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CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD1YYYY)
<br /> 9/16/2025
<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(les)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 CONTACT
<br /> NAME: AnnlOwens
<br /> AssuredPartners Design Professionals Insurance Services, LLC PHONE 510-272-1465 FAX No):
<br /> 3697 Mt. Diablo Blvd Suite 230 EMAIL
<br /> Lafayette CA 94549 ADDRESS: CertsDesig nPro Assured Partners,com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> License*6003745 INSURER A:BERKLEY INSURANCE COMPANY 32603
<br /> INSURED MIGINCO-01 INSURERB:Travelers Property Casualty Company of America 25674
<br /> MIG, Inc.
<br /> Moore lacofano Goltsman, Inc. INSURERC:The Travelers Indemnity Company of Connecticut 25682
<br /> 800 Hearst Ave INSURER D:National Indemnity Company 20087
<br /> Berkeley CA 94710 INSURERE:Twin City Fire Insurance Company 29459
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:137385536 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 ADDL SUER POLICY EFF POLICY EXP
<br /> LTR POLICYNUMBER MMIDDIYYYY MMIDD YY LIMITS
<br /> B X COMMERCIAL GENERAL LIABILITY Y Y 6801HB99998 8/31/2025 8/31/2026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE FT1 OCCUR DA WWTE TO RENTED
<br /> PREMISES Ee occurrence $1,000,000
<br /> X Contractual Llab MED EXP Any one person) $10,000
<br /> Included PERSONAL&ADV INJURY $1,000,000
<br /> GFN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGRFGATE $2,000,000
<br /> POLICY PRO-
<br /> JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> C AUTOMOBILE LIABILITY Y Y BAOS579947 8/31/2025 8131/202B COMBINEbSINGLELIMIT $1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS (Per acciden!BODILY INJURY $
<br /> �
<br /> X HIRED X NON-OWNED pROpERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> B X UMBRELLA LIAB X OCCUR Y Y CUPOH758762 8/31/2025 8131/2026 EACH OCCURRENCE $10,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $10,0o0,0o0
<br /> DED I X RETENTION$ $
<br /> g WORKERS COMPENSATION Y UB21-553909 8/31/2025 8/31/2026 X PER OTH-
<br /> AN1]EMPLOYERS'LIABILITY Y f N STATUTE ER
<br /> ANYPROPRIETORIPARTNERIEXECUTIVE MIA
<br /> E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERtMEMBEREXCLUDED9
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT $1,000,000
<br /> A Professional Liab&Contr.Poll AEC909023107 8/3112025 8/31/2026 Per Claim!$5,000,000 $5,000,000/Aggr
<br /> ❑ Drone Liability 9004014 8/31/2025 8/31/2026 Limit $1,000,000
<br /> E Cyber Liability 57MB035552025 8/31/2025 8/31/2026 Dmit $1.000,000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required)
<br /> The following policies are included in the underlying schedule of insurance for umbrellatexcess liability:General Liability/Auto Liability/Employers
<br /> LiabilitylEmployee Benefits Liability.
<br /> Project Name:City of Santa AnaOn-call Graphic Design Services.
<br /> City of Santa Ana Public Works,its City Council,Its officers,officials,employees,and volunteers are named as additional insureds as respects general liability
<br /> as required per written contract.General Liability is Primary/Non-Contributory per policy form wording. Insurance coverage includes waiver of subrogation per
<br /> the attached endorsement(s).
<br /> SEVERABILITY OF INTERESTS
<br /> Separation of Insureds-Except with respect to the Limits of Insurance,and any rights or duties specifically assigned in this Coverage Part to the first Named
<br /> See Attached...
<br /> CERTIFICATE HOLDER CANCELLATION 30 Da Notice of Cancellation
<br /> "�Pi�R�dFI� -
<br /> By Tu Tran Nguyen at 4.10 pm;Sep 16,Zt7Z5_. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN
<br /> Dlgitallysigned ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana Public Works TU Tran by TUTran
<br /> 20 Civic Center Plaza, M-36 Nguyen
<br /> Santa Ana CA 92701 N J Uyen Date:94?09006 AUTHORIZED REPRESENTATIVE
<br /> 16:32, O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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