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ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />8/28/2025
<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 />Acrisure Southwest Partners Insurance Services, LLC
<br />4000 Westerly Place
<br />Suite 110
<br />CONTACT
<br />NAME: Monica Segura
<br />PHONE Ext: 949-348-2080 (FAX,No:949-201-4515
<br />(A CE-MAIL
<br />ADDRESS: MSegura@Acrisure.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />Newport Beach CA 92660
<br />INSURERA: Ohio Security Insurance Company
<br />24082
<br />License#: BR-1801370
<br />INSURED PROFSPO-01
<br />Professional Sports Field Maintenance, Inc
<br />29466 Ridge Rd
<br />INSURERB: California Automobile Insurance Company
<br />38342
<br />INSURERC: American Fire & Casualty Company
<br />24066
<br />INSURERD: Evanston Insurance Company
<br />35378
<br />San Juan Capistrano CA 92675
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER:275319750 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 />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERALLIABILRY
<br />BKS59328473
<br />11/1/2024
<br />11/1/2025
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CLAIMS -MADE � OCCUR
<br />PREMISES DAMAGE TO
<br />PREMISES Ea occurrence)
<br />ccurrence
<br />$ 500,000
<br />MED EXP (Any one person)
<br />$ 15,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />POLICY D PRO
<br />JECT LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />BA040000090235
<br />7/26/2025
<br />7/26/2026
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<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 />C
<br />D
<br />X
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />ESA59328473
<br />EZXS 3206125
<br />11/1/2024
<br />6/23/2025
<br />11/1/2025
<br />11/1/2025
<br />EACH OCCURRENCE
<br />$2,000,000
<br />AGGREGATE
<br />$ 2,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />Each Occ/Aggregate
<br />$ 2,000,000
<br />A
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />XWS59328473
<br />10/30/2024
<br />10/30/2025
<br />X PER OTH-
<br />STATUTE ER
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICE R/MEMBER EXCLUDED? ❑
<br />N/A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers are included as additional insured per the attached endorsement.
<br />Broker agrees to 30 day written notice of cancellation applies, except 10 day notice of non-payment of premium.
<br />Tu Tran Digitally signed by
<br />Tu Tran Nguyen
<br />Date: 2025.09.03
<br />Nguyen
<br />11:59:28-07'00'
<br />APPROVED
<br />By Tu Tran Nguyen at 11:58 am, Sep 03, 2025L]
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of Santa Ana
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana CA 92701
<br />USA
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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