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PERETEC-01 CLAMONT
<br /> ,d►coRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 5/4/2026
<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 rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Christine Lamont
<br /> NAME:
<br /> Kore Insurance Holdings, LLC PHONE FAX
<br /> P.O. Box 473 (A/C,No,Ext):(973)974-9430 (A/C,No):
<br /> 354 Eisenhower Parkway,Plaza 1 E-MAIL clamont@koreins.com
<br /> Livingston, NJ 07039
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURERA:Lloyds of London 15792
<br /> INSURED INSURER B:Evanston Insurance Company 35378
<br /> Peregrine Technologies,Inc. INSURER C:The Hartford* 19682
<br /> 71 Stevenson St
<br /> Ste 700 INSURER D:Axis Surplus Insurance Company 26620
<br /> San Francisco,CA 94105 INSURER E:Scottsdale Insurance Company 41297
<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 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD MM/DD/YYYY MM/DD/YYYY
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE X OCCUR ES00040779318 4/12/2026 4/12/2027 rl DAMAGE TO RENTED 250,000
<br /> X X PREMISES Ea occurrence $
<br /> X Owner's&Contractor MED EXP(Any oneperson) $ 10,000
<br /> PERSONAL&ADV INJURY $ 2,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY PRO- ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> JECT
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000
<br /> Ea accident $
<br /> ANY AUTO X X ES00040779318 4/12/2026 4/12/2027 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000
<br /> EXCESS LIAB CLAIMS-MADE MKLVl EUL105929 4/12/2026 4/12/2027 AGGREGATE $ 3,000,000
<br /> DED RETENTION$ $
<br /> C WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> 13WECAC3TVE 12/4/2025 12/4/2026 1,000,000
<br /> ANY PROPRIETOR/EXCLUDED?
<br /> R/EXECUTIVE N/A X E.L.EACH ACCIDENT $
<br /> IMF EMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,UOU
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> D Cyber Liability/Technology E&O X 26-110016507 3/8/2026 3/1/2027 Cyber/Tech E&O 5,000,000
<br /> E Cyber Liability/Technology E&O X �EKS3611560 3/8/2026 3/8/2027 Cyber/Tech E&O 5,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> If required by written contract,the following is included as additional insured:
<br /> City of Santa Ana,its City Council,its officers,officials,employees,agents,and volunteers are to be covered as additional insureds,under Company's CGL
<br /> and AL policies,with respect to any liability arising out of work or operations performed by or on behalf of the Company including materials,parts,
<br /> equipment,and personnel furnished in connection with such work or operations.
<br /> Company's Insurance companies agree to waive all rights of subrogation against City of Santa Ana,its City Council,its officers,officials,employees,agents,
<br /> SEE ATTACHED ACORD 101
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By Tu Tran Nguyen at 12:39 pm,May 07,2026
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92701
<br /> AUTHORIZED REPRESENTATIVE
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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