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r "I lisomn Tori Pierson Data:2,22➢4.2608:5044-07TV A� � CERTIFICATE OF LIABILITY INSURANCE DATE(MMMOrYYYY) 412112022 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 Venbrook Insurance Services 16815 Von Karmen Avenue Suite 180 Irvine, CA 92606 CNAME,ONTACT Emily Jun PHONE 818-598-8900 n/CC No: 818-598-8910 EmilIL E-MAtill ADDRESS: e'un venbrook.com INSURERS AFFORDING COVERAGE NAICN www.venbrook.com CA Lic No. OD80832 INSURER A: Travelers Casualty Insurance Co of America 19046 INSURED Monument ROW INSURER B: Travelers Property Casualty Cc of America 25674 INSURER C: Underwriters at Lloyds of London 15642 200 Spectrum Center, Suite 300 INSURER D: Employers Compensation Insurance Company11512 Irvine CA 92618 INSURER E INSURER F: 1ERTIFICATE NUMBER: R77D1170 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 LTRPOLICYNUMBER TYPE OFINSURANCE ADDLSUBR POLICYEFF MM/DD/YYYY POLICTO MWOO/YYYY LIMITS A ,/ COMMERCIALGENERALUABILITY CLAIMS -MADE OCCUR `/ ✓ 6807P4562802242 4/23/2022 4/23/2023 EACH OCCURRENCE $1 000 000 OHMAGE TO RENTED PREMISES ffa occurrence $300,000 MED EXP (Any one person) $ 5,000 ✓ Deductible: none PERSONAL &ADV INJURY $1,000000 GEN'L ✓ AGGREGATE LIMIT APPLIES PER: POLICY D PRO- ❑ LOC ECT GENERALAGGREGATE $2,000,000 PRODUCTS-COMP/OPAGG $2.000000 $ OTHER: A AUTOMOBILE LIABILITY 6807P4562802242 4/23/2022 4/23/2023 COEO eBINEDtSINGLE LIMIT His 00Q QQ0 ANYAUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY ✓ AUTOS ONLY ✓ PROPERTYOAMAGE Per accident $ B ✓ UMBRELLA LIAB ✓ OCCUR CUPSN8889392242 4/23/2022 4/23/2023 EACH OCCURRENCE $5 QQQ QQQ AGGREGATE $5000000 EXCESS LIAB CLAIMS -MADE E. I ✓ I RETENTION$0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN OFFICEANYPRIMEMB REXC UDED?ECUTIVE OFFICER/MEMBEREXCLUOEOT ❑ NIA ✓ EIG473996501 4/23/2022 4/21/2023 V ✓ STATUTE �RH EACH ACCIDENT $1 QQQ ODD E.L. DISEASE - EA EMPLOYE $ 0Q (Mandatory in NH) under E.L. DISEASE -POLICY LIMIT $1000 QQQ DESC IPTION DESCRIPTION OF OPERATIONS below C Professional Liability (Claims Made MPL444730522 4/23/2022 4/23/2023 $2,000,000 Each Claim/ Aggregate Limit & Reported) Retention: $5,000 Each Claim DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if mare space is required) RE: The City of Santa Ana, its officers, employees, agents, and representatives are named as Additional Insured in respects General Liability perform CGD105 0494. Primary/Non-Contributory form CGT1000219, Waiver of Subrogation form CGD842 0219, WC040306 4-84 applies in favor of the Additional Insured when required by written contract. 30 Day Notice of Cancellation per policy provisions. Subject to policy terms, conditions and exclusions. City Of Santa Ana Risk Management Division 20 Civic Center Plaza, 4th Floor Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988.2015 ACORD C(L) ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 67991179 2022 GL, HNO, ., WC, PL Emily Sung 1 4/21/2022 9: 06: 54 AM (PDT) I Page 1 of 8 This cer ificat, cancels and supersedes ALL previously issued certificates.