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KIMCSTA-01 MMCALLISTER
<br /> CERTIFICATE OF LIABILITY INSURANCE DATE 12IY5
<br /> I26/26i2025
<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 License#OM70471 CONTACT
<br /> NAME:
<br /> Orion Risk Management Insurance Services,An Alera Group Insurance PHONE,Exrl:(949 263-885D FAX
<br /> Agency, LLC ) {A1C,Nol:(949)263-8860
<br /> 18575 Jamboree Rd,Suite 500 AMDRESS:
<br /> Irvine,CA 92612
<br /> INSURER.S AFFORDING COVERAGE _ NAIC#
<br /> INSURER A:PHILADELPHIA INDEMNITY INSURANCE COMPANIES' 18058
<br /> INSURED INSURERB:XL Insurance America Inc 24554
<br /> Kimco Staffing Services,Inc. INSURER C:
<br /> 17872 Cowan Ave INSURER D:
<br /> Irvine,CA 92614
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR NSD WVD MMfDDIYYYY MMIDD
<br /> A X COMMERCIALGENERALLIABILITY EACH OCCURRENCE g 1,000,000
<br /> CLAIMS-MADE [X] OCCUR X X PHPK2599195007 91112025 9/1/2026 pRErAGE TO a oecu rice $ 100,000
<br /> ME[)EXP(Any one erson $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GFN1 AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 3,000,000
<br /> X POLICY[_] PRO" 0 LOG 3,000,600
<br /> JFGT PRODUCTS ACG S
<br /> OTHER: SEXUAL PHYSICAL 1,000,000
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> Ea accident S
<br /> X ANY AUTO X X PHPK2599195007 91112025 9/1/2026 HOUILY INJURY Per erson S
<br /> OWNED SCHEDULED
<br /> AUTOSONLY AUTOS HODILYINJURY Per accident $
<br /> X HIRED X NON-OWNED PROPERPerTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY
<br /> accident S
<br /> S
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $
<br /> EXCESS LIAR CLAIMS-MADE AGGREGATF S
<br /> DED I I RETENTION S S
<br /> B WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> ANY PROPRIETOWPARTNERIEXECUTiVE YIN X RWD300121609 12l28I2025 12I28I2026 1,000,000
<br /> OFFICERIM EMBER EXCLUDED? Y� N i A E.L.EACH ACCIDENT $
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,DOD,a00
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Professional Liabili X PHPK2599195007 911I2025 9/1/2026 Each Claim 1,000,000
<br /> A Professional Liabili PHPK2599195007 911/2025 9/1/2026 Aggregate 2,000,000
<br /> DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES IACORD 101,Additional Remarks Schedule,may be attached if more space is requiredl
<br /> City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are listed as additional insured with respects to General Liability and
<br /> Auto Liability per the terms of the attached endorsements.
<br /> Waiver of Subrogation applies per the terms of the attached General Liability,Auto Liability,Workers Compensation,and Professional Liability endorsements.
<br /> Digirally signed
<br /> TU Tran by TuTf3e
<br /> Nguyen
<br /> Nguye 3in9 aoo2
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION 1 By TO Tran Nguyen of 1:30 pm,Jan 12,2026
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS,
<br /> Attention: Human Resources
<br /> 20 Civic Center Plaza
<br /> Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE
<br /> ACORD 25(2016103) Cc31988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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