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LIEBCAS-Cl ACARDARAS <br />ACORO"° CERTIFICATE OF LIABILITY INSURANCE <br />`..•--''" <br />DATE(MM/DD/YYYY) <br />4/3/2025 <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 <br />CONTACT <br />NAME: <br />PHONE <br />(A/C, No, Ext): (626) 799-7000 (A/c, No):(626) 441-3233 <br />IMA, Inc. - Pasadena <br />3475 E. Foothill Boulevard <br />Suite 100 <br />Pasadena, CA 91107 <br />ABDRIESS: <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURERA: Hartford Casualty Insurance Company <br />29424 <br />INSURED <br />INSURER B:Federal Insurance Company <br />20281 <br />INSURERC: QBE Insurance Corporation <br />39217 <br />Liebert Cassidy Whitmore, A Professional Corporation <br />INSURER D : <br />6033 W. Century Blvd 5th Floor <br />Los Angeles, CA 90045 <br />INSURER E <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER- 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD/YYYY <br />POLICY EXP <br />MMIDD/YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 2,000,000 <br />CLAIMS -MADE X OCCUR <br />X <br />X <br />72SBABL8FM5 <br />12/14/2024 <br />12/14/2025 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />1,000,000 <br />$ <br />MED EXP (Any oneperson) <br />$ 10,000 <br />PERSONAL & ADV INJURY <br />$ 2,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />X <br />POLICY PELT LOC <br />PRODUCTS-COMP/OPAGG <br />$ 4,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />2,000,000 <br />$ <br />BODILY INJURY Perperson) <br />$ <br />ANY AUTO <br />72SBABL8FM5 <br />12/14/2024 <br />12/14/2025 <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY Per accident <br />$ <br />X <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />A <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 4,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />72SBABL8FM5 <br />12/14/2024 <br />12/14/2025 <br />AGGREGATE <br />$ 4,000,000 <br />DED X RETENTION $ 10,000 <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />N/A <br />X <br />2671750595 <br />4/1/2025 <br />4/1/2026 <br />X PER OTH- <br />STATUTE ER <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 />C <br />Prof. Liability <br />63902 <br />7 <br />12/10/2024 <br />12/14/2025 <br />Each Claim/Agg <br />10,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />General Liability forms apply to Automobile as written in the policy. <br />Tu Train Digitally signed by Tu <br />GL Additional Insured applies per SL 30 32 06 21 attached, only if required by written contract/agreement. Tran Nguyen <br />GL Primary & Non -Contributory Wording applies per SL 00 00 10 18 attached. Nguyen Date: 0e-mo0207'0'3 <br />s 11 nz <br />GL & WC Waivers of Subrogation apply per SL 30 03 10 18 & WC 90 03 75 attached. <br />RE: Legal Services Agreement A-2021-276 <br />Additional Insured(s): City of Santa Ana, its officers, officials, employees and agents. E <br />y 'Tu 'Tran N uyen at 11:42 Bassi, Apr 03, 2025 <br />CERTIFICATE HOLDER <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />City of Santa Ana <br />ty <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Risk Management Division <br />20 Civic Center Plaza <br />AUTHORIZED REPRESENTATIVE <br />Santa Ana„ CA 92701 <br />Ile, <br />ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />