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7ATE (MMIDDIYYYY) <br />ACOR" CERTIFICATE OF LIABILITY INSURANCE <br />5/1/20251/2024 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADD'TI A,_ IRy UKP, the policy(ies) st have ADDITIONAL INSURED provisions or be endorsed. <br />nSUBROGATICM IS WAIVED, subject to the tel ms a �(c`bj�� Apfgy�,ri�/�olicies may require an endorsement. A statement on <br />lAs Me fiEa�i AdMt confer riohts to the certi `icate h er in lied of su endorsement(s). <br />/ROr)rd1tR ILO't <br />#Fn1CNmpanies Angie AceLockton <br />3 eachtree Road NE, Suite 41000 <br />Atlanta GA 30305 <br />AC(6 3 Date. 202 <br />do — <br />Technical Services <br />H (404) 460-3600 FAx <br />IC No Ext : A/c No <br />E VSCerts@lockton.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />u . Hartford Fire Insurance Company <br />19682 <br />_ <br />INSURED NV_5,Inc. <br />1491108 133 Technology Drive <br />Suite 200 <br />Irvine CA 92618 <br />INSURER B:Navigators Specialty insurance Company <br />36056 <br />INSURERC: Twin City Fire Insurance Company <br />29459 <br />INSURER D : Everest Indemnity Insurance Company <br />10851 <br />INSURER E : National Fire and Marine Insurance CO <br />20079 <br />INSURER F : <br />COVERAGES Irvine CERTIFICATE NUMBER: 171 (fIA 71(, REVISION NUMBER: XXXXXXX <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM/DDIYYYY <br />POLICY EXP <br />W MMIDD/YY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />y <br />y <br />21 CSE S88600 <br />5/l /2024 <br />5/1/2025 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />CLAIMS -MADE � OCCUR <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />$ 300,000 <br />MED EXP (Any one person) <br />$ 15,000 <br />PERSONAL & ADV INJURY <br />$ 2,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />JPRO- <br />POLICY LOC <br />PRODUCTS - COMP/OP AGG <br />$ 4,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />y <br />y <br />21 CSE S88601 <br />5/1/2024 <br />5/1/2025 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 2,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ XXXXXXX <br />ANY AUTO <br />BODILY INJURY (Per accident) <br />$ XXXXXXX <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />X <br />PROPERTY DAMAGE <br />Per accident <br />$ XXXXXXX <br />HIRED X NON -OWNED <br />ONLY AUTOS ONLY <br />$XXXXXXX <br />B <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />N <br />N <br />GA24EXRZOD`VT51C <br />5/1/2024 <br />5/1/2025 <br />EACH OCCURRENCE <br />$ 10,000,000 <br />AGGREGATE <br />$ 10,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED X RETENTION $ $0 <br />$ XXXXXXX <br />C <br />WORKERS COMPENSATIONPER <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ <br />OFFICER/MEMBER EXCLUDED? N <br />(Mandatory in NH) <br />H I A <br />y <br />22 WE BE9P58 <br />5/l /2024 <br />5/1/2025 <br />X STATUTE OER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />D <br />Excess Liab <br />N <br />N <br />XC3EX00564-241 <br />5/1/2024 <br />5/1/2025 <br />Ea. Claim/Agg. $1OM/$1OM <br />E <br />Prof/Poll Liab <br />42-EPP-321328-03 <br />5/l/2024 <br />5/1/2025 <br />Ea. Claim/Agg. $10NI120M <br />A <br />Bus Per Prop <br />22 UIJN AF9909 <br />5/l /2024 <br />5/1/2025 <br />Limit $20,415,609 <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />*SEE PAGE TWO* <br />17506716 <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th floor <br />Santa Ana CA 92701 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PRC <br />oR.N a RA Mougmumt DMslcrn <br />AUTHORIZED REPRIESENTATIVE! REVIEWED & APPROVED BY: <br />Risk Management Specialist <br />ACORD 25 (2016/03) <br />© 1988-2016 AC <br />The ACORD name and logo are registered marks of ACORD <br />