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DATE(MMIDWYYYY)
<br /> Ac®Ro® CERTIFICATE OF LIABILITY INSURANCE
<br /> �.� 8/28/2026 8/26/2025
<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(les) 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 Lockton Companies,LLC CONTACT
<br /> NAME:
<br /> DBA Lockton Insurance Brokers,LLC in CA PHONE FAX
<br /> CAA license 40FI5767 EMAIL a1C No
<br /> 444 W.47th St.,Ste.900 ADDRESS:
<br /> Kansas City MO 64112-1906 INSURERS)AFFORDING COVERAGE NAIC#
<br /> (816)960-9000 kcasu(a lockton.com INSURER A:Zurich Amefican Insurance Company an 16535
<br /> INSURED DUDEK INSURER B:American Guarantee and Liab.Ins.Co. 26247
<br /> 1475838 605 THIRD STREET INSURER c:Continental Casuafty Company Compwy 20443
<br /> ENCINITAS CA 92024 INSURER D:
<br /> INSURER E:
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: 16765248 REVISION NUMBER: XXXXXXX
<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 13Y PAID CLAIMS.
<br /> INSR ADDLSUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDPOLICY EFF fIY ICY EXP
<br /> LTR MMDDYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y GLOO146311 8/28/2025 8/28/2026 EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE T OCCUR PREMISES Eaoccurtancs $ 100000
<br /> MED EXP(Any one parson) $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GFN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY I JEo Lk LOC PRODUCTS-COMPIOPAGG $ 2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY Y Y BAP0146329 8/28/2025 ? 8/28/2026 (Ea tSINGLE LIMIT $ 1,000,000
<br /> X ANY AUTO i BODILY INJURY(Per person) $ )aXXXyX
<br /> OWNED SCHEDULED I BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS XXXX=
<br /> HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> $ XXXXXXX
<br /> B X UMBRELLA LAB }�' OCCUR N Y AUC0146407 9/28/2025 8/28/2026 EACH OCCURRENCE $ 1,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1 000 000
<br /> DED RETENTION$ $ XXXXXXX
<br /> WORKERS COMPENSATION PER OTH-
<br /> A AND EMPLOYERS'LIABILITY YIN Y WC0146330 8/28/2025 8/28/2026 X STATUTE ER
<br /> ANY PROPRIETOR/PARTNERIEXECUTIVE N!A E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICERIM EMBER EXCLUDED7
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,desorlon,under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,00()
<br /> C PROFESSIONAL N N EEH59I III III INCL POLL 112112111 112112,126 PER CLAIM$2,000,000
<br /> LIABILITY AGGREGATE$2,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> CITY OF SANTA ANA,OFFICERS,AGENTS,EMPLOYEES AND VOLUNTEERS ARE ADDITIONAL INSURED ON GENERAL AND AUTO LIABILITY
<br /> COVERAGE ON A PRIMARY,NON-CONTRIBUTORY BASIS,AS REQUIRED BY WRITTEN CONRACT WAIVER OF SUBROGATION IN FAVOR OF THE
<br /> ADDITIONAL INSURED APPLIES ON WORK COMP,GENERAL,AUTO AND UMBRELLA LIABILITY COVERAGE,AS REQUIRED BY WRITTEN CONTRACT
<br /> AND WHERE ALLOWED BY LAW.COVERAGE IS SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY.
<br /> APPROVE®
<br /> By Tu Tran Nguyen at 7.44 am,Sep 02,2025
<br /> CERTIFICATE HOLDER CANCELLATION See Attachments
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 16765248 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> CITY OF SANTA ANA ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> ATTENTION:PUBLIC WORKS AGENCY,
<br /> CIP/DESIGN ENGINEERING AUTHORIZED REPRESENTATIV.
<br /> 20 CIVIC CENTER PLAZA
<br /> SANTA ANA CA 92702,M-36 �tf
<br /> c0 I988 OI5 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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