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AC"R& CERTIFICATE OF LIABILITY INSURANCE `,I DATE (MM 00 YY ) 12/v2021 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 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 AssuredPartners Design Professionals Insurance Services, LLC 3697 Mt. Diablo Blvd Suite 230 Lafayette CA 94549 CONTACT NAME: Dods A. Chambers PHONE PAX A/CNo)- noonkss: Doris.Chambers AssuredPartners.com INSURERS AFFORDING COVERAGE NAIL# INSURER A: XL Specialty Insurance Co. 37885 License#: 6003745 INSURED MARKTHOMA INSURER B: Mark Thomas & Company, Inc. 2833 Junction Avenue, Suite 110 INSURER C: San Jose CA 95134 INSURER D: E FNSURER NSURER F: COUEFM _FS CFRTIFITtATF NIIMRFR- 18310(1750E 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. LTR TYPE OF INSURANCE ADOL BUBR POLICY NUMBER MM/UDY/YY)Y MM/FF DDY/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ AIMS -MADE OCCUR Cl-AIMS-MADE DAMAGE TO RENTED m PREMISES Eaoccrence $ MED EXP (Any one person) It PERSONAL &ADV INJURY $ GEN-L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMPIOPAGG $ POLICY JEa LOG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT accident ItEa BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS NONOWNED HIREDAUTOS HAUTOS PROPERTY DAMAGE Peraccident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DIED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LABILITY ANY PROPRIETOR/PARTNEWEXECUTIVE Y�N/A STATUTE ERµ E.L.EACHACCIDENT is E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? (Mandatary In NH) E.L. DISEASE -POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below A Prefessional Liability &Contractors DPR9980226 7n2021 7/1/2022 Par Claim $2,00.000 Annual Aggregate $2,00 ,000 Pollution LabilityT DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached if more space is required) REF: 21-00208 - SAGS Grant Applications - Notice of Cancellation: It is understood and agreed that in the event of cancellation of the policy for any reason other than nonpayment of premium, 30 days written notice Will be sent to the certificate holder by mail. In the event the policy is cancelled for non payment of premium, 10 days written notice will be sent to the above. City of Santa Ana 20 Civic Center Plaza Santa Ana CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Rhk MarugamJIDM�7+e7°TC W 79SS-Z1.174 AUUKU ILL - ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD