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<br />A� " CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />01 /09/2025
<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 Christina DeWeese
<br />NAME:
<br />Milt Brandt General Insurance
<br />ACNE. Ext : (707) 433-4436 q c, No): (707) 433-6239
<br />250 Healdsburg Ave., 3rd Floor
<br />E-MAIL christina@brandtinsurance.com
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />P.O. Box V
<br />Healdsburg CA 95448
<br />INSURERA: Fireman's Fund Insurance Company
<br />21873
<br />INSURED
<br />INSURER B : American Automobile Insurance Company
<br />21849
<br />E & M Electric & Machinery, Inc.
<br />INSURER C : Sentinel Insurance Company, LTD
<br />11000
<br />126 Mill Street
<br />INSURER D : Lloyd's of London
<br />AA1128623
<br />INSURER E :
<br />Healdsburg CA 95448
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: CL251213539 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 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 />MM/DD/YYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE OCCUR
<br />DAMAGE TO
<br />PREM SES Ea 0NcurrDence
<br />$ 100,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />A
<br />Y
<br />USCO13340250
<br />01/01/2025
<br />01/01/2026
<br />GEN'LAGGREGATE LIMITAPPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />X POLICY ❑ PRO ❑ LOC
<br />JECT
<br />PRODUCTS-COMP/OPAGG
<br />$ 2,000,000
<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 />B
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />Y
<br />SCVO 118132501
<br />01/01/2025
<br />01/01/2026
<br />BODI LY I NJ U RY (Pe r accide nt)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />Uninsured motorist
<br />$ 1,000,000
<br />UMBRELLA LIAB
<br />OCCUR
<br />`Zl_" `"" "'y" "", "
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED I I RETENTION $
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABI LI TY YIN
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N/A
<br />Y
<br />57WEBM3S9J
<br />12/31/2024
<br />12/31/2025
<br />X1 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 Annual
<br />$2,000,000
<br />D
<br />Professional Liability (E&O) incl Cyber
<br />Increased Limits Active 10/06/2020
<br />B0621PEMEL000224
<br />06/01/2024
<br />06/01/2025
<br />AggregateOccurrence
<br />$2,000,000
<br />Deductible
<br />$25,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana, its officers, employees, agents and representatives are named as Additional Insureds with respect to General Liability and Auto Liability
<br />per the attached endorsements CG 71 93 3 19 and CA 70 18 10 14. Insurance is Primary and Non -Contributory. Such insurance as is afforded by this
<br />policy shall be primary, and any insurance carried by City shall be excess and noncontributory per attached form CG 71 93 03 19 and CA 00 01 10 13.
<br />30 Day Notice of Cancellation with 10 Days Notice for Non -Payment of Premium in accordance with the policy provisions per attached form 145977 01 11 &
<br />145977 03 19.
<br />Waiver of subrogation applies to Workers' Compensation insurance per attached form WC 04 03 06. APPROVED
<br />CERTIFICATE HOLDER CANCELLAi
<br />City of Santa Ana Risk Management Division
<br />20 Civic Center Plaza, 4th FI
<br />Santa Ana
<br />By Cynthia Mora at 9:17 am, Jan 15, 2025
<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 PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />CA 92701 �,
<br />@ 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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