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HomeMy WebLinkAboutJACOB GREEN & ASSOCIATES (2)N-2025-041 INSURANCE NOT ON FILE WORK MAY NOT PROCEED CITY CLERK CONSULTANT AGREEMENT WITH DATE: MAR 0 5 1015 JACOB GREEN & ASSOCIATES THIS AGREEMENT is made and entered into on this 10`h day of February, 2025 by and between Jacob Green & Associates, a California corporation ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of 6 ' God the State of California ("City"). �r�,anr ��non RECITALS A. The City desires to retain a Consultant having special skill and knowledge in providing training courses on business writing skills, leadership, management, coaching, focus groups and team building. B. To that end, the City issued Request for Proposal No. 24-135 (the "RFP") and Consultant submitted a proposal in response dated October 14, 2024. C. Consultant represents that Consultant is able and willing to provide the services set forth in the RFP to the City. D. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform during the term of this Agreement, the tasks and obligations including all labor, materials, tools, equipment, and incidental customary work required to fully and adequately complete the services described and set forth in Scope of Services - Exhibit A, attached hereto and incorporated by reference. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services for City, the rates and charges identified in Compensation - Exhibit B. The total amount to be expended during the term of this Agreement shall not exceed fifty thousand dollars and zero cents ($50,000.00.) Work is performed on an as needed basis and no amount of work is promised or guaranteed pursuant to this Agreement. b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. City and Consultant agree that all payments due and owing under this Agreement shall be made through Automated Clearing House (ACH) transfers. Consultant agrees to execute the City's standard ACH Vendor Payment Authorization and provide required documentation. Upon verification of the data provided, the City will be authorized to deposit payments directly into Consultant's account(s) with financial institutions. Page 1 of 9 #2018628vl 3. TERM This Agreement shall commence on the date first written above for a three year term ending February 9, 2028, with the option for the City to grant up to two, one-year renewals, exercisable by a writing by the City Manager and the City Attorney, unless terminated earlier in accordance with Section 15, below. 4. INDEPENDENT CONSULTANT Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE A. Minimum Scone and Limit of Insurance: Consultant shall maintain limits of insurance coverage in the following minimum amounts and shall be at least as broad as: 1. Commercial General Liability (CGL): Insurance Services Office Form CG 00 Ol covering CGL on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence and $2,000,000 aggregate. 2. Automobile Liability (AL): Insurance Services Office Form CA 00 01 covering Code 1 (any auto), with combined single limits of $1,000,000. In the event Consultant does Page 2 of 9 42018628vl not maintain commercial automobile liability insurance, City will accept evidence of personal automobile insurance with existing limits, which can be lower than $1,000,000. Workers' Compensation (W/C): as required by the State of California, with statutory limits, and Employer's Liability Insurance with limit of no less than $1,000,000 per accident, per employee, per policy for bodily injury or disease. This requirement can be waived if Vendor has no employees. If Consultant maintains broader coverage and/or higher limits than the minimums shown above, City requires and shall be entitled to the broader coverage and/or the higher limits maintained by Consultant. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to City. B. Other Insurance Provisions: The insurance policies are to contain, or be endorsed to contain, the following provisions: 1. CGL and AL policies: City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds with respect to liability arising out of work or operations performed by or on behalf of the Consultant including materials, parts, equipment, and personnel furnished in connection with such work or operations. 2. All required insurance policies: Insurance company(ies) agrees to waive all rights of subrogation against City, its City Council, its officers, officials, employees, agents, and volunteers for losses paid under the terms of any policy which arise from work performed by Consultant for City. 3. All required insurance policies: For any claims related to this Agreement, Consultant's insurance coverage shall be primary and any insurance maintained by City, its City Council, its officers, officials, employees, agents, or volunteers shall not contribute with it. 4. All required insurance policies: A severability of interest provision must apply for all the additional insureds, ensuring that Consultant's insurance shall apply separately to each insured against whom a claim is made or suit is brought, except with respect to the insurer's limits of liability. 5. Each insurance policy required herein shall provide that coverage shall not be canceled, suspended, voided, reduced in coverage or in limits, non -renewed by the carrier, or materially changed except after thirty (30) days prior written notice has been given to City. Ten (10) days prior written shall be provided to City for policy cancellation or non -renewal due to non-payment. 6. Certificate Holder on each Evidence of Insurance certificate shall be: City of Santa Ana, Attention: Human Resources Department, Sofia Style, Organizational and Training Manager), 20 Civic Center Plaza, M-34, Santa Ana, CA 92701. The name and location of event should be included in the Description of Operations section of each certificate. C. Self -Insured Retentions: Self -insured retentions must be declared to and approved by the City. City may require Consultant to purchase coverage with a lower retention or provide Page 3 of 9 42018628vl proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. D. Acceptability of Insurers: Insurance is to be placed with insurers authorized to conduct business in the state of California with a current A.M. Best rating of no less than A:VII, unless otherwise acceptable to City. E. Verification of Coverage: Consultant shall furnish City with original Certificates of Insurance including all required amendatory endorsements (or copies of the applicable policy language effecting coverage required by this clause) and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements to Entity before work begins. However, failure to obtain the required documents prior to the work beginning shall not waive Consultant's obligation to provide them. City reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. F. Claims Made Policies: If any of the required policies provide coverage on a claims -made basis: 1. The retroactive date must be shown and must be before the date of the Agreement or the beginning of work. 2. Insurance must be maintained and evidence of insurance must be provided for at least three (3) years after completion of work. 3. If coverage is canceled or non -renewed, and not replaced with another claims -made policy form with a retroactive date prior to the contract effective date, Company must purchase "extended reporting" coverage for a minimum of three (3) years after completion of work. G. Subcontractors: Consultant shall require and verify that all sub -contractors maintain insurance meeting all the requirements stated herein, and Consultant shall ensure that City is an additional insured on insurance required from sub -contractors. H. Special Risks or Circumstances: City reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. 7. INIDEMNIEICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, Consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant, its subcontractors, agents, employees, or other persons acting on its behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable Page 4 of 9 #2018628vl relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimmn period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement. 10. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Page 5 of 9 #2018628v1 Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 11. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 12. NON-DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, gender identity, gender expression, gender, medical conditions, genetic information, or military and veteran status, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, teaching, training, utilization, promotion, termination or other employment related activities or any services provided wider this Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which is not embodied herein. 14. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other Consultants retained by City. Page 6 of 9 #20186280 15. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product(s) completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 16. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 17. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 18. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 19. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: Page 7 of 9 #2018628vl To City: City Clerk City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: 714- 647-6956 With courtesy copies to: Executive Director, Human Resources Agency City of Santa Ana 20 Civic Center Plaza (M-24) P.O. Box 1988 Santa Ana, California 92702 To Consultant: Mr. Jacob Green President and CEO Jacob Green & Associates 13217 Jamboree Road, Suite 248 Tustin, California 92780 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 20. