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AeOOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) n14/2022 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 Assured Partners Aerospace 25548 Genesee Trail Road Golden, CO 80401 CONT NAMEACT PAHONE No. Exit aC No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURERA: Old Republic Insurance Comp Tv 24147 INSURED TACenergy, LLC 2900 St. Michael Drive, 5th Floor INSURER B INSURER C: INSURERD: Texarkana TX 75503 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 6051177 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 LTR TYPE OF INSURANCE AOOL SUER POLICY NUMBER POLICY (MMIDDJYYYY1 MMIDDIYYYYI LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO REN I ED PREMISES Ea ocrurm.. $ MED EXP (Any one person) $ PERSONAL B ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ECT PRO- LOG OTHER: GENERALAGGREGATE $ PRODUCTS - COMP/OP AGO $ $ AUTOMOBILE LIABILITY ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ H id Per accent BODILY INJURY ( ) $ PROPERTYDAMAGE Per accident $ $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DIED I I RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILDY YIN ANYPROPRIETORIPARTNER/EXECUTIVE ❑ W OFFICEMEMBEREXCLUDED7 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA OCAT05603001 7/1/2022 1E.L. 7/1/2023 ,/ STATUTE °aH E.L. EACH ACCIDENT $2000000 E.L. DISEASE -EA EMPLOYEE $2,000,000 DISEASE - POLICY LIMIT s2,000,000 17 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) City of Santa Ana 20 Civic Center Plaza 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. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD v 14 69251172 1 22-23 Work Camp (TAC) I Gift Treybig 1 7/14/2022 1:42:29 PM (NET) I Page 1 of 1