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AoC"R" CERTIFICATE OF LIABILITY INSURANCE D ATE(l71f2Da25YYY)
<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 /> Arthur J. Gallagher Risk Management Services, LLC Francisco Honzura FAX
<br /> PHONE
<br /> 4201 Westown Parkway, Suite 120 ;515-309-6220 Alc No:
<br /> West Des Moines IA 50266 ADDRess: Francisco Honzura@ajg.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Sentry Insurance Company 24988
<br /> INSURED MUSCLIG-01 INSURER B: Indian Harbor Insurance Company 36940
<br /> Musco Sports Lighting, LLC
<br /> 100 1st Ave W INSURER c:Travelers Proper Prope!ly Casualty Company of America 25674
<br /> Oskaloosa, IA 52577 INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER.999167056 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 /> ILN.TR TYPE OF INSURANCE ADDL 5UBR POLICY NUMBER (MMf�DNYYY MM16DY� LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 9016877004 711l2025 7/112026 EACH OCCURRENCE $1,000,000
<br /> GLAIMS-MADE ®OCCUR OAMAGE TO RENTED
<br /> PREMISES Ea occurrence $1,004,004
<br /> MED EXP(Any one person) $10,040
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000
<br /> X POLICY O JE O O LOC PRODUCTS-COMPJOP AGG $2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY Y Y 9016877003 77112025 7/112026 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) 5
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) 5
<br /> AUTOS ONLY AUTOS
<br /> X HIRE X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> $
<br /> G X UMBRELLA LIAB X OCCUR CUP9X03061125NF 7/112025 711/2026 EACH OCCURRENCE $10,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000
<br /> DED X RETENTION$ $
<br /> A WORKERS COMPENSATION Y 9016877001 7/1/2025 71112026 X I STER
<br /> ATUTE ERH
<br /> A AND EMPLOYERS'LIABILITY Y f N 9016877002 7/112025 711/2026
<br /> ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEM6EREXCLUDED? FNIN J 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 Architects&Engineers CE0742113905 71112025 711/2026 Each Claim $5,000,000
<br /> Professional Liability& Aggregate $5,000,000
<br /> Pollution Liability Retention $250,000
<br /> DESCRIPTION OF OPERATIONS f LOCATIONS J VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Re:Musco Project 223727—Centennial Park Fields 5&6.
<br /> City of Santa Ana,City Council,officers,officials,employees,agents and volunteers are shown as Additional Insured solely with respect to General Liability
<br /> coverage as evidenced herein on a Primary/Non-Contributory basis and Auto Liability as required by written contract with respect to work performed by the
<br /> Named Insured. A Waiver of Subrogation is included in favor of Additional Insured under the General Liability,Auto Liability and Workers Compensation
<br /> coverages as evidenced herein as required by written contract.
<br /> Dlgitahysi9nedby
<br /> Tu Trdn
<br /> Tu Tran Nguyen
<br /> Date:2025.11.2
<br /> Nguye r-�106.2330 08004 APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Train Nguyen at 8:22 am,Nov 24,2025
<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 /> PWA Parks Maintenance Division
<br /> 20 Civic Center Plaza AUTHORrLEDREPRESENTATIVE
<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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