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. Page 8 of 9 #2018628vl IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: � no - Jennifer all i y Clerk APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: asy.0, . , . w,6" Laura A. Rossini Chief Assistant City Attorney RECOMMENDED FOR APPROVAL: Lori Schnaider Executive Director Human Resources Agency CITY OF S NTA ANA �� Z1,;6, - -1 Alvaro Nuflez City Manager CONSULTANT: qt�� /�-� Jacob Green President and CEO Page 9 of #2018628vl EXHIBIT A SCOPE OF SERVICES SCOPE OF SERVICES SECTION A PAGE 2 �JACOB GREEN F A11.11 AT I I- SERVICE #1: LEADERSHIP TRAINING JGA's leadership training is designed to equip public sector leaders with the skills and insights necessary to thrive in today's fast -paced and evolving municipal environments. These training sessions emphasize the critical role that leadership plays in fostering organizational success and resilience, particularly in challenging times. By offering a diverse range of courses, JGA empowers participants to improve decision -making, enhance communication, and create a culture of innovation and trust within their organizations. JGA's leadership training sessions enhance participants' ability to navigate complex governmental structures while fostering strong external partnerships. Leaders gain the tools needed to manage crucial conversations, lead change initiatives, and build cohesive teams that align with organizational goals. This focus on leadership, communication, and operational excellence allows participants to emerge as confident, adaptable leaders, prepared to inspire their teams and stakeholders. Typical outcomes of leadership development training include: 1. Stronger organizational alignment 2. Improved performance management 3. Enhanced readiness for leadership roles 4. Actionable strategies to implement within the organizations 5. Fostering a culture of continuous improvement 6. Collaboration and innovation 7. Operate more efficiently 8. Respond proactively to both internal and external challenges We understand that each organizational challenge is unique, requiring tailored solutions to achieve desired outcomes. Our training sessions are completely customizable to the City's needs (see course listing on page 4) and can include: • One -hour virtual webinars • In -person half- or full -day training facilitation • A Trauma -Informed Approach • Action and Work Planning • Body, Mind, and Badge - A First Responder Wellness Course • Building a City Brand • Building Effective Teams • Building Personal and Professional Resilience • Building Professional Development Plan & Network • Building Tomorrow's Local Government Leaders • Building Trust and Respect • Building Workplace Resilience • Communication: E-mail and Written Professional Protocols • Communication Styles and Approaches for Workplace Success • Conflict Resolution • Creating a Customer Service Experience • Crisis Leadership • Crisis Management • Crucial Conversations • Cultivating Staff Resilience in Law Enforcement • Dealing with Difficult Situations • Effective Municipal Leadership; Navigating City Hall & Building External Partnerships • Ethics in Local Government • Emergency Management Overview: NIMS, SEMS and ICS • First Responder Suicide Awareness and Prevention • First Time Supervisor/Manager Readiness • LE and IPV: Collaborations for Improving Responses to Victims of Violence • Leadership at all Levels • Leadership Communication & Crucial Conversations • Leadership Health and Wellness • Leadership Readiness • Leading Without Fear • Leading Innovation Initiatives • Leveraging Change: Operational Enhancement Facilitation • Management Perspective: Defining Management Through the Lens of Leadership • Organizational Alignment • Organizational Culture Development • Performance Review (Courses and Facilitation) • Performance Management and Data Analytics • PTSI, Sleep Disturbances, and the Impact on First Responder Safety and Wellness • Public Speaking and Presentation Skill Development • Servant Leadership • Situational Leadership • Strategic Planning • Stress Management • Succession Planning • Surviving First Responder Stress & Trauma • Supervisor as Coach • Time Management and Project Management Excellence • Trauma -Informed Interviewing • Trauma -Informed Leadership • Understanding Stakeholder Needs and Perspectives • Understanding Stress and Trauma • Vicarious Trauma • Why My Story Matters • Workflow Assessments & Building Efficiency — JACOB GREEN 1A11.11AT[S PAGE 4 SERVICE #2: LEADERSHIP ACADEMY One of the most unique and popular offerings from Jacob Green and Associates (JGA) is our municipal Leadership Academy, which is custom-built to suit the needs and culture of each City or organization. We work collaboratively with municipalities to design and implement a premier Leadership Development Academy, reflecting a commitment to employee growth, development, and long-term retention. By investing in leadership development, cities can attract top talent, reduce turnover, and cultivate a connected and motivated workplace culture. Our facilitators employ best -practice adult learning techniques to ensure each participant engages deeply with the material and applies the lessons to their roles. The Academy sessions are interactive and designed to maximize participant involvement through role-playing, scenario -based discussions, team exercises, and small -group collaboration. This approach ensures that each attendee leaves with practical tools and strategies to bring back to their teams, empowering them to lead effectively. At the conclusion of the Academy, each participant will receive a customized Certificate of Completion, marking their achievement and commitment to leadership excellence. JGA's Leadership Development team will handle the planning, organization, and delivery of a Leadership Academy that offers an immersive, transformative experience. During these sessions, participants will expand their leadership skills, challenge existing perspectives, and become equipped to lead not just within their departments but also in broader community interactions. Moreover, the Academy is adaptable, with content tailored to different employee levels, ensuring that emerging leaders, mid -career professionals, and senior management all gain valuable insights. Below are some of our typical Leadership Academy options: Standard Leadership Academy (6 Sessions over 6 Months) - This option includes six full -day sessions, each focusing on a core leadership competency, such as communication, strategic thinking, and team management. The Academy is designed for mid -level and senior leaders and includes interactive exercises, role-playing, and small group discussions to deepen participants' skills and insights. Accelerated Leadership Academy (3 Sessions over 3 Months) - For organizations seeking a quicker but impactful program, the Accelerated Leadership Academy compresses the training into three intensive sessions. These sessions can run as full -day workshops, focusing on high -impact topics like leadership under pressure, change management, and operational excellence. This format is ideal for employees needing targeted development within a shorter timeframe. Customized Leadership Academy (Tailored for Specific Groups or Needs) - This flexible option allows cities to tailor the Academy for specific employee groups, such as new supervisors, emerging leaders, or senior management. The content, schedule, and delivery methods are adapted to meet the unique needs of the group, with topics ranging from foundational leadership skills to advanced leadership techniques, fostering a targeted and personalized learning experience. Each of these options is designed to create a lasting impact and position participants to contribute to their organization's success long after the Academy concludes. PAGE 5 JACOB GREEN &ASSOCIATE{ - SERVICE #3: EXECUTIVE COACHING One of the best ways public sector organizations can retain a high -caliber workforce is by investing in an employee's personal and professional development. JGA's executive coaching team is comprised of experienced local government professionals who understand how to support the professional growth of the public servant. Leadership coaching is the process of working one-on-one with an employee, typically an executive, manager, supervisor, or "high -potential" individual in a series of focused sessions to develop their professional impact. The process of coaching is designed to help the participant enhance their workplace self-awareness, tackle blind spots, clarify goals, unlock their potential, and have a trusted source for feedback and guidance. Coaching sessions are designed to provide a means for the participant to clarify and solve problems on their own; promoting ownership and successful implementation of their self- created strategies. JGA coaches subscribe to the "Brief Coaching" philosophy developed by Insoo Kim Berg and Peter Szabo. Essentially, the coach is responsible for ensuring the sessions are focused on results; think SWAT team - get in, tackle the mission, and go home better and stronger. Sessions examine future achievement and support the identification of successful strategies based on past experiences. JGA's coaching approach is solution -focused. Each client engaged in JGA's comprehensive coaching program may participate in the AEM-Cube Assessment to discover their own strengths, opportunities, and place in the greater team context. It provides a robust platform for understanding and unlocking the participant's capacities. By illuminating their unique contributions, coaches can guide clients in harnessing their strengths, both individually and in their interactions with others. (See page 9 for additional information on the AEM-Cube Assessment). Our coaching program typically results in the following: • Movement toward a solution -focused paradigm when addressing challenges • Improved performance and job satisfaction • Enhanced communication skills • Greater accountability • Clarification of professional goals • A roadmap to reach those goals • A deeper understanding of their role within their team • Renewed energy as a stakeholder for their organization SERVICE # 4• CUSTOMIZED KEYNOTE JGA's President and CEO, Jacob Green, provides organizations with an energizing and thought -provoking keynote focused on helping audience members navigate change, leverage adversity, and build diverse and inclusive teams. Jacob's keynotes: • Enhance leadership development • Help teams break boundaries to go beyond personal and professional limits • Create alignment around organizational change • Build a positive mindset around new initiatives • Increase the organization's overall performance Jacob has provided keynote leadership development training sessions to public and private organizations including Mattel, FedEx, and Hyundai Capital. In 2019, Jacob distilled his personal and professional experiences into an Amazon bestseller: See Change Clearly. Leveraging Adversity to Sharpen Your Vision and Build Resilient Teams. This book can be utilized to enhance the session and provide a takeaway for learning and growth beyond the keynote session. SERVICE #5: TEAMBUILDING JGA's facilitation team will build a customized one -day teambuilding experience for your team. Top - performing teams take time away from the daily workplace grind to enhance team cohesion, engagement, and build alignment for future success. JGA's teambuilding facilitation services are customized to meet client needs and include the opportunity to reflect on the existing operation and ensure the team is ready for inevitable future change and challenges. Facilitation services enable all members