Laserfiche WebLink
Aco CERTIFICATE OF LIABILITY INSURANCE °ATE`MM'°°"YYY) <br /> 12/2/2025 <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 lieu of such ondorsement(s). <br /> PRODUCER CONTANAME: Betty Tran <br /> ICA Insurance Services PHONE 949-297-6962 F,v'�C No): 949-297-5960 <br /> 130 Vantis, Suite 250 E-MAIL <br /> Allso Viejo, CA 92656 DD bett .tran ioausa.com <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> www.loausa.com CA License#OE67768 INSURER A: RLI Insurance Company 13056 <br /> INSURED INSURER B: <br /> Johnson-Frank&Associates, Inc. <br /> 5150 E.Hunter Avenue INSURER C <br /> Anaheim CA 92807 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 88127141 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 PAIL]CLAIMS. <br /> ILTR TYPE OF INSURANCE INSD WVDSUBRI POLICPOLICY NUMBER MM DDmYY MMIDD� LIMITS <br /> A ✓ COMMERCIAL GENERAL LIABILITY �/ ✓ PSB0001301 12/1/2025 12/1/2026 EACH OCCURRENCE $1 000 000 <br /> CLAIMS-MADE ❑✓ OCCUR Scheduled Al Endt PREMISENTE $1 000 000 <br /> ✓ Prim/NonCon Professional <br /> 2rofessional Services S Ea occurrence) <br /> MED EXP(Any one person $10 000 <br /> P <br /> ✓ Wvr of Subr performed by the Insured PERSONAL&ADV INJURY $1 000 000 <br /> GENT.AGGREGATE LIMIT APPLIES PER: are Excluded GENERAL AGGREGATE $2,000,000 _ <br /> POLICY� JECT FI/I LOG <br /> PRODUCTS-COM?lOPAGG $200O000 <br /> OTHER: Deductible $0 <br /> A AUTOMOBILE LIABILITY ✓ ✓ PSA0001078 1211/2025 12/1/2020 Ee MBIN DlSINGLE LIMIT $1 000 000 _ <br /> ✓ ANYAUTO Designated Insured Endt BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED #CA20481013;Prim/NOnCon BODILY INJURY(Per accident $ <br /> HIRED AUTOS ONLY NAUTOSON-OWNED and Blkt Wvr of Subr f <br /> ✓ AUTOS ONLY 1// <br /> AUTOS ONLY included on pg 2 of Form Par acROPE idenDAMAGE $ <br /> ✓ Prlm/NonCOnWvr of Subr i#PPA3000313 Deductible $0 <br /> A UMBRELLA LIAB OCCUR PSE0001230 12/1/2025 12/1/2026 PACH OCCURRENCE $4 000 000 <br /> / EXCESS LIAB CLAIMS-MADE Follow Form;Excl Prof AGGREGATE $4 00p 000 <br /> DED I ✓I RETENTION$0 Liability <br /> A WORKERS COMPENSATION �/ PSWO002298 12/1/2025 12/1/2026 ,/ STATUTE ERH Deductible- 0 <br /> AND EMPLOYERSLIABILITY YIN U5L&H Included; <br /> ANYPROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $1 ODO 000 <br /> OFFICERIMEMBEREXCLUDED? � N f A Scheduled Waiver Of , <br /> (Mandatory In NH) Subrogation Endt EL.DISEASE-EA EMPLOYEE $1 0 '. <br /> If yes,describe under 9 <br /> 00.000 <br /> DESCRIPTION OF OPERATIONS below #WC0403060484 E.L.DISEASE-POLICY LIMIT 1 $11,000,000 <br /> A Professional Liability ROP0060563 12/1/2025 12/1/2026 $2,000,000 Each Claim <br /> Claims-Made $2,000,000 Annual Aggregate <br /> $25,000 Each Claim Deductible <br /> DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Certificate Holder is an Additional Insured with respect to General Liability(GL)and Automobile Liability when required by contract with the <br /> Insured,but only to the extent provided within the Endorsements noted above. GL includes Separation Of Insureds and Contractual Liability per <br /> limitations in the BusinessOwners'Coverage farm. A Workers'Compensation Waiver is included for the person or organization named in the Schedule <br /> that are parties to a written contract,but only to the extent provided within the Endorsement noted above. Coverage is subject to all policy terms, <br /> conditions,limitations and exclusions. 30 Day Notice of Cancellation 110 Days for Non-Payment in accordance with policy provisions. <br /> ei9lTaM/,19,M <br /> TU Trani hDiT.'r— <br /> q9-M <br /> 2025.12im APPROVEp <br /> CERTIFICATE HOLDER CANCELLATION' <br /> Agreement#A-2023-071-01 and#A-2023-072-01 Sy Tu Tran Nguyen at&49 am,Dec 08 2 25 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> City of Santa Ana its officers and employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 20 Civic Center Plaza <br /> Santa Ana CA 92701 <br /> AUTHORIZED REPRESENTATIVE <br /> {AVC}Alicia K.]gram <br /> OO 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> B8127241 ( 12/25-26 OL/AUTO/EXCESS/NC/PL I Teresa Frank 112/2/2925 3;03:18 PM (PST) I Page 1 of 7 <br />