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OR DCERTIFICATE OF LIABILITY INSURANCE rAcATE(MMf a2Y) 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, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Lisa Shimizu-FOokes AssureclPartners Design Professionals Insurance Services, LLC PHONN 714�27-3482 FAX 3697 Mt. Diablo Blvd Suite 230 A1C No: Lafayette CA 94549 E-MAIL CertsDesignPro@AssuredPartners.com INSURER(S)AFFORDING COVERAGE NAIC# License#:6003745 INSURER A:XL Specially Insurance Co. 37885 INSURED PSOMASM1 INSURER B: PSOMAS 865 S. Figueroa Street, Suite 3200 INSURERC: Los Angeles CA 90017 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1191246620 REVISION NUMBER. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICYNUMBER MMfDDlYYYY MMfDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence 5 MED EXP(Any one person) 5 PERSONAL&AOV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ JECT POLICY❑ PRO ❑ LOC PRODUCTS-COMPIOPAGG $OTHER: $ AUTOMOBILE LIABILITY CoMHINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY{Per accident} $ HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE S CEO RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT i $ A Professional Liah s Pall,Liah Y ❑PR5048464 10115/2025 10/15/2026 Per Claim $2,000,000 Claims-Made Form Aggregate Llmit $2,000,000 Retro Oates 10/15/1947 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more spate is required( orgi,allY signed Additional Insured Status is not available on Professional Liability Policy. TU Tran by Tu T.. 2SAN051700/01 -Cityof Santa Ana On-Call Agreement A-2023-075-07. Datei2 g N g Uye n Dace:zozs.,,oa Insurance coverage includes waiver of subrogation per the attached endorsement(s). m-J,n9-caoo' APPROVED sy Tu Tran Nguyen at 7:30 am,Nov 04,2025 CERTIFICATE HOLDER CANCELLATION 30 Day Notice ot Uancellation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attn: June VU&Zianya Arroyo 20 Civic Center Plaza M-11 AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 ,r.r. O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD