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O �®
<br />ACC�Z CERTIFICATE OF LIABILITY INSURANCE
<br />DATE IYYYY)
<br />�V
<br />11/24/20254/2025
<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 endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />NAME'
<br />MARSH USA, LLC.
<br />PHONE FAX
<br />TWO ALLIANCE CENTER(A/C,
<br />No Ext : A/C, No):
<br />E-MAIL
<br />3560 LENOX ROAD, SUITE 2400
<br />ATLANTA, GA 30326
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A : The Charter Oak Fire Insurance Co.
<br />25615
<br />CN130114897-8/31-10m-25-26
<br />INSURED
<br />CentralSquare Technologies, LLC
<br />INSURER B : Phoenix Insurance Company
<br />25623
<br />INSURER C : Travelers Property Casualty Company Of America
<br />25674
<br />Superion, LLC
<br />TriTech Software Systems
<br />INSURER D : Travelers Casualty And Surety Company
<br />19038
<br />1000 Business Center Dr.
<br />INSURER E : AIG Specialty Insurance Company
<br />26883
<br />Lake Mary, FL 32746
<br />INSURER F : Indian Harbor Insurance Co.
<br />36940
<br />COVERAGES CERTIFICATE NUMBER: ATL-005306760-22 REVISION NUMBER: 13
<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
<br />LTR
<br />OF INSURANCE
<br />ADDLSUBRTYPE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DDIYYYYI
<br />POLICY EXP
<br />iMMIDDIYYYYI
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />X
<br />H-660-6S758660-COF-25
<br />08/31/2025
<br />08/31/2026
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE X� OCCUR
<br />RENTEDDAMAGE TO
<br />FIR SES Ea occurre...
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />POLICY ❑ JECT PRO ❑ LOC
<br />PRODUCTS - COMP/OPAGG
<br />$ 2,000,N000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE LIABILITY
<br />BA-6S783539-25-13-G
<br />08/31/2025
<br />08/31/2026
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTYDAMAGE
<br />Per accident)$
<br />HIRED NON -OWNED
<br />X AUTOS ONLY L AUTOS ONLY
<br />C
<br />X
<br />UMBRELLALIAB
<br />OCCUR
<br />X
<br />CUP-6S801390-25-13
<br />08/31/2025
<br />08/31/2026
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION $ 10000
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED? N❑
<br />(Mandatory in NH)
<br />NIA
<br />UB-6S783668-25-13-G
<br />08/31/2025
<br />08/31/2026
<br />PER H-
<br />OT
<br />X STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />E
<br />E&O/Cyber
<br />01-232-82-99
<br />08/31/2025
<br />08/31/2026
<br />SIR: $1,000,000 Limit.
<br />5,000,000
<br />F
<br />Excess E&O/Cyber
<br />MTE9043949 04
<br />08/31/2025
<br />08/31/2026
<br />xs $5,000,000
<br />5MM XS $5MM
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana, its elected and appointed officials, officers, employees, agents, and successors are included as additional insured with respect to Tu Tran Digitally signed by
<br />liability arising out of the operations of the insured and to the extent provided by the policy language or endorsements issued or approved by the insurance Tu Tran Nguyen
<br />carrier. Umbrella is follow form of primary subject to policy terms, conditions and exclusions. 11 11 ozs.rz0'
<br />P ry 1 P Y Nguyen n:n:az-oa�oo�
<br />APPROVED
<br />By Tu Tran Nguyen at 11:11 am, Dec 10, 20251-1
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />City of Santa Ana
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Risk Management Division
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />20 Civic Center Plaza, 4th floor
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Santa Ana, CA 69791
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA LLC
<br />i
<br />© 1988-2016 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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