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DATE(MM/DDNYYY)
<br /> AFRO CERTIFICATE OF LIABILITY INSURANCE I
<br /> 03/10/2026
<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. If
<br /> SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this w
<br /> certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> AOn Risk services Northeast, Inc. -NAME:
<br /> PHONE FAX i
<br /> New York NY Office (A/C.No.Ext): (866) 283-7122 (A/C.No.): (800) 363-0105 y
<br /> One Liberty Plaza E-MAIL 0
<br /> 165 Broadway, suite 3201 ADDRESS: _
<br /> New York NY 10006 USA
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURED INSURERA: Vigilant Ins CO 20397
<br /> Horvitz & Levy LLP INSURERB: Federal Insurance Company 20281
<br /> Business Arts Plaza
<br /> 3601 W. Olive Ave., 8th Fl. INSURERC: Chubb Indemnity Insurance CO. 12777
<br /> Burbank CA 91505 USA INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 57011 841 91 60 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. Limits shown are as requested
<br /> LTR TYPE OF INSURANCE INS WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 35767164 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE OCCUR commercial Package Policy DAMAGE TO RENTED $1,000,000
<br /> PREMISES Ea occurrence
<br /> MED EXP(Any one person) $10,000
<br /> PERSONAL&ADV INJURY $1,000,000 0
<br /> GEN'LAGGREGATE LIMITAPPLIES PER. GENERAL AGGREGATE $2,000,000 rn
<br /> POLICY PECOT- LOC PRODUCTS-COMP/OP AGG $2,000,000 0000
<br /> OTHER. o
<br /> B AUTOMOBILE LIABILITY Y (25)7499-25-98 09/27/2025 09/27/2026 COMBINED SINGLE LIMIT
<br /> Ea accident) $1,000,000
<br /> Business Auto Coverage ••
<br /> ANY AUTO BODILY INJURY(Per person) 0
<br /> Z
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) N
<br /> AUTOS ONLY AUTOS
<br /> HIREDAUTOS X NON-OWNED PROPERTY DAMAGE V
<br /> XONLY AUTOS ONLY (Per accident)Jw
<br /> L
<br /> d
<br /> B X UMBRELLALIAB X CLAIMS-MADE OCCUR 79781939 09/27/2025 09/27/2026 EACH OCCURRENCE $1,000,000
<br /> EXCESS LABU
<br /> umbrella Liability AGGREGATE $1,000,000
<br /> DED RETENTION
<br /> C WORKERS COMPENSATION AND y 71777133 09/27/2025 09/27/2026 X I PERSTATUTE I JOTH-
<br /> EMPLOYERS'LIABILITY ER
<br /> Y/N Workers Compensation - ch
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE 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 IrAPPROVED E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> By Tu Tran Nguyen at 11:09 am,Mar 25,2026 -
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> city of Santa Ana, its city council, officers, officials, employees, agents, and volunteers are added as Additional Insured as
<br /> respects to the General Liability as required by written contract.
<br /> General Liability is primary and non-contributory to other insurance available to the certificate holder, but only to the
<br /> extent required by written contract with the insured.
<br /> A waiver of subrogation in favor of Additional Insured as respects the General Liability, Auto Liability and Workers
<br /> CERTIFICATE HOLDER CANCELLATION 0
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br /> POLICY PROVISIONS.
<br /> city Of Santa Ana AUTHORIZED REPRESENTATIVE
<br /> Attention: city Attorney's Office
<br /> 20 civic Center Plaza, M-29 a �� � d'��
<br /> Santa Ana CA 92701 USA c(J�/
<br /> ©1988-2016 ACORD CORPORATION.All rights reserved.
<br /> ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD
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