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;►► CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />01/14/2025
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
<br />THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
<br />POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
<br />AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED,
<br />subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not
<br />confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />WHINS INSURANCE AGENCY LLC/PHS
<br />NAME:
<br />PHONE (866)467-8730
<br />(A/C, No, Ext):
<br />FAX
<br />(A/C, No):
<br />72186575
<br />The Hartford Business Service Center
<br />3600 Wiseman Blvd
<br />E-MAIL
<br />San Antonio, TX 78251
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE NAIC#
<br />INSURED
<br />INSURERA: Hartford Underwriters Insurance Company
<br />30104
<br />Igoe & Company, Incorporated DBA Igoe Administrative Services,
<br />INSURERB:
<br />Incorporated
<br />10905 TECHNOLOGY PL STE A
<br />INSURERC:
<br />INSURER D
<br />SAN DIEGO CA 92127-1811
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
<br />TERMS, 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 />INSR
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DD/YYY
<br />LIMITS
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$2,000,000
<br />CLAIMS -MADE OCCUR
<br />DAMAGE TO RENTED
<br />$1 000 000
<br />PREMISES Ea occurrence
<br />X
<br />MED EXP (Any one person)
<br />$10,000
<br />General Liability
<br />A
<br />X
<br />72 SBA BH9RMS
<br />02/07/2025
<br />02/07/2026
<br />PERSONAL & ADV INJURY
<br />$2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$4,000,000
<br />POLICY ❑ PRO-
<br />X JECT ❑ LOC
<br />PRODUCTS - COMP/OPAGG
<br />$4,000,000
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />$2,000,000
<br />Ea accident
<br />BODILY INJURY (Per person)
<br />ANY AUTO
<br />A
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />72 SBA BH9RMS
<br />02/07/2025
<br />02/07/2026
<br />BODILY INJURY (Per accident)
<br />X
<br />HIRED NON -OWNED
<br />AUTOS X AUTOS
<br />PROPERTY DAMAGE
<br />(Per accident)
<br />X
<br />UMBRELLA LABX
<br />OCCUR
<br />EACH OCCURRENCE
<br />$2,000,000
<br />A
<br />EXCESS LAB
<br />CLAIMS-
<br />MADE
<br />72 SBA BH9RMS
<br />02/07/2025
<br />02/07/2026
<br />AGGREGATE
<br />$2,000,000
<br />DED
<br />RETENTION $ 10,000
<br />WORKERS COMPENSATION
<br />PER
<br />OTH-
<br />AN D EMPLOYERS' LIABILITY YSTATUTE
<br />ER
<br />E.L. EACH ACCIDENT
<br />ANY Y/N
<br />PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />N/A
<br />E.L. DISEASE -EA EMPLOYEE
<br />(Mandatory in NH)
<br />If yes, describe under
<br />E.L. DISEASE - POLICY LIMIT
<br />DESCRIPTION OF OPERATIONS below
<br />A
<br />Employee Benefits Liability
<br />72 SBA BH9RMS
<br />02/07/2025
<br />02/07/2026
<br />Each Claim Limit
<br />Aggregate Limit
<br />$2,000,000
<br />$4,000,000
<br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Those usual to the Insured's Operations. City of Santa Ana, its officers, agents, employees, and volunteers, but only as required by a valid written
<br />contract, agreement, or permit is an additional insured per the Business Liability Coverage Part includes a Blanket Additional Insured By Contract
<br />Endorsement, Form SL 30 32, attached to this policy.
<br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
<br />Human Resources Department BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
<br />20 CIVIC CENTER PLZ IN ACCORDANCE WITH THE POLICY PROVISIONS.
<br />SANTA ANA CA 92701-4058 .. AUTHORIZED REPRESENTATIVE
<br />APPROVED-
<br />----------------------------------------------------------------------------- © 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Digitally signed byTu
<br />Tu Tran Tran Nguyen
<br />Date:2025.02.04
<br />Nguyen
<br />14:31:11-08'00'
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