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ACC)ROO� ATE{MM/OD/YYYY)CERTIFICATE OF LIABILITY INSURANCEE�2 0 111 812 0 2 5 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 REPRESENTATIVEOR PRODUCER,ANDTHE CERTIFICATE HOLDER. IMPORTANT:IFthe certificate holder is an AODITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions ofthe 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 CONTACT NAME: Van Gordon(97153A1) PHONE FAX 8927 Westminster Ave (A/C,NO,EXT):714-903-5555 (A/C,NO):(657)200-2550 E-MAIL Garden Grove CA 92844-2609 ADORESs: vgordcn@farmersagent.com INSURER(S)AFFORDING COVERAGE NAIC P INSURED INSURER A: Truck Insurance Exchange 21709 TOOINSURERB: Farmers Insurance Exchange 21652 1381 V ALENCIA AVEE DESIGNS, INSURERC: Mid Century Insurance Company 21687 381 INSURER D: STE G TIJSTIN CA 92780 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES Of INSURANCE LISTED BELOW HAVE BEEN ISSUE[)TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED.NOT'WITHSTAiNDING ANY REQUIREMENT.TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENTVVITH RESPECTTO(WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHETFRMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPEOFINSURANCE ANSDL SUBR WVD POLICY NUMBER POLICY D/YY POLICY EXP LIMITS (MM/DDIYYYY) (MM/DDiYYYY) X COMMERCIAL GENERAL LIAMUTY EACH OCCURRENCE 3 2,000,000 CLAIMS-LIADE OCCUR DAMAGE TO RENTED $PREMISES[Ea Occurrence) 1,000,fl00 MEDEXPt.Any one persani $ 10,000 B Y Y 607113383 01/1812025 01/18/2026 PERSONAL 3,ADVINJURY 5 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GFNERAL AGGREGATE 3 4,000,000 X POLICY ❑ PROJECT F1 LDC PRODUCTS-CONIP OPAGG 3 2,000,000 OTHER' 5 AUTOMOBILE LIABILITY COMBINEDSlI`IGL;_(MIT IEaaccideau 5 .ANYAUTO BODILY INJURYI Per person; 5 OVINED AUTOS SCHEDULED ONLY AUTOS N BODI1d INJURY;Per accidertl 3 HIRED AUTOS NON-OWNED PROPERTY DAiMAGE 3 ONU AUTOSOM1IL`e IPeraccidenC i UMBRELLALIAB OCCUR EACHJCCURRENCE 3 EXCESS LIAR CLAIMS-MADE AOGrR=aATE 3 DES I I RETuM1IT:0N 5 5 WORKERS COMPENSATION PER AND 90PLOYERS'LIABILITY STATUTE 0T'HE:R 5 ANY PROPWFTnR �4RTNER Y/'N E.L.EAC`i ACCIDY`IT S 1.000,000 EXECUTPVE OFFICER.MELIBER N/A N �09523307 01/18/2025 01/18/2026 EXCLUDED'(Mandatary in NH) Y EL rJ15ca3E--A EMP{=J"EE 1,000,000 It/es, OPF_RATIONSbelow I E.L.DISE43E-POLICY OMIT 5 1,000,000 TU T r a n rTt°Tv. -d N9 Yen I _ _ APPROVED Nguyeno�«.za s-I9:44 G700' By Tu Tram)Nguyen at 3:19 pm,Mar 19,2025 DESCRIPTION OF OPERATIONS/LOCATIONS:VEHICLES(ACORD 10 1,Additional Remarks Schedule,may be attached if more space is requ 1381 VALENCIA AVE,TUSTIN,CA 92780 The City of Santa Ana,the entity,its officers,officials, employees,agents,and volunteer are the additional Insured and the Certificate Holder The policy is on a primary and non-contributory basis, A Waiver of Subgrotation is In the favor of the Certificate Holder I CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA AUTHORIZED REPRESENTATIVE SANTA ANA CA 92701 ACORD 25!2016'03) =1933-2015 ACORD COPPORATION.All Rights Reserved P; 3 11-1:) The ACORD name and logo are registered marks of ACORD