of the team to actively engage in the meeting process instead of having a designated team member take the role of facilitator and be excluded from group discussions. In advance of the off -site facilitation, JGA will survey a selection of attendees to explore expectations, topics of interest, and uncover individual and department needs. While maintaining participant confidentiality, findings will be shared with the executive leadership team in advance of the session to solidify the agenda and seek any additional direction necessary for the event's success. Each teambuilding session will be customized to the needs of each group. While the final agenda is subject to client direction, we propose focusing on team cohesion and strategic alignment activities, integrating the AEM-Cube Assessment tool as a foundation for building cognitive diversity and team optimization. Option #1 - Teambuilding for the Executive Team focused on alignment, empathy, and building relationships at the leadership level - 8 hours. Option #2 - Department Teambuilding with engaging interactive activities aimed at fostering trust and collaboration within a team - 8 hours. Customized facilitated services may include all or some components of the following services depending on the needs of the team: • Building Alignment • Organizational Culture Development • Building Trust and Respect • Operational Enhancement Facilitation • Conflict Resolution These sessions typically result in the following: • Workflow Assessments • Crucial Conversations • Leadership Facilitation • Stress Management • Team Dynamics - AEM-Cube Assessment 1. Improved communication 6. Focused collaboration 2. Greater trust between team members 7. Stronger alignment 3. Silo removal 8. Mission clarity 4. Teamwork solidification 9. Embrace of purpose/nobility of the profession S. Shared vision 10. Stronger connection and lower attrition PAGE 8 IJACOB GREEN 6 �110C.ATE5-- TEAM DYNAMICS ASSESSMENT TOOL - AEM-CUBE JGA's certified professional facilitators will administer the AEM-Cube team dynamics assessment to all teambuilding participants. The assessment was created as the result of decades of research focused on understanding how high -performing teams tackle complex challenges and enhance performance. J * O • 0 6 The AEM-Cube is a cutting -edge management tool that identifies and aligns the strategic diversity within an organization so that performance is optimized. Findings help management identify how teams interact and how to get the greatest contribution from each individual, team, and department, which in turn maximizes both productivity and collaboration. This exclusive suite of 31) tools visualizes where individuals contribute optimally to overall team and organization growth. The AEM-Cube is delivered as an online questionnaire that provides each team member with a comprehensive report describing where they add value and what this means in a team and organizational setting. Individual results are also compiled to provide a deeper understanding of the team's limitations and opportunities. PAGE 9 JACOB GREEN III SERVICE #6: DEPARTMENT STRATEGIC PLANNING JGA believes in a comprehensive and inclusive approach to the Strategic Planning Process. Our process involves standards and best practices. We aim to develop a plan that is tailored to the unique characteristics, challenges, and needs of the Department. The Strategic Planning Process will involve five steps: 1. Project Kickoff 2. Current State Assessment/Stakeholder Engagement 3. Future State Development/Strategic Planning Retreat 4. Three -Year Strategic Plan Development 5. Approval & Distribution STEP 1: PROJECT KICKOFF To initiate the Strategic Plan development process, JGA will meet with the City Council and City Manager. JGA will work with the Department to solidify the project committee members, critical strategic planning components, desired outcomes, and associated deadlines. V STEP 2: CURRENT STATE ASSESSMENT/STAKEHOLDER ENGAGEMENT JGA will collaborate with the Department during this phase of the Strategic Planning Process to explore the current context of the organization. The process will incorporate a SWOT assessment (Strengths, Weaknesses, Opportunities, Threats) for an accurate snapshot of current operations. JGA will collect data from a variety of sources including up to 15 one-on-one interviews conducted, in -person and via Zoom, of department personnel and community stakeholders, a community survey, and an anonymous department survey. Key focus areas and objectives will be identified. STEP 3: FUTURE STATE DEVELOPMENT/STRATEGIC PLANNING RETREAT JGA will work with the Department to develop a customized two-day Strategic Planning Retreat, where key leadership will come together to assess the Department's current and future state, align around a high-level Strategic Plan, and identify key initiatives that will support the Department's strategic goals. The final agenda for JGA's custom Strategic Planning Retreat is designed around the Department's needs. The facilitation will begin with building organizational and strategic alignment to ensure the development of a culture of collaboration, integrity, excellence, and respect that meets or exceeds the expectations of all team members. JGA will then work with the Department to develop the fundamental elements that define the Strategic Plan, which may include: Vision, Mission, Values, Priorities, etc. Finally, JGA will facilitate discussions to select and prioritize projects and programs in support of the Strategic Plan. The outcomes of the Strategic Planning Retreat will be consolidated into the final Strategic Plan. PAGE 10 JACOB GREEN -6 A'S.0 IA rE, STEP 4: THREE-YEAR STRATEGIC PLAN DEVELOPMENT Following the Strategic Planning Retreat, JGA will develop a three-year Strategic Plan focusing on achieving the priorities as identified during the retreat. The three-year Strategic Plan will include a work plan component developed by JGA with the Department stakeholders. The Work Plan will serve as the tactical roadmap for the execution of goals identified in the Strategic Plan. Sample Work Plan Q3 Q4 CU 42 Project10 Profectll PFo�ect l2 d STEP 5: APPROVAL & DISTRIBUTION A final Strategic Plan will be assembled by JGA and routed to key Department stakeholders for review and ultimate approval. The plan will then be distributed to the organization, and JGA will make recommendations to determine the most effective way to educate the Department regarding the final Strategic Plan and associated Work Plan. Separate presentations to the City Council, City Boards/Commissions, or community groups are not included in this scope and are available if desired by the City under a separate cost proposal. CITY OF SANTA ANA'S PROJECT COMMITMENT Successful project outcomes rely on a strong partnership between our team and yours. To ensure the best results, we've outlined key client responsibilities that foster effective collaboration and project efficiency. By fulfilling these roles, you actively contribute to the project's success, helping us deliver high -quality work on time and within scope. This mutual commitment not only improves project outcomes but also maximizes the value and impact of our combined efforts. • Clear Objectives: Define and communicate project goals, expectations, and deliverables clearly at the project's outset. • Active Participation: Engage in regular meetings and provide necessary feedback to ensure the project stays on track and aligns with expectations. • Resource Allocation: Ensure the availability of internal resources, including key personnel, data, and tools, required for the project. • Open Communication: Maintain open and honest communication with the Consultant, addressing any concerns or changes in scope as soon as they arise. • Decision -Making. Facilitate timely decision -making processes to avoid delays and ensure project progress. • Access Provision: Provide the Consultant with necessary access to relevant systems, documentation, and facilities. • Respect Timelines: Adhere to agreed -upon timelines for reviews, approvals, and information requests to maintain project momentum. • Change Management: Collaborate on managing any changes in project scope, requirements, or timelines, ensuring mutual agreement on modifications. • Partnership Approach: Foster a collaborative and respectful working relationship, recognizing that successful outcomes depend on both parties' commitment and cooperation. • Timely Payment: Pay invoices pursuant to contract terms and communicate any payment issues promptly with the Consultant. COMPENSATION vp vpp� SRC '' '� 9 41 COST PROPOSAL SECTION PAGE 2 1 JACOB GREEN I AI1( CIATlI COST PROPOSAL Service #1: Leadership Training One -Hour Virtual Webinar In -Person Half -Day Training (4 Hours) In -Person Full -Day Training (8 Hours) Service #2: Leadership Academy Standard Leadership Academy (Six Full -Day Sessions Over Six Months) Accelerated Leadership Academy (Three Full -Day Sessions Over Three Months) Customized Leadership Academy (Tailored For Specific Groups or Needs) Service #3: Executive Coaching Service #4: Customized Keynote Service #5: Teambuilding (8 Hours) Optional: Team Dynamics Assessment Tool - AEM-Cube Service #6: Department Strategic Planning Travel Printed Materials 0 $1,850 $7,500 $15,000 $75,000 $45,000 Customized* $250 Per Session $15,000 $15,000 $75 Per Participant $75,500 Invoiced at cost Invoiced at cost *While we have provided costing for our six-month and three-month Leadership Academy facilitation, our Leadership Academy services are fully customizable based on the client's needs, which can include additional days per month, annual academies, etc. Service #1: Leadership Training - 25% upon execution of contract and 75% upon completion of training session. Service #2: Leadership Academy - 25% upon execution of contract and percentage progress payments as determined by JGA. Service #3: Executive Coaching - A monthly invoice will include the participant's name and the date of the session. (Please note: JGA has a mandatory 24-hour cancellation policy for coaching sessions. If the session is not canceled 24 hours before the scheduled date and time, the individual will still be charged the full session fee.) Service #4: Customized Keynote - 25% upon execution of contract and 75% upon completion of keynote. Service #5: Teambuilding - 25% upon execution of contract and 75% upon completion of teambuilding session. Service #6: Department Strategic Planning - 25% upon execution of contract and percentage progress payments as determined by JGA. PAGE 22 JACOB GREEN EXCLUSIONS The following program expenses are not included in consultant fees and are the responsibility of the City, if necessary. • Venue rental fees for events • Food and beverages for events • Cost of Books for Academy • Academy Binders • Office Supplies Needed for Trainings, Workshops, and Academy • Graduation Ceremony Costs (graduation certificates, mementos, etc.) • Strategic Plan translation services LATE PAYMENT FEE All invoices are due and payable within 30 days of the invoice date. Any invoice not paid within 30 days will be subject to a late payment fee. A fee of 1.5% per month will be added to the outstanding balance until the invoice is paid in full. The prices, specifications, and conditions covered within this proposal are satisfactory and hereby accepted. JGA is authorized to do the work as specified. Name/Title: JACOBGREENANDASSOCIATES.COM r� u The costs outlined in this proposal are considered valid and binding for a period of 90 days, commencing from the date of the proposal's issuance. During this timeframe, the provided pricing and estimates for products, services, and associated expenses will remain unchanged, subject to the terms and conditions specified in the proposal document. Any modifications or alterations to the proposal, as well as adjustments to the costs, will require mutual agreement between the involved parties. PAGE 23 1JAS GREEN .4 f t(1 CIATf A� ®® CERTIFICATE OF LIABILITY INSURANCE DNY oA02/13/2025YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON LY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. IF SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: CONTACT Jordan Meyer Great Park Insurance Services, Inc. PHONE (949) 387-3242 (888) 370-4994 x AIC No: AIC No Eat)* go.REss: Jordan.meyer@greatparldnsurance.com 10 Corporate Park Suite 130 INSURERS) AFFORDING COVERAGE NAIC# Irvine CA 92606 INSURERA: Kinsale Insurance 38920 INSURED INSURER B: Berkshire Hathaway Homestate Companies 11014 Jacob Green&Associates INSURER c: Kinsale Insurance 38929 INSURER D: Lloyd's Syndicate 2987 13217 Jamboree RD #248 Tustin, CA 92782 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: CL238802967 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL INSD SUBS WVD POLICY NUMBER POLICYEFF POLICYEXP POLICY tAv LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FlOCCUR EACH OCCURRENCE $ 2,000,000 PREMISES Ea occurrence) $ 250000 MED EXP (Any one person) $ 5,000 A X X PSNO140030874 08/09/2024 08/0912025 PERSONAL &ADV INJURY $ GENLAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ X POLICY PRO JECT LOC PRODUCTS - COMPIOPAGG $ 4000000 Errors and Omissions $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLELIMIT Ea accident $ BCDILV INJURY Perperson) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER E STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE-E4 EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ C Professional Liability X X PSNO140030874 08109/2024 0810912025 Occurrence Aggregate $ 2,000,000 $ 2,000,000 D Cyber Liability X CYP17217224 09/23/2024 09/23/2025 Occurence $ 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD HIM, Additional Remarks Schedule, may be attached if morespace is required) I3I9ltelysi , RE: Leadership Training, Leadership Academy, Executive Coaching, Customized Keynote, Teambuilding, & Department Strategic Planning. Tu Tran by Ta Tran City of Santa Ana, its City Council, its officers, officials, employees, agents, and volunteers are to be covered as additional insureds with respect to liability rXI u en Nguyen ys. 3 arising out of work or operations by or on behalf of the Permlttee including materials, equipment, and furnished in connection WI `g y performed parts, personnel to:sa:3o-o 1e such work or operations APPROVED By Tu Tran Nguyen at 90:57 am, Mar 03, 2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana Attention: Human Resources - Lori Schnaider/Brearna Lynch THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza, 51h Floor, M-24 Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE ��^^LpfLJ Q NI mwm/ ' 1 W b 9988.2015 ACORG CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PSNO140030874 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) The City Of Santa Ana, Its Council, Officers, Officials, Employees, agents, and Volunteers Altentiom Human Resources - Lori SchnaidedBreanna Lynch 20 Civic Center Plaza, 5th Floor, M-24 Santa Ana, CA 92701 OR AS REQUIRED BY WRITTEN AGREEMENT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11 — Who Is An Insured Is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or `personal and advertising injury" caused, in whole or in part, by your.acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. Policy Number: PSNo1.40030874 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other Insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other Insurance; and (2) You have7rjagrd h'Writin'gginA contract or agreer,0'erit that'tJjjs insurance would be prim 'ry and,,,.,ould°jnpt seek contribution from, knny ,Pthar insurtiVe available to the kddi$o„nil' nsured., CG 20 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: PSNO140030874 COMMERCIAL GENERAL LIABILITY CO 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: The City Of Santa Ana, Its Council, Officers, Officials, Employees, agents, and Volunteers Attention: Human Resources - Lori SchnaidenBreanna Lynch 20 Civic Center Plaza, 5th Floor, M-24 Santa Ana, CA 92701 information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 00 ® Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER: PSNO140030874 Professional Liability THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: Professional Liability SCHEDULE Name Of Additional Insured Persons Or Organization(s) The City of Santa Ana, Its Council, officers, Officlals, Employees, agents, and Volunteers Attention: Human Resources - Lori Schnaider/Breanna Lynch 20 Civic Center Plaza, 5th Floor, M-24 Santa Ana, CA 92701 OR AS REQUIRED BY WRITTEN AGREEMENT Information required to com lete this Schedule, if not,shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the .Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising Injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: PSM0039722206 COMMERCIAL GENERAL LIABILITY SCHEDULE Certificate The City Of Santa Ana, Its Council, Officers, Officials, Employees, agents, and Volunteers Attention: Human Resources - Lori Schnaider/Breanna Lynch 20 Civic Center Plaza, 5th Floor, M-24 Santa Ana, CA 92701 Section XXIII. CONDITIONS, 4. Cancellation is amended by the addition of the fallowing: If we cancel this Policy before the expiration date thereof, we will mail 30 days written notice ('10 days for non-payment of premium) to the Certificate Holder(s) indicated in the SCHEDULE above. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. AcoRO® CERTIFICATE OF LIABILITY INSURANCE DaTE Y) 1..�� 02113/20/13/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Lesley Sayers NAME: Scot& McCauley Insurance Agency ACNo (949)503-1953 FAX Eer, No: 2 Ritz Carlton Drive E-MAIL lesley@sminsurenceagency.com ADDRESS: Suite 204 INSURER(S) AFFORDING COVERAGE NAIC # Dana Point CA 92629 INSURERA: Hartford Accident and Indemnity Company 22357 INSURED INSURER B: Jacob Green and Associates INSURER C : 13217 Jamboree Rd #248 INSURER D: INSURER E : Tustin CA 92782 INSURER F: COVERAGES CERTIFICATE NUMBER: JGAMSTR24-25 REVISION NHMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSLTR TYPE OF INSURANCE INSD MU POLICYNUMBER POLICYEFF MMIDDNWY POLICY EXP MMIDDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE To TED R PREMISES Ea occurrence $ MED EXP(Any one person) If PERSONAL ADV INJURY $ GEN'L AGGREGATE LI MITAPPLI ES PER: POLICY ❑ PRO. ❑ JECT LOC GENERALAGGREGATE $ PRODUCTS - COMPlOPAGG $ $ OTHER: i AUTOMOBILE LIABILITY COMRINED SINGLE LIMIT Ea accltlenl $ 1,000,000 X ANYAUTO BODILY INJURY (Par person) $ A OWNED SCHEDULED AUTOS ONLY AUTOS Y Y 72UEC5041YM 10/08/2024 10/08/2025 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY H PROPERTY DAMAGE Per accltlenl $ a UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS UPS CLAIMS-MAOE DED I I RETENTION $ $ I I WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) byes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below APPROVED �10:57 By y Tu T_ra_n_ Nguyen -at am, Mar 03, 2 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If moms aceIs mqulred) RE:Leadership Training, Leadership Academy, Executive Coaching, Customized Keynote, Teambuilding, & Department Strategic Planning. City of Santa Ana, is included as an Additional Insured as required by a written contractor agreement on the Auto Liability. Coverage is Primary & Non -Contributory when required by a wrlten contractor agreement with the named Insured. Blanket Walver-of-Subrogation is granted in favor of the Additional Insured with respect to the Auto Liability when required by written contractor agreement. Thirty (30) days' notice of cancellation with ten (10) days' notice for non-payment of premium Is provided to the certificate holder. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana Atn Human Resources - Lori Schnaider/Breanna ACCORDANCE WITH THE POLICY PROVISIONS. 20 Dlvis Center Plaza 5th Fir M 24 AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 1988.2015ACORD CORPORATION. All rinh4e m...ri ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTOMOBILE HA99161221 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED Paragraph .1. - WHO IS AN INSURED - of Section II - Liability Coverage is amended to add the following: d. Subsidiaries and Newly Acquired or Formed Organizations The Named Insured shown in the Declarations is amended to include: (1) Any legal business entity other than a partnership or joint venture, formed as a subsidiary in which you have an ownership interest of more than 50% on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. (2) Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a) That is a partnership or joint venture, (b) That is an "insured" under any other policy, (c) That has exhausted its Limit of Insurance under any other policy, or (d) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation. Coverage does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization. Form HA 9916 12 21 e. Employees as Insureds (1). Any "employee" of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. f. Lessors as Insureds (1). The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if: (a) The agreement requires you to provide direct primary insurance for the lessor and (b) The "auto" is leased without a driver. Such a leased "auto" will be considered a covered "auto" you own and not a covered "auto" you hire. g. Additional Insured if Required by Contract (1) When you have agreed, in a written contract or written agreement, that a person or organization be added as an additional insured on your business auto