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CERTIFICATE OF uignmy signea F DAM (MM DO rYYY) )e 5/9/2023 THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLYAND CO RS NO RIGHTi k'll�f{F,�Cr$j�TIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, E END OR ALTER TH JV ED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTAC�Ie�"1 E)�ft- Zff2Wn.lLg'HORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER//��\ ��/// �� V IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must Ve ndorsed. I O ED, subject to the terms and conditions of the policy, certain policies may require an endorsement. k -Atement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER „,„-_ Driscoll & Driscoll Insurance Agency, Inc. 41235 lath St west, Suite B Palmdale CA 93551 INSURED REBL (661)266-9390 (AIC No)' 1961126a-9391 e. CertsMDriscollandDriscoll.com Chambers Group, Inc INSURER D: 3151 Airway Ave, Suite P208 INSURER E: Costa Mesa CA 92626 INSURER F: C11VFRAr]FS CFOTIClr ATC MItMGCC•1T.119411PO9 u„nae ve. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF ADOL SUBR POLICY NUMBER POLICY EFF MMIOOIYYYY POLICY UP MMIDCNYYY LIMITS X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ 1, 000, 000 A CLAIMS -MADE OOCCUR DAMAGE TO RENTED PREMISES Is ocramence $ 100, 000 MED UP (Any one person) $ 10,000 X Y ECP2026303-15 5/12/2023 5/12/2024 PERSONAL &ADV INJURY S 11000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE S 2,000,000 X ❑ PRO ❑ POLICY JECT LOG PRODUCTS-COMP/OPAGG $ 2,000,000 S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 11000,000 X BODILY INJURY (Per parson) $ B ANYAUTO BODILY INJURY (Per accident) $ AOSCHEDULED AUTOS AUTOG EA22031737-11 5/12/2023 5/12/2029 NON -OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE Pera'ent $ $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 A EXCESS UAB CLAIMS -MADE FFX2026322-15 5/12/2023 5/12/2024 DED RETENTION $ $ WORKERS COMPENSATION X PER OTH- ST UTE ER AND EMPLOYERS' LIABILITY YIN E.L. EACH ACCIDENT $ 11000,000 ANY PROPRIETORIPARTNERIEXECUTIVE NIA C OFFICERIMEMBER EXCLUDED? N❑ (Mandatory in NH) wvE 5055233 03 5/12/2023 5/12/2024 E.L. DISEASE - EA EMPLOYEE $ 1.000,000 If yes, deacdbe no., E.L. DISEASE -POLICY LIMIT $ 1,000 000 DESCRIPTION OF OPERATIONS below A Conti Pollution Liability MCP2026303-15 5/12/2023 5/12/2024 Per Occl Agg 1 M / 2 M A Pio£essional Liability ECP2026303-15 5/12/2023 5/12/2024 Claims Made 1,000,000 DESCRIPTON OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is inquired) Blanket Waiver applies to the General Liability Policy per form # ECP 1260 01 21. Blanket Primary & Non -Contributory wording applies to the General Liability Policy per form # ECP 1246 01 21. Blanket Additional Insured applies to the General Liability Policy per form # ECP 1246 01 21 & ECP 1248 01 21, in favor of: City of Santa Ana, officers, agents, employees, and volunteers. 10 day Notice of Cancellation for Non-payment & 30 day for all other. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL RE DELIVERED IN ACCORDANCE WITH THE POLICY PROI '%en'yr RmkMwgettmdlTivulDn AUTHORIZED REPRESENTATIVE (. REVIEV•tED i= tS lMlial Boss Driscoll, Sr/DM Risk Manage-mentSpedalist © 1988-2014 ACI ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401)