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AC")?"?0 C" CERTIFICATE 4F LIABILITY INSURANCE DATE(MMIDDAYYY) 07/17/2025 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 INSURERS), 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 STATE FARM INSURANCE GARY BLACKBURN, AGENT LIC# 0490552 23881 VIA FABRICANTE, S7E 506 LiMISSION VIEJO, CA 92691 CONTACT NAME: GARY BLACKBURN PHONE . a " 81-08o j. 949-581-1400 1-1 aDDREss: GARY.BLACKBURN.B8CZ STATEFARM.COM INSURER(S) AFFORDING COVERAGE NAIC u INSURER A: State Farm Mutual Automobile Insurance ComDanv 2S178 INSURED DIVERSIFIED WATERSCAPES, INC INSURERS: INSURERC: 27324 CAMINO CAPISTRANO STE. 213 LAGUNA NIGUEL, CA 92677 INSURERD: INSURER E : INSURER F : rn.r�nnr_�cc r`=0TIl7ir`ATK MI IIURPP- REVISION NUMBER: f 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 15 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 LIM ADDLSU9R POLICY NUMBER MMIDD1YYYIr OLICY EFF MMIOD.IYl YY LIMITS GENERAL LIABILITY ❑ EACH OCCURRENCE $ DAMAGE TO R PREMISES Ea occurcence $ COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ CLAIMS -MADE OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ $ POLICY PRO» LOC A AUTOMOBILE. LIABILITY �,. FY �OMarB1INdEeDISINGLE LIMIT $ BODILY INJURY (Per person) S 1.000,000 ANY AUTO 332 1267-EOS-76U 05/0512025 11105/2025 BODILY iNJURY (Per accident) S 1,000,000 ALL OWNED SCHEDULED AUTOS NAUTOS ON -OWNED HIRED AUTOS x AUTOS Ix 3607-E09-753 05/09/2025 11/09/2028 PROPERTY DAMAGE PROPERTY Per accident $ 1,000,000 UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATION WC STATU- OTH- LIMTa I ITY AND EMPLOYERS' LIABILY ANY PROPRIETORIPARTNERIEXECUTNE � OFFICE�MEMBER EXCLUDED? I N ! A ❑ E.L. EACH ACCIDENT $ _ (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT I S IF yes, descdhe under APPROVED By Tu Tran Nguyen at 9:34 am, Aug O5, 2025 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS AND REPRESENTATIVES ARE ADDITIONAL INSUREDS. 628 3607-E09-75S IS AN ENOL POLICY 332 1267-EO5-75U IS A 2006 TOYOTA TUNDRA CERTIFICATE OF INSURANCE SHALL PROVIDE THIRTY (30) DAY PRIOR WRITTEN NOTICE OF CANCELLATION CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RISK MANAGEMENT ACCORDANCE WITH THE POLICY PROVISIONS. 20 CIVIC CENTER PLAZA, 4TH FLOOR AUTHORIZED RE.PRE A19VE SANTA ANA, CA 92701 O 1988-2,P1G'lllkCGRlD CORPORATION, All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of A RD 1001486 132849.6 11-15-2010