nov 12, 2025
<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 />Attention: Jaime Lopez
<br />801 W. Civic Center Drive, Suite 200 AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701 /
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />Y I Y I04-PO23-02-25
<br />A rUMBRELLA LIAB X OCCUR Y Y 04-PO23-03-25
<br />EXCESS LIAB CLAIMS -MADE
<br />❑ED RETENTION $
<br />B WORKERS COMPENSATION Y TWC4548688
<br />AND EMPLOYERS' LIABILITY Y I N
<br />ANYPROPRIETORIPARTN EPJEXECUTIV E
<br />OFFICERIMEMBEREXCLUDED? Y NIA
<br />(Mandatary In NH)
<br />it yes, describe under
<br />DESCRIPTION OF OPERATIONS helnw
<br />1/1/2025 1 1 /112026
<br />111 /2025 1 111/2026
<br />1 /112025 1 1/112026
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached of more space is requil
<br />TE HOLDER
<br />CANC
<br />LIMITS
<br />EACH OCCURRENCE $1,004,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence) $ 1,000,000
<br />MED EXP (Any one person) $ 5,000
<br />PERSONAL & ADV INJURY $1,000,000
<br />GENERAL AGGREGATE $2,000,000
<br />PRODUCTS - COMP/OPAGG $2,000,000
<br />GLDeductitde $1,000
<br />COMBINED SINGLE LIMIT $ 1,000,000
<br />Ea accident
<br />BODILY INJURY (Per person) 3
<br />BODILY INJURY (Per accident) $
<br />PROPERTY DAMAGE $
<br />Per accident
<br />S
<br />EACH OCCURRENCE $ 51000,000
<br />AGGREGATE 35.000,000
<br />$
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT $ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE $1,000,000
<br />E.L. DISEASE -POLICY LIMIT $1,000,000
<br />Nguyen o95�20-08�002
<br />APPROVED
<br />By Tu Tran Nguyen at 9:56 am, Nov 12, 2025
<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 />Attention: Jaime Lopez
<br />801 W. Civic Center Drive, Suite 200 AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701 /
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />Nguyen o95�20-08�002
<br />APPROVED
<br />By Tu Tran Nguyen at 9:56 am, Nov 12, 2025
<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 />Attention: Jaime Lopez
<br />801 W. Civic Center Drive, Suite 200 AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701 /
<br />©1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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