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DATE(MMIDDIYYYY)
<br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br /> 09/10/2025
<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 CONTACT
<br /> Vazquez Prado Insurance Services NAME:
<br /> 18100 Von Karman Ave, Suite 890 AIC No EXt: 949-536-5602 A/C,No): 844-274-0020
<br /> Irvine, CA 92612 ADDRESS: certificates vaz uez rado.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Spinnaker Insurance Company 24376
<br /> INSURED INSURER B:Coast National Insurance Company 25089
<br /> J and A Engineering Corporation 41297
<br /> INSURER C:Scottsdale Insurance Company
<br /> DBA J and A Fence 20338
<br /> 824 North Todd Ave INSURER D:Palomar Specialty Insurance
<br /> Azusa, CA 91702 INSURERE:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:27016335 REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE 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 /> INSIR
<br /> A POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER W LIMITS
<br /> (MM/DD/YYYY) (MM/DD/ YY)
<br /> A �/ COMMERCIAL GENERAL LIABILITY X X CSG-00212682-00 11/20/2024 11/20/2025 EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE I ✓ I OCCUR DAM
<br /> AGETORENTED
<br /> PREMISES Ea occurrence $ 50,000
<br /> MED EXP(Any one person) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY PROJECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER:
<br /> B AUTOMOBILE LIABILITY X X M00-0093815-00 08/01/2025 02/01/2026 (Ea accident) $ 1,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> C UMBRELLA LAB ✓OCCUR LS1228546 11/20/2024 11/20/2025 EACH OCCURRENCE $ 4,000,000
<br /> EXCESS LAB CLAIMS-MADE AGGREGATE 4,000,000
<br /> DED RETENTION$ $
<br /> D WORKERS COMPENSATION X PSC10701340202 11/01/2024 11/01/2025 ✓ STATUTE EERH
<br /> AND EMPLOYERS'LIABILITY /N
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> C INLAND MARINE RBS0335430 06/10/2025 06/10/2026 LIMIT OF INSURANCE $ 78,936
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana, PWA- Facilities, its officers, officials, employees, and volunteers are listed as an additional
<br /> insured per the blanket additional insured endorsement if required by written contract or agreement.
<br /> UgAally signed
<br /> Tu Tran byTnTran
<br /> Nate-2 APPROVED
<br /> Nguyen 07-5246-0700'
<br /> 07:52:46-07'00'
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 7:52 am,Sep 18,2025
<br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> PWA- Facilities THE EXPIRATION DATE THEREOF, 30 DAY NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 20 Civic Center Plaza
<br /> Santa Ana, Ca. 92702 AUTHORIZED REPRESENTATIVE
<br /> Socrates Vazquez
<br /> ©1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD
<br /> 27016335 1 CSG-00212682-00 I M00-0093815-00 I XLS1228546 1 PSCI0701340202 I RBS0335430 1 24/25 Master Certificate 09/09/2025 12:58:26 PM(PDT)
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