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A� o CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
<br />O5/23/2024
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER I IiMrmed
<br />Milestone Risk Manage me &Insurance Service (9 9 Fad (949) 852-1131
<br />License No. 0B72766 � I e
<br />8 Corporate Park, Suite
<br />Irvine
<br />INSURED
<br />COVERAGES
<br />by
<br />C3 Office tions LLC, DBA: C3 Technology Se e'
<br />1536E. r eve O Da,
<br />Santa Ana CA 92705
<br />CERTIFICATr. N',MBER: 24/25
<br />INSURER °E :
<br />kauffman@milestonepromise.com
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />Travelers Casualty Insurance Company ofAmerica 019046
<br />T velers Property Casualty Company of America 256740
<br />Lloyd's of London
<br />REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />LTR
<br />TYPE OF INSURANCE
<br />INSD
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MWDD/YYYY
<br />POLICY EXP
<br />MWDD/YYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />CLAIMS -MADE FX OCCUR
<br />TE
<br />PREM SES Ea oNcurDrence
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL &ADV INJURY
<br />$ 2,000,000
<br />A
<br />Y
<br />680-6N797658
<br />05/23/2024
<br />05/23/2025
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />X POLICY ❑ PRO ❑ LOC
<br />JECT
<br />PRODUCTS-COMP/OP AGG
<br />$ 4'000'000
<br />$
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTO
<br />A
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BA-61\1798090
<br />05/23/2024
<br />05/23/2025
<br />BODILY INJURY (Pe r accide nt)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$ 1,000,000
<br />B
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />CUP-7N447797
<br />05/23/2024
<br />05/23/2025
<br />DED I X1 RETENTION $ 0
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABI LI TY YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />NIA
<br />UB-2R956754
<br />10/02/2023
<br />10/02/2024
<br />X STATUTE EORH
<br />E.L. EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />1,000,000
<br />$
<br />Each Claim
<br />$2,000,000
<br />C
<br />Professional Liability/ E&O
<br />ESM013996478
<br />05/23/2024
<br />05/23/2025
<br />Aggregate
<br />$2,000,000
<br />Retention
<br />$10,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Professional Liability/E&O - $2M per claim/$10k retention
<br />City of Santa Ana, its officers, employees, agents, volunteers and representatives are named as additional insureds with respects to GL per the attached
<br />endorsement. Such insurance as is afforded by this policy shall be primary, and any insurance carried by City of Santa Ana shall be excess and
<br />noncontributory per attached endorsement. A waiver of subrogation is in favor or the certificate holder, with respects to the GL, where required by written
<br />contract, per the attached endorsement form. *30 days written notice of cancellation to the certificate holder/10 days notice for nonpayment of premium.
<br />CERTIFICATE HOLDER CANCELLATION
<br />City of Santa Ana
<br />Risk Management Division
<br />20 Civic Center Plaza, 4th Flr
<br />Santa Ana
<br />CA 92701
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PRO\
<br />AUTHORIZED REPRESENTATIVE
<br />F Risk ManagmumtDMsian
<br />% x REVIEWED & APPROVEDBY.
<br />Risk Management Specialist
<br />@ 1988-2015
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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