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DATE(MM/DD/YYYY) <br /> ACCOR" CERTIFICATE OF PROPERTY INSURANCE <br /> 11/13/2025 <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 /> PRODUCER CONTACT <br /> NAME: <br /> HISCOX Inc. PHONE 844-357-0403 FAX <br /> 5 Concourse ParkwayA/ <br /> C No Ext: A/C,No): <br /> Suite 2150 ADDRESS: contact hiscox.com <br /> Atlanta GA, 30328 PRODUCER <br /> CUSTOMER ID: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURERA: HISCOX Insurance Company Inc. 10200 <br /> United Youth of America Inc INSURERB: <br /> 10880 Wilshire Blvd,Ste 1101 <br /> Suite 1101 INSURERC: <br /> Los Angeles, CA 90024 INSURER D <br /> INSURER E <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> LOCATION OF PREMISES/DESCRIPTION OF PROPERTY(Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> 7621 Pleasant Hill Rd, Lithonia,GA 30058 <br /> 10880 Wilshire Blvd,Ste 1101, Los Angeles, CA 90024 <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 /> INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION COVERED PROPERTY LIMITS <br /> LTR DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) <br /> X PROPERTY BUILDING $ <br /> CAUSES OF LOSS DEDUCTIBLES X PERSONAL PROPERTY $ $ 10,000 <br /> BASIC BUILDING X BUSINESS INCOME <br /> P 105.652.747.1 10/29/2025 10/29/2026 $ <br /> BROAD CONTENTS X EXTRA EXPENSE $ <br /> A X SPECIAL $ 1,000 RENTALVALUE $ <br /> EARTHQUAKE BLANKET BUILDING $ <br /> WIND BLANKET PERS PROP $ <br /> FLOOD BLANKET BLDG&PP $ <br /> INLAND MARINE TYPE OF POLICY $ <br /> CAUSES OF LOSS $ <br /> NAMED PERILS POLICY NUMBER $ <br /> CRIME <br /> TYPE OF POLICY $ <br /> BOILER&MACHINERY/ $ <br /> EQUIPMENT BREAKDOWN <br /> SPECIAL CONDITIONS/OTHER COVERAGES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Santa Ana,The Entity,its officers,officials,employees,and volunteers are to be covered as additional insureds on the CGL policy with respect to liability <br /> arising out of work or operations performed by or on behalf of the Consultant including materials,parts,or equipment furnished in connection with such work or <br /> operations.General liability coverage can be provided in the form of an endorsement to the Consultant's insurance. <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Santa Ana Attn:Audrey Goodson <br /> 801 W Civic Center Dr.Ste 200 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Santa Ana,CA 97201 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> ©1995-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 24(2016103) The ACORD name and logo are registered marks of ACORD <br />