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ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DD/YYYY)
<br />3/20/2025
<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 />Inszone Insurance Services, LLC
<br />2721 Citrus Road, Suite A
<br />Cordova, CA 95742
<br />CONTACT
<br />NAME: Certificate Team
<br />PHONE FAX
<br />A/C No EXt: 877-308-9663 vc,No:916-400-2625
<br />E-MRancho
<br />ADDRESS: certs@inszoneins.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: Certain Underwriters at Lloyd's of London
<br />32727
<br />License#: OF82764
<br />INSURED DENOVOP-01
<br />De Novo Planning Group
<br />1020 Suncast Lane
<br />INSURERB: United Financial Casualty Co.
<br />11770
<br />INSURERC: Starstone Specialty Insurance Co.
<br />44776
<br />INSURERD: Hartford Casualty Insurance Company
<br />29424
<br />El Dorado Hills, CA 95762
<br />INSURERE: Arch Specialty Insurance Company
<br />21199
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER:827224762 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 GENERAL LIABILITY
<br />Y
<br />PSM0039941132
<br />4/29/2024
<br />4/29/2025
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />X CLAIMS-MADE1:1 OCCUR
<br />DAMAGETORENTED
<br />PREMISES Ea occurrence
<br />$ 250,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL & ADV INJURY
<br />$ 2,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 4,000,000
<br />POLICY PRO ❑
<br />JECT LOC
<br />X
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />Hired and Non -Owned
<br />$ 1,000,000
<br />OTHER:
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />994357605
<br />3/15/2025
<br />9/15/2025
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED X SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />FIR ERTYDAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />C
<br />UMBRELLA LAB
<br />X
<br />OCCUR
<br />Y
<br />CSX00090224P-01
<br />4/29/2024
<br />4/29/2025
<br />EACH OCCURRENCE
<br />$1,000,000
<br />X
<br />AGGREGATE
<br />$ 1,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />$
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />57 WEC Z03688
<br />4/29/2024
<br />4/29/2025
<br />X PER OTH-
<br />STATUTE ER
<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 />A
<br />Errors & Omissions
<br />PSM0039941132
<br />4/29/2024
<br />4/29/2025
<br />Aggregate/Occurrence
<br />$2,000,000
<br />A
<br />E
<br />Professional Liability
<br />Cyber Liability
<br />PSM0039941132
<br />C-4LPT-161699-CYBER-2024
<br />4/29/2024
<br />6/9/2024
<br />4/29/2025
<br />6/9/2025
<br />Aggregate
<br />Aggregate
<br />$2,000,000
<br />$1,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
<br />Additional Insured on the General Liability and Auto Liability. Excess follows form, subject to the terms and conditions of the policy.
<br />The aforementioned coverage is provided to the extent in the attached forms for: City of Santa Ana
<br />Tu Tran Digitally signed by APPROVED
<br />Tu Tran Nguyen
<br />Date: 2025.04.01 By Tu Tran Nguyen at 10:07 am, Apr 01, 2025
<br />Nguyen ,0:08:2,-07'00'
<br />CERTIFICATE HOLDER 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 />Planning and Building Agency
<br />AUTHORIZED REPRESENTATIVE
<br />20 Civic Center Plaza
<br />Santa Ana, CA 92701
<br />� f
<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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