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AC" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 6/18/2025 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 WANED, 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 COOMEACT Telisa Gibson RBN Insurance Services PHONE 3sa Gibson 303 E Wacker Dr Ste 650 ac No):312-856-9425 o IL 60601 E-MAIL Chicago ADDRESS: tqibsc)n@rbninsurance.com INSURERS AFFORDING COVERAGE NAICIt INSURER A:Underwriters at Lloyds 15792 INSURED ESOURCE-01 INSURERS:Hartford Insurance Group E Source Companies LLC Utiliworks INSURER C:Hartford Fire Insurance Co. 19682 3020 Carbon Place, Suite 300 INSURERD:Trumbull Insurance Company 27120 Boulder CO 83301 INSURER E:Hartford Casualty Insurance Co 29424 INSURER F: COVERAGES CERTIFICATE NUMBER:6381OD529 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. IN ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE 7Y POLICY NUMBER MMIDDYYY MMIDDIYYYY LIMITS C X COMMERCIAL GENERAL LIABILITY Y Y 83UUNBM5WWW 6114/2025 8/14/2026 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR DAMAGE Ea occurrence $300,000 MED EXP(Any one person) $10,o00 PERSONAL&ADV INJURY $1,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMPIOP AGG $2,000,000 OTHER: $ U AUTOMOBILE LIABILITY Y 83UENBG3L2R 6/14/2025 6/14/2026 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PRDPERTYDAMAGE AUTOS ONLY AUTOS ONLY leer accident $ $ E X UMBRELLA LIAB X OCCUR 83RHUBP3ZPX 6114/2025 6/14/2026 EACHOCCURRENCE $5,000.000 EXCESS LIAB CLAIMS-MADE AGGREGATE S 5.000,000 DED RETENTION$ I $ B WORKERS COMPENSATION Y 63UUEBG3L3G 6/14/2025 6/1412026 X AND EMPLOYERS'LIABILITY YIN STATUTE ERH ANYPROPRIETORIPARTNERJrXECUTIVE N E.L.EACH ACCIDENT OFFICER/MEMBEREXCLUDED7 NIA 51,000,000 Mandatary in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $1.000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A TechnolcgylProfessional Liability APT1237925 6/14/2025 6/14/2026 Each Claim/Aggregate 5000000 each C Grim e 10 KB 0778860-25 6/14/2025 6/14/2026 Limit 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are listed as additional insured on primary and non-contributory basis with respect to the General Liability as required by written contract or agreement.Waiver of Subrogation applies in favor of additional insured with respect to the General Liability and Workers Compensation as required by written contract or agreement.30 Days'Notice of Cancellation applies. Umbrella Liability follows the GL,Auto Liability and Workers Comp. D€gltatJysignedhy Tu Tran Tu Tran Nguyen Nguyen° APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 7:34 am,Jun 19,2025 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, Attention: Public Works Agency 215 S Center St AUTHORIZED REPRESENTATIVE Santa Ana CA 92703 �- ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD