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DATE(MMMDIYYYY)
<br /> .�Ct�►Ro CERTIFICATE Off' LIABILITY INSURANCE
<br /> 11/25/2025
<br /> 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,LXTEND OR
<br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF L14SURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR
<br /> PRODUCER,AND THE CERTIFICATE HOLDER
<br /> IMPORTANT:Ifthe—tit ate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisimaor be endorsed.If SIJBROGA'1°tON IS WAIVED,subject to the terms and conditions of the Polley,certain p0leies may
<br /> require an endorsement.A statement on this certificate does not confer rights to the eer8tteate holder in Gen afsueh endorsement(').
<br /> PRODUCER CONTACT NAME:Jan Gillespie
<br /> The Baldwin Group Specialty Solutions,LLC PHONE(AFC No.Est):646-854-1058 FAX(A/C No):
<br /> 4211 West Boy Seoul Blvd,Suite 800 Tampa,Florida,33607 E-1vIAH.ADDRESS:coiOi?founderahield:com
<br /> INSURER(S)AFFORDING COVERAGE NAIL#
<br /> INSURER A:ACE Property&Cas Ins Co 28699
<br /> INSURED INSURER B:ACE Property&Cis Ins Co 20699
<br /> Sensel4lakers,LLC INSURER C:Hartford Underwriters Ins Co(Hartford) 30104
<br /> 2401 East Katella Avenue,Suite 610 INSURER D:United States Liability Ins Co(USLI) 25B95
<br /> Anaheim,California,92806 INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS 1S TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD INDICATED.NOT'WITHSTANDUs'G ANY REQUIREMENT,TERM OR
<br /> CONDITION OF ANY CONTRACTOR OTEER DOCUMENT WITH RESPECT TO WHICHTHIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERES'4 15 SUBJECT TO
<br /> ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY RAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUSR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD (MMfDD1YYYY) (\tMfDDIYYYY)
<br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00
<br /> CLAIMS MADE V OCCUR DAMAGE TO RENTED S1,On0,Uuilml
<br /> PREMISES(Ea occurrence)
<br /> f MED EXP(Any one person) S5.,000.00
<br /> A GEN'L AGGREGATE LINT APPLIES PER: M D%63786A 1112812025 1112912026 PERSONAL&ADV INJURY S1,000,000..nn
<br /> I14'POLICY 'PROJECT LOC GENERAL AGGREGATE S2,000,000.00
<br /> PRODUCTS-COMPIOP AGG $2,000,000.00
<br /> OTHER
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIM[T $1,000,000.00
<br /> ANY AUTO (EA accident)
<br /> BODH.Y INJURY(Per person)
<br /> OWNED AUTOS SCHEDULED
<br /> A ONLY D9663788A 11F2812025 ft12812026 BODILY INJURY(Per
<br /> ,r accident)
<br /> Y HIRED AUTO5 ONLY �1�NON-OWNED AUTOS PROPERTY DAMAGE Per
<br /> ONLY (
<br /> 11'
<br /> accident)
<br /> UMBRELLA LIAR EXCESS LIAR Each orcurence 52,000,000.00
<br /> B D96637871 1112812025 1 U28M126
<br /> -OCCUR CLAIMS-MADE Aggregate $2,000,000,00
<br /> WORKERS COMPENSATION AND EMPLOYERS'LIABILITY
<br /> PER S'['A"I'ITF.
<br /> ANYP ROPRIETORIPARTNER/EXECUTIV YIN OTHER
<br /> OFFICERIMEMBER.EXCLUDED? N
<br /> (Mandatary in NH) ,/ E.L.EACH ACCIDEN S1,000,000.00
<br /> C If yes,describe order DESCRIPTION'OF OPERATIONS below NIA �r I01VE'CAK6NRL 05/0912025 051091211126 E.L.DISEASE-EA 51,OOn,000.00
<br /> EMPLOYEE
<br /> E.L.DISEASE-POLICY $1,006,000.00
<br /> LIMIT
<br /> D Errors&Omissions SP 1572206F 1210512025 12/05/2026 S3,000,000 per nee S3,000,000 in agg
<br /> DESCRIPTION OFOPEHATIONS 1 LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached Uutore space Is required)
<br /> The City of Sant.Ana,I"offle—,employer',agents and representatives—additional insured with respect to general liability per attached endorsements as required by written contract Insurance is primary and non—tribatory.Wavier of
<br /> Su6rogatam
<br /> The Certificate Holder Is included as an Additional Insured on the above referenced policy where required by writteu contract.
<br /> A Waiveror5ubrogatian applies in favor of the CerttOcale Hinder
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRF13ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
<br /> The City of Santa Ana THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division 20 Civic Center Plaza 4th Floor
<br /> Santa Ana,California 92701 ^
<br /> AUTHORIZED REPRESENTATIVE
<br /> 9ita n9ne
<br /> Tu Tran by T.Tran
<br /> Ngu
<br /> Nguyen Datey:e2nM1 2 6.4109
<br /> OR'M5008100' APPROVED
<br /> nPRVVCC®
<br /> By Tu Tran Nguyen at 8:29 am,Jan 09,2026 (0 1988-2016 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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