policy, such person or organization is an "insured", but only to the extent such person or organization is liable for "bodily injury" or "property damage" caused by the conduct of an "insured" under paragraphs a. or b. of Who Is An Insured with regard to the ownership, maintenance or use of a covered "auto." The insurance afforded to any such additional insured applies only if the "bodily injury" or "property damage" occurs: (a) During the policy period, and (b) Subsequent to the execution of such written contract, and Page 1 of 5 © 2021, The Hartford (Includes copyrighted material of Insurance Services Office, Inc. with its permission.) (c) Prior to the expiration of the period of time that the written contract requires such insurance be provided to the additional insured. (2) How Limits Apply If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the most we will pay on behalf of such additional insured is the lesser of: (a) The limits of insurance specified in the written contract or written agreement; or (b) The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations and described in this Section. (3) Additional Insureds Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance. (4) Duties in The Event Of Accident, Claim, Suit or Loss If you have agreed in a written contract or written agreement that another person or organization be added as an additional insured on your policy, the additional insured shall be required to comply with the provisions in LOSS CONDITIONS 2. - DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS — OF SECTION IV — BUSINESS AUTO CONDITIONS, in the same manner as the Named Insured. 2. Primary and! Non -Contributory if Required by Contract Only with respect to insurance provided to an additional insured in A.1.g. - Additional Insured If Required by Contract, the following provisions apply: (1) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Other Insurance 5.d. (2) Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract or written agreement that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (1) and (2) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self -insured amounts under all that other insurance. We will share the remaining loss, if any, by the method described in SECTION IV - Business Auto Conditions, B. General Conditions, Other Insurance 5.d. 3. AUTOS RENTED BY EMPLOYEES Any "auto" hired or rented by your "employee" on your behalf and at your direction will be considered an "auto" you hire. The SECTION IV- Business Auto Conditions, B. General Conditions, 5. OTHER INSURANCE Condition is amended by adding the following: e. If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the "employee's" personal insurance. Page 2 of 5 Form HA 99 16 12 21 4. AMENDED FELLOW EMPLOYEE EXCLUSION EXCLUSION 5. - FELLOW EMPLOYEE - of SECTION II - LIABILITY COVERAGE does not apply if you have workers' compensation insurance in -force covering all of your "employees". Coverage is excess over any other collectible insurance. 5. HIRED AUTO PHYSICAL DAMAGE COVERAGE If hired "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired "auto" is: (1) $100,000; (2) The actual cash value of the damaged or stolen property at the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property, whichever is smallest, minus a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1000 per "accident". This extension of coverage does not apply to any "auto" you hire or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. 6. PHYSICAL DAMAGE - ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph AA.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day and a maximum limit of $1,000. 7. LOAN/LEASE GAP COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, in the event of a total "loss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the "loss" and the "outstanding balance" of the loan/lease. "Outstanding balance" means the amount you owe on the loan/lease at the time of "loss" less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; lease termination fees; security deposits not returned by the lessor; costs for extended warranties, credit life Insurance, health, accident or disability insurance purchased with the loan or lease; and carry-over balances from previous loans or leases. Fm_11 V-LTC14101Tl4 N_Bl4 Under Paragraph B. EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. 9. ELECTRONIC EQUIPMENT - BROADENED COVERAGE a. The exceptions to Paragraphs B.4 - EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE are replaced by the following: Exclusions 4.c. and 4.d. do not apply to equipment designed to be operated solely by use of the power from the "auto's" electrical system that, at the time of "loss", is: (1) Permanently installed in or upon the covered "auto"; (2) Removable from a housing unit which is permanently installed in or upon the covered "auto"; (3) An integral part of the same unit housing any electronic equipment described in Paragraphs (1) and (2) above; or (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered "auto's" operating system. b. Section III, Physical Damage Coverage, Limit of Insurance, Paragraph C.2. is amended to add the following: $1,500 is the most we will pay for "loss" in any one "accident" to all electronic equipment (other than equipment designed solely for the reproduction of sound, and accessories used with such equipment) that reproduces, receives or transmits audio, visual or data signals which, at the time of "loss", is: Form HA 99 1612 21 Page 3 of 5 (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; (2) Removable from a permanently installed housing unit as described in Paragraph 2.a. above or is an integral part of that equipment; or (3) An integral part of such equipment. c. For each covered "auto", should loss be limited to electronic equipment only, our obligation to pay for, repair, return or replace damaged or stolen electronic equipment will be reduced by the applicable deductible shown in the Declarations, or $250, whichever deductible is less. 10. EXTRA EXPENSE -BROADENED COVERAGE Under Paragraph A. - COVERAGE - of SECTION III - PHYSICAL DAMAGE COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. 11. GLASS REPAIR -WAIVER OF DEDUCTIBLE Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 12. TWO OR MORE DEDUCTIBLES Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: If another Hartford Financial Services Group, Inc. company policy or coverage form that is not an automobile policy or coverage form applies to the same "accident", the following applies: (1) If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; (2) If the deductible under this Business Auto Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. 13. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITIONS 2.a. - DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS - of SECTION IV - BUSINESS AUTO CONDITIONS that you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. 14. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. 15. HIRED AUTO - COVERAGE TERRITORY SECTION IV, BUSINESS AUTO CONDITIONS, PARAGRAPH B. GENERAL CONDITIONS, 7. - POLICY PERIOD, COVERAGE TERRITORY - is added to include the following: (6) For short-term hired "autos", the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the "insured's" responsibility to pay damages for "bodily injury" or "property damage" is determined in a "suit," the "suit" is brought in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. 16. WAIVER OF SUBROGATION Paragraph 5. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - of SECTION IV - BUSINESS AUTO CONDITIONS A. Loss Conditions is amended by adding the following: We waive any right of recovery we may have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form. 17. RESULTANT MENTAL ANGUISH COVERAGE The definition of "bodily injury" in SECTION V- DEFINITIONS, C. is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish or death resulting from any of these. 18. EXTENDED CANCELLATION CONDITION Paragraph 2. of the COMMON POLICY CONDITIONS - CANCELLATION - applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. Page 4 of 5 Form HA 99 16 12 21 19. HYBRID, ELECTRIC, OR NATURAL GAS VEHICLE PAYMENT COVERAGE In the event of a total loss to a "non -hybrid" auto for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended as follows: a. If the auto is replaced with a "hybrid" auto or an auto powered solely by electricity or natural gas, we will pay an additional 10%, to a maximum of $2,500, of the "non -hybrid" auto's actual cash value or replacement cost, whichever is less, b. The auto must be replaced and a copy of a bill of sale or new lease agreement received by us within 60 calendar days of the date of "loss," c. Regardless of the number of autos deemed a total loss, the most we will pay under this Hybrid, Electric, or Natural Gas Vehicle Payment Coverage provision for any one "loss" is $10,000. For the purposes of the coverage provision, a. A "non -hybrid" auto is defined as an auto that uses only an internal combustion engine to move the auto but does not include autos powered solely by electricity or natural gas. b. A "hybrid" auto is defined as an auto with an internal combustion engine and one or more electric motors; and that uses the internal combustion engine and one or more electric motors to move the auto, or the internal combustion engine to charge one or more electric motors, which move the auto. 20. VEHICLE WRAP COVERAGE In the event of a total loss to an "auto" for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended to add the following: In addition to the actual cash value of the "auto", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss. Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage provision for any one "loss" is $5,000. For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. Form HA 99 16 12 21 Page 5 of 5 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other than for nonpayment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. B. If this policy is cancelled by the Company for nonpayment of premium, or by the insured, notice of such cancellation will be provided within (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. Form IH 0313 06 11 Page 1 of 1 0 2011, The Hartford Fl THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other than for nonpayment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. B. If this policy is cancelled by the Company for nonpayment of premium, or by the insured, notice of such cancellation will be provided within (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. Form IH 03 13 06 11 Page 1 of 1 © 2011, The Hartford CERTIFICATE OF LIABILITY INSURANCE DATE (MMMD/YYYY) 02/26/2025 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: AUTOMATIC DATA PROCESSING INS AGCY 76250717 71 HANOVER ROAD FLORHAM PARK NJ 07932 PHONE (800) 524-7024 (A/C, No, Fax (A/C, No): ESS: E-MAILADDRESS: INSURER(3) AFFORDING COVERAGE NAICk INSURER A: Hartford Fire and Its P&C Affiliates 00914 INSURED INSURER B JACOB GREEN AND ASSOCIATES INC. INSURER c 13217 JAMBOREE RD If 248 INSURER 0: TUSTIN CA 92782-9158 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR R TYPE OF INSURANCE ADDL INSR SUBR WID POLICY NUMBER POLICY EFF MMIDD/YYYV POLICY UP MMIDD V V LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE ❑OCCUR DAMAGE TO RENTED PR�MISES Ea occurrence MED EXP (Any one person) PERSONAL &ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY❑PRO- ❑LOC ECT PRODUCTS - COMP/OPAGG OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accitlenl BODILY INJURY (Per person) ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accitlent) HIRED NON -OWNED PROPERTY DAMAGE AUTOS AUTOS (Peraxldent) UMBRELLA LIAB EACH OCCURRENCE EXCESS LIAB HOCCUR CLAIM& MADE AGGREGATE OEO RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PER STATUTE OTH- ER E.L. EACH ACCIDENT $1,000,000 ANY YIN A PROPRIETORIPARTNERJEXECUTIVE OFFICER/MEMBER EXCLUDED? NIA X 76 WEG AS7GJL 05l24l2024 05l24l2025 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION City Of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Attention: Human Resources - Lori Schna BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 20 CIVIC CENTER PLZ # M-24 FL 5 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE SANTA ANA CA 92701-4058 © 1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD APPROVED By Tu Tran Nguyen. at 10:57 am, Mar 03, 2025 AGENCY CUSTOMER ID: LOC#: ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMEDINSURED AUTOMATIC DATA PROCESSING INS AGCY JACOB GREEN AND ASSOCIATES INC. 13217 JAMBOREE RD # 248 POLICY NUMBER SEE ACORD 25 TUSTIN CA 92782-9158 CARRIER NAIC CODE SEE ACORD 25 EFFECTIVE DATE: SEE ACORD 25 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Blanket Waiver of Subrogation applies in favor of the City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers per the Waiver of Our Right to Recover from Others Endorsement WC040306, attached to this policy. Notice of Cancellation will be provided in accordance with Form WC990394, attached to this policy. RE; State job is performed in: CA, Project / Location: JGA Organizational Development Services / City of Santa Ana ADDITIONAL REMARKS ACORD 101 (2014101) © 2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Policy Number: 76 WEG AS7GJL Endorsement Number: Effective Date: 05/24/24 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: Jacob Green and Associates Inc. 13217 JAMBOREE RD # 248 TUSTIN CA 92782 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE Any person or organization for whom you are required by contract or agreement to obtain this waiver from us. Endorsement is not applicable in KY, NH, NJ or for any MO construction risk Countersigned by Jhaaae eendkywala' Authorized Representative Form WC 00 03 13 Printed in U.S.A. Process Date: 04/14/24 Policy Expiration Date: 05/24/25 DATE(MMIDD/YYYY) ACCOR" CERTIFICATE OF LIABILITY INSURANCE 08/04/2025 Ill THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Meyer Jordan NAME: Great Park Insurance Services,Inc. a/cNr o Ext: (949)387-3242 a/c,No): (888)370-4994 10 Corporate Park Suite 130 E-MAIL Jordan.meyer@greatparkinsurance.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Irvine CA 92606 INSURERA: Kinsale Insurance 38920 INSURED INSURER B: Berkshire Hathaway Homestate Companies 11014 Jacob Green&Associates INSURER C: Kinsale Insurance 38920 13217 Jamboree RD INSURER D: Lloyd's Syndicate 2987 #248 INSURER E: Tustin,CA 92782 INSURER F COVERAGES CERTIFICATE NUMBER: CL238802967 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ 250,000 MED EXP(Any one person) $ 5 000 A X X PSN0140030874 08/09/2025 08/09/2026 PERSONAL&ADV INJURY $ 2000000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4000000 X POLICY El PEA ❑ LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: Errors and Omissions $ 2000000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BODILY INJURY(Per accide nt) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Professional Liability X X PSNO140030874 08/09/2025 08/09/2026 Occurrence $2,000,000 Aggregate $2,000,000 D Cyber Liability X CYP17217224 09/23/2024 09/23/2025 Occurence $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Santa Ana, its City Council, officers, employees, agents and volunteers as additionally insured Tu Tra n Digitally signed by Tu Tan Nguyen Nguyen °08;020°00' Sy Tu Traar.Nguyen at 12:07 darer,Autry 14,025 CERTIFICATE HOLDER CANCELLATION ------------------------------- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attention:Human Resources-Lori Schnaider/Breanna Lynch 20 Civic Center Plaza,5th Floor,M-24 AUTHORIZED REPRESENTATIVE Santa Ana,CA 9270 1988-2015 P Rlb CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACCOR" CERTIFICATE OF LIABILITY INSURANCE 08/14/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTNAMEACT Automatic Data Processing Insurance Agency, Inc. Automatic Data Processing Insurance Agency, Inc. A//C,No Ext: 1-800-524-7024 (A///C,No): E-MAIL ADDRESS: 1 Adp Boulevard INSURER(S)AFFORDING COVERAGE NAIC# Roseland NJ 07068 INSURERA: Rated by Multiple Companies INSURED Jacob Green And Associates Inc. INSURER B: INSURER C: 13217 Jamboree Rd#248 INSURER D: INSURER E: Tustin CA 927829158 INSURER F: COVERAGES CERTIFICATE NUMBER: 4485224 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- Y/N AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED? N/A Y 76WEGAS7GJL 05/24/2025 05/24/2026 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) This certificate has a blanket Waiver of Subrogation for the following state(s):CA PPROVED y To Train Nguyen at 12a7 pm,Aug,14,20�0, CERTIFICATE HOLDER CANCELLATION ---------------------------------- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attention: Human Resources-Lori Schna 20 CIVIC CENTER PLZ#M-24 FL 5 AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD .0-tulk THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Policy Number: 76 WEG AS7GJL Endorsement Number: Effective Date: 05/24/25 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: Jacob Green and Associates Inc. 13217 JAMBOREE RD#248 TUSTIN CA 92782 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE Any person or organization for whom you are required by contract or agreement to obtain this waiver from us. Endorsement is not applicable in KY, NH, NJ or for any MO construction risk Countersigned by Authorized Representative Form WC 00 03 13 Printed in U.S.A. Process Date: 04/14/25 Policy Expiration Date: 05/24/26 POLICY NUMBER: PSNO140030874 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) The City of Santa Ana,its City Council,officers,employees,agents and volunteers as additionally insured OR AS REQUIRED BY WRITTEN AGREEMENT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganizations) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. Policy Number: PSNO140030874 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have,,agreed in`writing,in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: PSN0140030874 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the,following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/CO,M:PLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City Of Santa Ana,Its Council,Officers,Officials,Employees,agents,and Volunteers Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The fol'lowing is added to, Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV-Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising, out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 @Insurance Services Office, Inc., 2008 Page I of I POLICY NUMBER: PSNO140030874 Professional Liability THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Professional Liability SCHEDULE Name Of Additional Insured Persons Or Organization(s) The City of Santa Ana,its City Council,officers,employees,agents and volunteers as additionally insured OR AS REQUIRED BY WRITTEN AGREEMENT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION BY US CERTIFICATE HOLDER(S) This endorsement modifies insurance provided under the following: PSM0039722206 COMMERCIAL GENERAL LIABILITY SCHEDULE Certificate Holder(s): The City of Santa Ana,its City Council,officers,employees,agents and volunteers as additionally insured Section XXIII. CONDITIONS, 4. Cancellation is amended by the addition of the following: If we cancel this Policy before the expiration date thereof, we will mail 30 days written notice (10 days for non-payment of premium)to the Certificate Holder(s) indicated in the SCHEDULE above. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. DATE /Y(MM/DDYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 08/04/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Meyer Jordan NAME: Great Park Insurance Services,Inc. pAHCNr o Ext: (949)387-3242 FAAic,No): (888)370-4994 10 Corporate Park Suite 130 E-MAIL Jordan.meyer@greatparkinsurance.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Irvine CA 92606 INSURERA: Kinsale Insurance 38920 INSURED INSURER B: Berkshire Hathaway Homestate Companies 11014 Jacob Green&Associates INSURER C: Kinsale Insurance 38920 13217 Jamboree RD INSURER D: Lloyd's Syndicate 2987 #248 INSURER E: Tustin,CA 92782 INSURER F COVERAGES CERTIFICATE NUMBER: CL238802967 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MWDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ 250,000 MED EXP(Any one person) $ 5 000 A X X PSN0140030874 08/09/2025 08/09/2026 PERSONAL&ADV INJURY $ 2000000 nGEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4000000 X POLICY El PEA ❑ LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: Errors and Omissions $ 2000000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BODILY INJURY(Per accide nt) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Professional Liability X X PSNO140030874 08/09/2025 08/09/2026 Occurrence $2,000,000 Aggregate $2,000,000 p Cyber Liability X CYP17217225 09/23/2025 09/23/2026 Iccurence $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) byT.T,a signed Tu Tran City of Santa Ana, its City Council, officers, employees, agents and volunteers as additionally insured Nguyen Nguyen°528 °Z5Boo° APPROVED By Tu Tran Nguyen at 3:27 pm,Nov 20,2025 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Attention:Human Resources-Lori Schnaider 20 Civic Center Plaza,5th Floor,M-24 AUTHORIZED REPRESENTATIVE (� Santa Ana,CA 9270 ©1988-2015 ACOR CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 11/20/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Lesley Sayers NAME: Scott&McCauley Insurance Agency PHONE (949)503-1953 FAx A/C No Ext: A/C,No): 2 Ritz Carlton Drive E-MAIL lesley@sminsuranceagency.com ADDRESS: Suite 204 INSURER(S)AFFORDING COVERAGE NAIC# Dana Point CA 92629 INSDRERA: Hartford Accident and Indemnity Company 22357 INSURED INSURER B Jacob Green and Associates Inc INSURER C: 13217 Jamboree Rd#248 INSURER D: INSURER E: Tustin CA 92782 INSURER F: COVERAGES CERTIFICATE NUMBER: Master 25-26 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RETED CLAIMS-MADE OCCUR -PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y Y 72UECCM3860 10/08/2025 10/08/2026 BODILY INJURY(Pe r accide nt) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Underinsured motorist $ 1,000,000 UMBRELLA LIAB OCCUR EH`VAC"""OCC _RURRE"'y,_NC E E, $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Santa Ana and its officers,officials,employees,agents,and volunteers are included as an Additional Insured as required by a written contract or agreement on the Auto Liability.Coverage is Primary&Non-Contributory when required by a written contract or agreement with the named insured.Blanket Waiver-of-Subrogation is granted in favor of the Additional Insured with respect to the Auto Liability when required by written contract or agreement.Thirty (30)days'notice of cancellation with ten(10)days'notice for non-payment of premium is provided to the certificate holder. APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 3:27 pm,Nov 20,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Santa Ana Attn Human Resources ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE M-24 Santa Ana CA 92701 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PSNO140030874 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) City of Santa Ana,its City Council,officers,employees,agents and volunteers as additionally insured OR AS REQUIRED BY WRITTEN AGREEMENT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. Policy Number: PSNO140030874 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in`writing,in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: PSNO140030874 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: City Of Santa Ana,Its Council,Officers,Officials,Employees,agents,and Volunteers Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 Insurance Services Office, Inc., 2008 Page 1 of 1 POLICY NUMBER:PSNO140030874 Professional Liability THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: Professional Liability SCHEDULE Name Of Additional Insured Persons Or Organization(s) The City of Santa Ana,its City Council,officers,employees,agents and volunteers as additionally insured OR AS REQUIRED BY WRITTEN AGRE04ENT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION BY US CERTIFICATE HOLDER(S) This endorsement modifies insurance provided under the following: PSM0039722206 COMMERCIAL GENERAL LIABILITY SCHEDULE Certificate Holder(s): The City of Santa Ana,its City Council,officers,employees,agents and volunteers as additionally insured Section XXIII. CONDITIONS, 4. Cancellation is amended by the addition of the following: If we cancel this Policy before the expiration date thereof, we will mail 30 days written notice (10 days for non-payment of premium)to the Certificate Holder(s) indicated in the SCHEDULE above. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional If notice is mailed, proof of mailing to the last known Conditions: mailing address of the certificate holder(s) on file with A. If this policy is cancelled by the Company, other the agent of record or the Company will be sufficient than for nonpayment of premium, notice of such proof of notice. cancellation will be provided at least thirty (30) Any notification rights provided by this endorsement days in advance of the cancellation effective date apply only to active certificate holder(s) who were to the certificate holder(s) with mailing addresses issued a certificate of insurance applicable to this on file with the agent of record or the Company. policy's term. B. If this policy is cancelled by the Company for Failure to provide such notice to the certificate nonpayment of premium, or by the insured, notice holder(s) will not amend or extend the date the of such cancellation will be provided within (10) cancellation becomes effective, nor will it negate days of the cancellation effective date to the cancellation of the policy. Failure to send notice shall certificate holder(s) with mailing addresses on file impose no liability of any kind upon the Company or its with the agent of record or the Company. agents or representatives. Form IH 03 13 06 11 Page 1 of 1 © 2011, The Hartford COMMERCIAL AUTOMOBILE HA99161221 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED e. Employees as Insureds Paragraph .1. - WHO IS AN INSURED - of (1). Any "employee" of yours while using a Section II - Liability Coverage is amended to covered "auto" you don't own, hire or add the following: borrow in your business or your personal d. Subsidiaries and Newly Acquired or affairs. Formed Organizations f. Lessors as Insureds The Named Insured shown in the Declarations (1). The lessor of a covered "auto" while the is amended to include: "auto" is leased to you under a written (1) Any legal business entity other than a agreement if: partnership or joint venture, formed as a (a) The agreement requires you to subsidiary in which you have an provide direct primary insurance for ownership interest of more than 50% on the lessor and the effective date of the Coverage Form. (b) The "auto" is leased without a driver. However, the Named Insured does not Such a leased "auto" will be considered a include any subsidiary that is an "insured" covered "auto" you own and not a covered under any other automobile policy or "auto" you hire. would be an "insured" under such a policy but for its termination or the exhaustion of g. Additional Insured if Required by Contract its Limit of Insurance. (1) When you have agreed, in a written (2) Any organization that is acquired or contract or written agreement, that a formed by you and over which you person or organization be added as an maintain majority ownership. However, additional insured on your business auto the Named Insured does not include any policy, such person or organization is an newly formed or acquired organization: "insured", but only to the extent such person or organization is liable for "bodily (a) That is a partnership or joint venture, injury" or "property damage" caused by (b) That is an "insured" under any other the conduct of an "insured" under policy, paragraphs a. or b. of Who Is An Insured (c) That has exhausted its Limit of with regard to the ownership, Insurance under any other policy, or maintenance or use of a covered "auto." (d) 180 days or more after its acquisition The insurance afforded to any such or formation by you, unless you have additional insured applies only if the given us notice of the acquisition or "bodily injury" or "property damage" formation. occurs: Coverage does not apply to "bodily injury" (a) During the policy period, and or "property damage" that results from an (b) Subsequent to the execution of such "accident" that occurred before you written contract, and formed or acquired the organization. Form HA 99 16 12 21 Page 1 of 5 ©2021, The Hartford (Includes copyrighted material of Insurance Services Office, Inc. with its permission.) (c) Prior to the expiration of the period of This insurance is primary if you have time that the written contract requires agreed in a written contract or written such insurance be provided to the agreement that this insurance be primary. additional insured. If other insurance is also primary, we will (2) How Limits Apply share with all that other insurance by the method described in Other Insurance 5.d. If you have agreed in a written contract or written agreement that another person or (2) Primary And Non-Contributory To Other organization be added as an additional Insurance When Required By Contract insured on your policy, the most we will If you have agreed in a written contract or pay on behalf of such additional insured is written agreement that this insurance is the lesser of: primary and non-contributory with the (a) The limits of insurance specified in the additional insured's own insurance, this written contract or written agreement; insurance is primary and we will not seek or contribution from that other insurance. (b) The Limits of Insurance shown in the Paragraphs (1) and (2) do not apply to other Declarations. insurance to which the additional insured has Such amount shall be a part of and not in been added as an additional insured. addition to Limits of Insurance shown in When this insurance is excess, we will have the Declarations and described in this no duty to defend the insured against any Section. "suit" if any other insurer has a duty to defend (3) Additional Insureds Other Insurance the insured against that "suit". If no other insurer defends, we will undertake to do so, If we cover a claim or "suit" under this but we will be entitled to the insured's rights Coverage Part that may also be covered against all those other insurers. by other insurance available to an When this insurance is excess over other additional insured, such additional insured insurance, we will pay only our share of the must submit such claim or suit to the amount of the loss, if any, that exceeds the other insurer for defense and indemnity. sum of: However, this provision does not apply to (1) The total amount that all such other the extent that you have agreed in a insurance would pay for the loss in the written contract or written agreement that absence of this insurance; and this insurance is primary and non-contributory with the additional (2) The total of all deductible and self-insured insured's own insurance. amounts under all that other insurance. (4) Duties in The Event Of Accident, Claim, We will share the remaining loss, if any, by Suit or Loss the method described in SECTION IV- If you have agreed in a written contract or Business Auto Conditions, B. General written agreement that another person or Conditions, Other Insurance 5.d. organization be added as an additional 3. AUTOS RENTED BY EMPLOYEES insured on your policy, the additional Any "auto" hired or rented by your "employee" on insured shall be required to comply with your behalf and at your direction will be the provisions in LOSS CONDITIONS 2. - considered an "auto" you hire. DUTIES IN THE EVENT OF ACCIDENT, The SECTION IV- Business Auto Conditions, B. CLAIM , SUIT OR LOSS — OF SECTION General Conditions, 5. OTHER INSURANCE IV — BUSINESS AUTO CONDITIONS, in Condition is amended by adding the following: the same manner as the Named Insured. 