|
A�'�� DATE(MMrDDIt'1'YYI
<br /> CC CERTIFICATE OF LIABILITY INSURANCE ATE(MM(Dfi
<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 pollcy(los) must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and condltlons of the pollcy,Certain policies may require an endorsement. A statement on
<br /> this Cerilflcate does not confer rights to the certificate holder In Ileu of such endorsement s).
<br /> PRODUCER CONTACT
<br /> NAME' _
<br /> Next First Insurance Agency.Inc. PHONE (65512225919 - `. F _...-
<br /> PO Box 60787 _ _
<br /> [M'C,f{4�E6t1: �jAlc.Not:
<br /> Palo Alto,CA 94306 E MA4 supportripnextlnsurance cum
<br /> 1LD.QERSS
<br /> INSURERM AFFORDING COVERAGE MAIC
<br /> INSURER A: Next Insurance US Company 16285
<br /> INSURED
<br /> Bongwon Kim INSURER a+
<br /> Banggwwcn Kim INSURERC:
<br /> 1801)W Santa Clara Ave
<br /> Santa Ana,CA 92706 INSURER D:
<br /> INSURER E
<br /> INSURER F-
<br /> COVERAGES CERTIFICATE NUMBER:865574329 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 /> EXCLUSICN$AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> lNSR SUOR
<br /> POLICY EFF POLICY E.7CP
<br /> LTA TYPE OF INSURANCE l LffiaPOLICY NUMBER MMlDOrM I(MMZONYYYI L1MrTs
<br /> X COMMERCULL GENERAL LIABILITY
<br /> --� EACH OCCURRENCE s2,000,000-00
<br /> GW4tS-141.GE X OCCUR" PREMISES IEO aamirmaw) S100,000.00
<br /> MED EXP(Any one person) $15,000.00
<br /> A X X NXT3LYQQQ3-04-GL 04/24/2026 04/24/2027 PERSONAL 6 ADV INJURY $2.000.000 00
<br /> GENT.AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE s4,000.000,00
<br /> X POLICY
<br /> J)r'0. LOC PRODUCTS•COhSPrOPAGG S4,000,000.00
<br /> 4
<br /> drHER ABUSE 6 MOLESTATION s I00,000.00
<br /> E AUTOMOBILE LIA1BILn'Y COMBINED S{NGLE UNIT s
<br /> ANY AUTO Ea ecradent
<br /> OWNED SC>"EDVL ED
<br /> BODILY INJURY(Per person) S
<br /> AUTOS ONLY � AUTOS BODILY INJURY(Per aocW"t) S
<br /> MREO NON-OWNED A PROPER TY DAALtGE
<br /> ALIT 04'LY I-7 AUTOS ONLY Per occtdenll S
<br /> �j UMBRELLA LAB OCCUR S
<br /> EACH OCCURRENCE S
<br /> EXCESS LIA18 I CLAIMS-MADE AGGREGATE $
<br /> CED RE eNTONS
<br /> s
<br /> i WORKERS COMPENSATION AN R O H
<br /> AND EMPLOYERS'LLALB11 ITY YIN STATUTE ER
<br /> YPROME`DR PART-ER,EXECUTIVE
<br /> IOFFicr;R7AEMBEgEXCLVDED1 NfA E-L.EACH ACCIDENT I$
<br /> IimaSRndatory M NH) E.L DISEASE-
<br /> 'OESC'AtIPTlO OF,.,RATIONS aeto+�r EA EMPLOYEEI S
<br /> E L DISEASE•POLICY LIMIT I 5
<br /> Each Occurrence s2,o0D,o00.0o
<br /> A Professional Llab Lry I NXT3LYQQQ3.04-GL 04/2412026 04/2412027 Aggregate: $4,000,000.00
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101,Additional Remarks Schedula,may be anachad If mom apace is requited)
<br /> The Certificate Holder Is City cf Santa Ana.Atin,Parks,Recreation,and Community.Wer of Subrogation applies on General{_lability in favor of the Certificate Holder and as
<br /> required by written contract usual to the Insured's Operations.City or Santa Ana, Is citycounsels,officers,officials,employees,agents,and volunteers are an Additional
<br /> In5Lred on the General Liability policy per the Additional Insured Automatic Status Endorsement.All Additional Insured privileges apply only If required by written aeemen
<br /> netvreen the Cemflcate Haider and t e Irsured,and are subject to policy terms and conditions, gr t
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 10:40 am,Apr 21,2026
<br /> City of Santa Ana,Attn:Parks,Recreation,and Community
<br /> Services Agency SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 20 to ccenter 27 r1 M-23 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Santa Ana,CA 9270i
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> AUTHORIZED REPRESENTATIVE
<br /> ©1988.2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
|