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Client#: 1778682 GALLSLLC11
<br /> DATE(MM/DD/YYYY)
<br /> ACORD.,,, CERTIFICATE OF LIABILITY INSURANCE 1 2/26/2026
<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 any rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER NAME: Jamie Melton
<br /> USI Insurance Services LLC PHONE 513 852-6300 FAX
<br /> 312 Elm Street, 24th Floor AMA Lo,Ext: (A/c,No): 513 852-6428
<br /> ADDRESS: jamie.melton@usi.com
<br /> Cincinnati, OH 45202 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> 513 852-6300
<br /> INSURER A:Federal Insurance Company 20281
<br /> INSURED INSURER B:Cincinnati Insurance Company 10677
<br /> CB General Holdings, LLC; Galls LLC
<br /> INSURER C
<br /> 1340 Russell Cave Road
<br /> INSURER D:
<br /> Lexington, KY 40505
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 /> ADDLSUBR
<br /> LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> (MM/DD/YYYY) (MM/DD/YYYY)
<br /> A X COMMERCIAL GENERAL LIABILITY 36090816 03/01/2026 03/01/2027 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE L*OCCUR PREMISES(ERENTED
<br /> nte) $1,000,000
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL$ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> PRO-
<br /> POLICY JECT LOC PRODUCTS-COMP/OPAGG $2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY 73649221 3/01/2026 03/01/202 EaaacccidenSINGLELIMIT $1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS ONLY X AUTOS ONLY Per accident $
<br /> A X UMBRELLA LIAB X OCCUR 56726792 3/01/2026 03/01/2027 EACH OCCURRENCE $10000000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $1 O 00O 000
<br /> DED I X I RETENTION$10000 $
<br /> A AND EMPLOYERS'LIABILITY WORKERS COMPENSATION 71843940 03/01/2026 03/01/202 X STATUTE EORH
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N] N/A
<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 /> B Excess Liabi EXS0570374 3/01/2026 03/01/2027 15,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE: Agreement Nos. A-2017-172 and A-2017-290.
<br /> The General Liability and Automobile Liability policies includes an automatic Additional Insured
<br /> endorsement that provides Additional Insured status to City of Santa Ana, its officers, employees, agents
<br /> and representatives, only when there is a written contract that requires such status, and only with regard
<br /> to work performed on behalf of the named insured. The General Liability policy contains a special
<br /> (See Attached Descriptions) I
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 8:00 am,Apr 07,2026
<br /> City f Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> y o THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> Santa Ana, CA 92702 AUTHORIZED REPRESENTATIVE
<br /> � �. /L
<br /> ©1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD
<br /> #S53098680/M53094580 BLKZP
<br />
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