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�`� CERTIFICATE OF LIABILITY INSURANCE F 11ATE;a.0.1y")
<br /> 12026
<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 CONTACT
<br /> NAME: Michael Tran
<br /> The Baldwin Group West, LLC PHONE 714 505-7000 PA No:X 714 573-1770
<br /> 15901 Red Hill Ave, Ste 100 0&N
<br /> Tustin CA 92780 ADD ESS: m!Ghael.trcin@wqb[b.com
<br /> INSURERS AFFORDING COVERAGE NAIL#
<br /> License#:OF69771 INSURER A:American Zurich Insurance Comp 40142
<br /> INSURED ONYXFAV-01 INSURER B:Evanston Insurance Company 35378
<br /> Onyx Paving Company, Inc.22707 La Palma Ave. INSURERC:Great American Insurance Coma 16691
<br /> Yorba Linda CA 92887 INSURERD:Scottsdale Insurance Company 41297
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:545049648 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 /> IY EXP
<br /> LTR TYPE OF INSURANCE SR ADDL 9UBR POLICY NUMBER MM,UDY EFF MMlDD LIMITS
<br /> D X COMMERCIAL GENERAL LIABILITY BCS2003096 10/1/2025 1a1112026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE � OCCUR DAMAGE T RENTED
<br /> PREMISES Ea occurrence $100,000
<br /> MED EXP Any one person) $5,000 !
<br /> PERSONAL&ADV INJURY $1,000.000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000.000
<br /> POLICY PRO-
<br /> JECT LOC PRODUCTS-COMPIOPAGG $2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY BAP106300607 10/1/2025 1011/2028 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident} $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED L
<br /> NON-OWNED PROPE;RTYDAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> C UMBRELLALIAB X OCCUR TUE490440203 10/1/2025 10/1/2026 EACH OCCURRENCE $6,000,000
<br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $6,aoa,000
<br /> DED RETENTION$ $
<br /> A WORKERS COMPENSATION WC106300507 10/1/2025 10/1/2026 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANYPROPRIETCR)PARTNERIEXECUTIVE ❑ E.L.EACH ACCIDENT $1,000,000
<br /> OFFICERIMEMBEREXCLUDED? NIA
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,060,000
<br /> If yas,describe under
<br /> DESCRIPTION OF OPERATIONS below F.L.DISEASE-POLICY LIMIT $1,000,000
<br /> B Conlraclors Pollution Llabillty MKLV5ENV105319 10I112025 10/1/2026 Aggregato $10,000,000
<br /> Occurence $6,000,000
<br /> Deductlble $10,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES tACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> "`*Excess Policy#TUE490440203 is Excess over the General Liability,Auto Liability,and Workers Compensation***
<br /> Certificate halder(s)is/are named as additional insured per the attached endorsements as required by written contract subject to the terms&conditions of the
<br /> policy:
<br /> GL Additional Insured Form#CG 20 10 12 19 and CG 20 37 12 19
<br /> GL Additional Insured State-Permits Form#CG 20 12 12 19 APPROVED
<br /> GL Primary and Non-Contributory Form#CG 20 01 12 19 By Tu Tran Nguyen at 4:56 pm,May 11,2026
<br /> See Attached..,
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> City of Santa Ana
<br /> 20 Civic Center Plaza
<br /> Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE
<br /> ©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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