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<br /> DATE(MMIDDNYYY)
<br /> ACiOR" CERTIFICATE OF LIABILITY INSURANCE 11/17/2025
<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 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 Willis Towers Watson Certificate Center
<br /> NAME:
<br /> Willis Towers Watson Southeast, Inc. PHOE FAX
<br /> c/o 26 Century Blvd 1AICN,
<br /> o Ezt: 1-877-945-7378 C No: 1-888-467-2378
<br /> EMAIL
<br /> P.O. Box 305191 ADDRESS:
<br /> Nashville, TN 372305191 USA INSUREI AFFORDING COVERAGE NAIC N
<br /> INSURER A: Hartford Fire Insurance Company 19682
<br /> INSURED INSURER B: Twin City Fire Insurance Company 29459
<br /> Chicago Title Company
<br /> Attn: Fidelity National Financial Inc. Risk Mgmt INSURERC: Hartford Accident and Indemnity Company 22357
<br /> 601 Riverside Ave, Bldg 5 INSURER D• Allianz Global Risks US Insurance Company 35300
<br /> Jacksonville, FL 32204
<br /> INSURER E
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER:W41833074 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 /> INS. TYPE OF INSURANCE II SUER
<br /> POLICY EFF POLICY EXP
<br /> LTR POLICY NUMBER MMIDDfYYY MM 6DlYYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 1,000,000
<br /> A X Host Liquor Liability MEP EXP(Any one person) $ 0
<br /> % 20 CSE C90929 11/15/2025 11/15/2026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000
<br /> X POI PRO � I PRODUCTS-COMPIOPAGG $ 2,000,000
<br /> JECT
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> �( ANY AUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED Y 20 CSI C90930 '11/15/2025 11/15/2026 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTYDAMAGE
<br /> 'ys0�QNLY ,(1eL1TP ONiXXd Per accident) $
<br /> Damage is X $
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000
<br /> B
<br /> EXCESS LIAB CLAIMS-MADE Y 20HV6BU5JL2 11/15/2025 11/15/2026 AGGREGATE $ 10,000,000
<br /> DED X I RETENTION$0 $
<br /> WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> �C ANYPROPRIETORIPARTNERIEXECUTNE No E.L.EACHACCIDENT $ 1,000,000
<br /> OFFICERIMEMBEREXCLUE No NIA 20 WN C90926 11/15/2025 11/15/2026
<br /> (Mandatary in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> B Workers Compensation and 20 WBR C90927 11/15/2025 11/15/2026 E.L. Each Accident $1,000,000
<br /> Employers Liability - WI S MA E.L. Disease- Ea Emp $1,000,000
<br /> 7?er Statute E.L.Disease-Pol Limi,. $1,000,000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> SEE ATTACHED
<br /> Tu Tran 0igilally,ignedby
<br /> Fu Tran Nguyen Da APPROVED
<br /> te'2e25.71.19
<br /> N g u ye n os:t4.55-0s'00
<br /> 8y Tu Tran Nguyen at 8:i4I am,Nov 19,2025
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana
<br /> AUTHORIZED REPRESENTATIVE
<br /> Risk Management Division
<br /> 20 Civic Center Plaza, 4th floor
<br /> ❑��-
<br /> Santa Ana, CA 92701 AU
<br /> O 1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> SR ID: 28885785 HATCH: 4210486
<br />
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