2. Primary and Non-Contributory if Required e. If an "employee's" personal insurance also applies on an excess basis to a covered by Contract "auto" hired or rented by your "employee" on Only with respect to insurance provided to an your behalf and at your direction, this additional insured in A.1.g. - Additional insurance will be primary to the "employee's" Insured If Required by Contract, the following personal insurance. provisions apply: (1) Primary Insurance When Required By Contract Page 2 of 5 Form HA 99 16 12 21 4. AMENDED FELLOW EMPLOYEE EXCLUSION obligation for any difference between the actual EXCLUSION 5. - FELLOW EMPLOYEE - of cash value of the "auto" at the time of the "loss" SECTION II - LIABILITY COVERAGE does not and the "outstanding balance" of the loan/lease. apply if you have workers' compensation "Outstanding balance" means the amount you insurance in-force covering all of your owe on the loan/lease at the time of "loss" less "employees". any amounts representing taxes; overdue Coverage is excess over any other collectible payments; penalties, interest or charges resulting insurance. from overdue payments; additional mileage charges; excess wear and tear charges; lease 5. HIRED AUTO PHYSICAL DAMAGE COVERAGE termination fees; security deposits not returned by If hired "autos" are covered "autos" for Liability the lessor; costs for extended warranties, credit Coverage and if Comprehensive, Specified life Insurance, health, accident or disability Causes of Loss, or Collision coverages are insurance purchased with the loan or lease; and provided under this Coverage Form for any "auto" carry-over balances from previous loans or you own, then the Physical Damage Coverages leases. provided are extended to "autos" you hire or g, AIRBAG COVERAGE borrow, subject to the following limit. Under Paragraph B. EXCLUSIONS - of SECTION The most we will pay for "loss" to any hired "auto" III - PHYSICAL DAMAGE COVERAGE, the is: following is added: (1) $100,000; The exclusion relating to mechanical breakdown (2) The actual cash value of the damaged or does not apply to the accidental discharge of an stolen property at the time of the "loss"; or airbag. (3) The cost of repairing or replacing the 9. ELECTRONIC EQUIPMENT - BROADENED damaged or stolen property, COVERAGE whichever is smallest, minus a deductible. The a. The exceptions to Paragraphs BA - deductible will be equal to the largest deductible EXCLUSIONS - of SECTION III - PHYSICAL applicable to any owned "auto" for that coverage. DAMAGE COVERAGE are replaced by the No deductible applies to "loss" caused by fire or following: lightning. Hired Auto Physical Damage coverage Exclusions 4.c. and 4.d. do not apply to is excess over any other collectible insurance. equipment designed to be operated solely by Subject to the above limit, deductible and excess use of the power from the "auto's" electrical provisions, we will provide coverage equal to the system that, at the time of"loss", is: broadest coverage applicable to any covered "auto" you own. (1) Permanently installed in or upon the We will also cover loss of use of the hired "auto" if covered "auto"; it results from an "accident", you are legally liable (2) Removable from a housing unit which is and the lessor incurs an actual financial loss, permanently installed in or upon the subject to a maximum of$1000 per"accident". covered "auto"; This extension of coverage does not apply to any (3) An integral part of the same unit housing "auto" you hire or borrow from any of your any electronic equipment described in "employees", partners (if you are a partnership), Paragraphs (1) and (2) above; or members (if you are a limited liability company), (4) Necessary for the normal operation of the or members of their households. covered "auto" or the monitoring of the 6. PHYSICAL DAMAGE - ADDITIONAL covered "auto's" operating system. TEMPORARY TRANSPORTATION EXPENSE b. Section III, Physical Damage Coverage, Limit COVERAGE of Insurance, Paragraph C.2. is amended to Paragraph AA.a. of SECTION III - PHYSICAL add the following: DAMAGE COVERAGE is amended to provide a $1,500 is the most we will pay for "loss" in limit of $50 per day and a maximum limit of any one "accident" to all electronic equipment $1,000. (other than equipment designed solely for the 7. LOAN/LEASE GAP COVERAGE reproduction of sound, and accessories used Under SECTION III - PHYSICAL DAMAGE with such equipment) that reproduces, receives or transmits audio, visual or data COVERAGE, in the event of a total "loss" to a signals which, at the time of"loss", is: covered "auto", we will pay your additional legal Form HA 99 16 12 21 Page 3 of 5 (1) Permanently installed in or upon the (2) A partner, if you are a partnership; covered "auto" in a housing, opening or (3) A member, if you are a limited liability other location that is not normally used by company; or the "auto" manufacturer for the installation of such equipment; (4) An executive officer or insurance manager, if (2) Removable from a permanently installed you are a corporation. housing unit as described in Paragraph 14. UNINTENTIONAL FAILURE TO DISCLOSE 2.a. above or is an integral part of that HAZARDS equipment; or If you unintentionally fail to disclose any hazards (3) An integral part of such equipment. existing at the inception date of your policy, we c. For each covered "auto", should loss be will not deny coverage under this Coverage Form limited to electronic equipment only, our because of such failure. obligation to pay for, repair, return or replace 15. HIRED AUTO - COVERAGE TERRITORY damaged or stolen electronic equipment will SECTION IV, BUSINESS AUTO CONDITIONS, be reduced by the applicable deductible PARAGRAPH B. GENERAL CONDITIONS, 7. - shown in the Declarations, or $250, whichever POLICY PERIOD, COVERAGE TERRITORY - is deductible is less. added to include the following: 10. EXTRA EXPENSE - BROADENED COVERAGE (6) For short-term hired "autos", the coverage Under Paragraph A. - COVERAGE - of SECTION territory with respect to Liability Coverage is III - PHYSICAL DAMAGE COVERAGE, we will anywhere in the world provided that if the pay for the expense of returning a stolen covered "insured's" responsibility to pay damages for "auto" to you. "bodily injury" or "property damage" is 11. GLASS REPAIR -WAIVER OF DEDUCTIBLE determined in a "suit," the "suit" is brought in the United States of America, the territories Under Paragraph D. - DEDUCTIBLE - of and possessions of the United States of SECTION III - PHYSICAL DAMAGE COVERAGE, America, Puerto Rico or Canada or in a the following is added: settlement we agree to. No deductible applies to glass damage if the glass 16. WAIVER OF SUBROGATION is repaired rather than replaced. Paragraph 5. TRANSFER OF RIGHTS OF 12. TWO OR MORE DEDUCTIBLES RECOVERY AGAINST OTHERS TO US - of Under Paragraph D. - DEDUCTIBLE - of SECTION IV - BUSINESS AUTO CONDITIONS SECTION III - PHYSICAL DAMAGE COVERAGE, A. Loss Conditions is amended by adding the the following is added: following: If another Hartford Financial Services Group, Inc. We waive any right of recovery we may have company policy or coverage form that is not an against any person or organization with whom you automobile policy or coverage form applies to the have a written contract that requires such waiver same "accident", the following applies: because of payments we make for damages (1) If the deductible under this Business Auto under this Coverage Form. Coverage Form is the smaller (or smallest) 17. RESULTANT MENTAL ANGUISH COVERAGE deductible, it will be waived; The definition of "bodily injury" in SECTION V- (2) If the deductible under this Business Auto DEFINITIONS, C. is replaced by the following: Coverage Form is not the smaller (or "Bodily injury" means bodily injury, sickness or smallest) deductible, it will be reduced by the disease sustained by any person, including amount of the smaller (or smallest) mental anguish or death resulting from any of deductible. these. 13. AMENDED DUTIES IN THE EVENT OF 18. EXTENDED CANCELLATION CONDITION ACCIDENT, CLAIM, SUIT OR LOSS Paragraph 2. of the COMMON POLICY The requirement in LOSS CONDITIONS 2.a. - CONDITIONS - CANCELLATION - applies except DUTIES IN THE EVENT OF ACCIDENT, CLAIM, as follows: SUIT OR LOSS - of SECTION IV - BUSINESS If we cancel for any reason other than AUTO CONDITIONS that you must notify us of an nonpayment of premium, we will mail or deliver to "accident" applies only when the "accident" is the first Named Insured written notice of known to: cancellation at least 60 days before the effective (1) You, if you are an individual; date of cancellation. Page 4 of 5 Form HA 99 16 12 21 19. HYBRID, ELECTRIC, OR NATURAL GAS b. A "hybrid" auto is defined as an auto with an VEHICLE PAYMENT COVERAGE internal combustion engine and one or more In the event of a total loss to a "non-hybrid" auto electric motors; and that uses the internal for which Comprehensive, Specified Causes of combustion engine and one or more electric Loss, or Collision coverages are provided under motors to move the auto, or the internal this Coverage Form, then such Physical Damage combustion engine to charge one or more Coverages are amended as follows: electric motors, which move the auto. a. If the auto is replaced with a "hybrid" auto or 20. VEHICLE WRAP COVERAGE an auto powered solely by electricity or In the event of a total loss to an "auto" for which natural gas, we will pay an additional 10%, to Comprehensive, Specified Causes of Loss, or a maximum of $2,500, of the "non-hybrid" Collision coverages are provided under this auto's actual cash value or replacement cost, Coverage Form, then such Physical Damage whichever is less, Coverages are amended to add the following: b. The auto must be replaced and a copy of a In addition to the actual cash value of the "auto", bill of sale or new lease agreement received we will pay up to $1,000 for vinyl vehicle wraps by us within 60 calendar days of the date of which are displayed on the covered "auto" at the "loss," time of total loss. Regardless of the number of c. Regardless of the number of autos deemed a autos deemed a total loss, the most we will pay total loss, the most we will pay under this under this Vehicle Wrap Coverage provision for Hybrid, Electric, or Natural Gas Vehicle any one "loss" is $5,000. For purposes of this Payment Coverage provision for any one coverage provision, signs or other graphics "loss" is $10,000. painted or magnetically affixed to the vehicle are For the purposes of the coverage provision, not considered vehicle wraps. a. A "non-hybrid" auto is defined as an auto that uses only an internal combustion engine to move the auto but does not include autos powered solely by electricity or natural gas. Form HA 99 16 12 21 Page 5 of 5