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ACa CERTIFICATE OF LIABILITY INSURANCE r
<br /> ATE(MM'D°"YYY}
<br /> 1116/2025
<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 IIGU of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> McGriff Insurance Services LLC NAME: Lauren Mayer
<br /> 9850 NW 41 st Street •954-385-6022 Nn:866 802-8684
<br /> PHONE
<br /> Suite 100 A RlEss: lauren.ma er marshmma.com
<br /> Doral FL 33178 INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Berkshire Hathaway Homestate Ins Co _ 20044
<br /> INSURED 132SAFEBLLC INSURER B:Everest Indemnity Insurance Company 10851
<br /> Interwest Consulting Group, Inc.
<br /> 444 N Clevevelandd Ave; INSURERC:Bridgeway Insurance Company 12489
<br /> Loveland CO 80538 INSURERD;Lexington Insurance Company 19437
<br /> INSURER E:Great American E&S Insurance Com an 37532
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:866768558 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 /> INSR ADDL SU'BR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDNYYY LIMITS
<br /> B X COMMERCIAL GENERAL LIABILITY Y Y CF3131-00415251 10/3/2025 10/312026 EACH OCCURRENCE $1.000,000
<br /> CLAIMS-MADE X OCCUR DAMAGE TO HEN EDPREMISES Ea occurrence $300,000
<br /> X 10,000 MED EXP{Any one person} 510,000
<br /> PERSONAL&ADV INJURY 51,000,000
<br /> GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,000.000
<br /> X POLICY I " I PE O LOC
<br /> PRODUCTS-COMPIOPAGG 52,DOO,DOO
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY Y Y CF3CA00337251 10/3/2025 10/3/2026 ECOMBINED c tSINGLE LIMIT $1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY Per accident $
<br /> AUTOS ONLY AUTOS { }
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> Excess 2er coo 1 a g $1,000,000
<br /> C UMBRELLALIAB N
<br /> OCCUR Y Y 8EA7XL000207904 10/3/2025 10/312026 EACH OCCURRENCE $10.0013,000
<br /> D 11170903 10/3/2025 10/3/2026
<br /> X EXCESS LIAR CLAIMS-MADE.
<br /> AGGREGATE 310,000,000
<br /> DED I 'X RETENTION$_ _ S
<br /> A WORKERS COMPENSATION Y SAWC666825 5/12/2025 5/12/2026 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANYPROPRIETORIPARTNFRJEXECUTIVE M E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMBEREXCLUDEr>7 NfA
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> ❑ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> E Professional Liability TER5780118 10/3/2025 10/312026 Each Claim/Aggregate $10,000,000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required),
<br /> Excess policy#140002058 effective 10/0312025-10/0312026-QBE Ins Corp NAIC#39217-Limits-$5,000,000 part of$10,000,000 Excess of$5,000,000.
<br /> Crime coverage—Federal Insurance Company,NAIC 20281-Policy#J06767825 effective 10/3125-1013126;Limit$1,000,000 DED$10,000.Technology Errors
<br /> &Omissions and Cyber Coverage-Allied World Assurance Company US,Inc. NAIC#19489-Policy#03148733
<br /> effective 1013125-1 013126.Each Claim/AGG$3,000,000 DED$100,000.
<br /> RE:RFP#23-142-On Call Environmental and Planning Services.
<br /> The City of Santa Ana,its officers,officials,employees,and volunteers are additional insureds with respects to general and automobile liability,with a written
<br /> contract.Waiver of Subrogation applies to general and automobile liability and workers compensation in favor of the additional insureds,with a written contract.
<br /> Coverage is primary and non-contributory for the additional insureds.Notice of Cancellation is 30 days,except 10 days for non-payment.
<br /> CERTIFICATE HOLDER APPROVED CANCELLATION
<br /> By Tu Tran Nguyen at 11.56 am,Nov 17,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> T
<br /> Planning and Building Agency TU p ran 6y Tu T an9rted
<br /> 20 Civic Center Plaza Nguyen
<br /> AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702 Nguyen Date:2025.11.17 ULL
<br /> V;V
<br /> O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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