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,a►coRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDlYYYY)
<br /> 2/10/2026
<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 1NSURER(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 /> NAME: Annette Romero
<br /> Acrisure Southwest Partners Insurance Services, LLC PHONE 949-486-7904 FAX
<br /> No:
<br /> 611 Anton Blvd., Suite#1400 E-MAIL
<br /> Costa Mesa, CA 92626 ADDRESS: aromero acrisure.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> www.patrisk.com OK07568 INSURERA: Travelers Property Casualty Co of America A++XV 25674
<br /> INSURED INSURERB: Evanston Insurance Company A+ XV 35378
<br /> R.J. Noble Company
<br /> 15505 Lincoln Avenue wsuRERc:
<br /> P,O. Box 620 INSURER D:
<br /> Orange CA 92856-9020 INSURERE:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 89209467 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 /> INSRLICY EXP
<br /> LTR ADDLTYPE OF INSURANCE FNSD SUBR POLICY NUMBER MMIDDY� MMlDBr YYY LIMITS
<br /> LTR
<br /> A ✓ COMMERCIAL GENERAL LIABILITY ✓ ✓ VTJ-EXGL-9F338142-TIL-25 7/1/2025 7/1/2026 EACH OCCURRFNCE $1000000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED
<br /> ✓ PREMISES Ea occurrence $1,000,000
<br /> $25,000 DED MED EXP(Anyone person) $5,000
<br /> PERSONAL&ADV INJURY $11,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000
<br /> POLICY JEC LOC PRODUCTS-GOMPIOPAGG $2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY VTC2E-CAP-9F338154-TCT-25 7/1/2025 7/9/2026 coMBINED SINGLE uMlr $
<br /> Ea accident 2,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> ✓ AUTOS ONLY ✓ AUTOS ONLY Per a.d.nl
<br /> A UMBRELLA LIAB �/ OCCUR CUP-4R630963-24-25 7/1/2025 7/1/2026 EACH OCCURRENCE $10 004 000
<br /> EXCESS LIAB CLAIMS-MADE Policy Follows Form Over AGGREGATE $10 004 000
<br /> 10,000 Underlying General Liab.
<br /> ❑ED ✓ RETENTION$ $
<br /> A WORKERS COMPENSATION ✓ UB-7N939386-25-25K 7/1/2025 7/1/2026 ,/ STATUTE ER
<br /> AND EMPLOYERS'LIABILITY YIN No Deductible for Workers
<br /> PER
<br /> ANYPROPRIETORIPARTNERfEXECUTIVE E.L,EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMBEREXCWDED? NIA Compensation
<br /> (Mandatory in NH) E.L DISFASE-FA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 000 000
<br /> B Contractors Pollution Liability MKLV5ENV104221 7/1/2023 7'112126 Ea Occ:$5,000,0001 Aggregate:$5,000,000
<br /> B Misc.Contractor's Professional Liab MKLV5ENV104221 7/1/2023 7/1/2026 Each Occurrence:$5 000 000
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> Re:RJN#919761 Project#23-67001 Grand Ave.Rehabilitation from Edinger Ave to McFadden Avenue,Santa Ana,CA
<br /> The City of Santa Ana,its City Council,its officers,officials,employees,agents and volunteers are named as Additional Insureds,
<br /> coverage includes Primary and Non-contributory and Waiver of subrogation applies per endorsements attached as
<br /> required by written contract.ExcesslUmbrella follows form
<br /> *30 days for non-payment of premium,10 days for non-payment of premium.
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION ByTu Trarl Nguyen-et-4& 3am,Feb-as-a026
<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 /> 20 Civic Center Plaza ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Santa Ana CA 92701
<br /> AUTHORIZED REPRESENTATIVE N /
<br /> Dave Jacobson
<br /> O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> 89209167 1 25(26 - GL/AtJ/EXC/WC - 23/26 POLL/PROF I Annette R. i 2/10/2026 5:59:52 AM (PST) I Page 1 of 13
<br /> This certificate cancels and supersedes ALL previOUSly issued certificates.
<br />
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