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<br /> A�CC>RL3I` CERTIFICATE OF LIABILITY INSURANCE DATE
<br /> fir-
<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(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 WTW Certificate Center
<br /> NAME:
<br /> Willis TOWerS Watson Northeast, inc. flea Willis of New Jersey, Inc. PHONE 1-877-945-7370 FAX 1-888-497-2378
<br /> c/o 26 Century Blvd C No,Ex : C No:
<br /> E-MAIL certificates@wtwco.c0m
<br /> P.O. Box 305191 ADDRESS.
<br /> Nashville, TN 372305191 U82k INSURERIS)AFFORDING COVERAGE NAICM
<br /> INSURERA: American Casualty Company of Beading Penns 20427
<br /> INSURED INSURERB: Continental Insurance Company 35289
<br /> z Corporation
<br /> 7 Roazel Road INSURER C: re Insurance Company National Fire I C of Hartfor 20478
<br /> 7 Roaz pan y
<br /> Princeton, Nd 08540 INSURERD: Chubb insurance Company of New Jersey 41386
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:W40061483 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 /> 1NSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY ECP LIMITS
<br /> LTR POLICYNUMBER MM1DDIYYYY MMIDDlYYYY
<br /> X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE �X OCCUR DAMAGE TO E RENTED 1,000,000
<br /> PREMISES a occurrence $
<br /> A MED EXP(Any one person) $ 15,000
<br /> Y Y 8033525966 08/01/2025 08/01/2026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000
<br /> X POL �ICYPECT 1:1LOC PRODUCTS-COMPIOPAGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea eccldent
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED 803339419E 08/01/2025 08/01/2026 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> X AUTOS ONLY X AUTOS ONLY Peraccldent $
<br /> v $
<br /> H
<br /> X uMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> EXCESSLIA13 CLAIMS-MADE 8033394234 08/01/2025 08/01/2026 AGGREGATE $ 5,000,000
<br /> DIED I X RETENTION 10,000 $
<br /> WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> Y 1 N
<br /> H ANYPROPRIBTORIPARTNERlEXECUTIVE E.L.EACH ACCIDENT $ 1,0D0,000
<br /> OFFICERIMEMBEREXCLUE No NIA Y 101131121-7 08/01/2025 08/01/2026 1,000,000
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe irder 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> C workers Compensation & 8033394220 08/01/2025 08/01/2026 E.L. Each Accident $1,000,000
<br /> Employera Liability - CA E.L. Dis. NA EIMployee $1,000,000
<br /> Per Statute 1E.L. Dis. Pot. Limit $1,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
<br /> This Voids and Replaces Previously issued Certificate Dated 07/31/2025 WITH ID: W39941914.
<br /> TLl TI BI1 Dig signed Twn
<br /> Tu Tren Nguyen
<br /> Dale;205.00,1
<br /> RE: Agreement# N-2022-243 Nguyen �aaasa•u�an
<br /> SEE ATTACHED
<br /> [APPROVED
<br /> =Aug
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Trait Nguyen a
<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 AUTHORIZED REPRESENTATIVE
<br /> Attention: Human Resources
<br /> 20 Civic Center Plaza, M-24
<br /> Santa Ana, CA 92701
<br /> O 1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> SR in2 2B243481 )MM, 4089623
<br />
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