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76/24/2024 (MM/DD/YYYY) A`oRo° CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Candace Allcea Sequel Insurance Services PHONE FAX 111 Scripps Drive A/C No Ext : 279-667-3558 A/C, No): Sacramento CA 95825 • AD RESS: nr�aceaQ quell com _ IN U ( C NAIC # nse#: 6010509 wsi v-RA: Insur a Company o e West 27847 AV NINSURED ECORCON-01 INSU ER : Westche r Surplus Lines Insu nce Company 10172 ECORP Consulting, c. ig 2525 Warren Dr INS'. R A a l r m 667 Rocklin CA 95677-2167 IN JR6 0: R I Indemnity C pany 22314 ' SURER Er\ Ov-k A-k #V% A A-k COVERAGES I I 0l%A11E NMWOERL20 M %. 1%.. 4 THIS IS TO CERTIFY LICIR So LO OD OTO R`0,��MEOB17 VEBYYNIII INDICATED. NOTW TT TAN I M TE 0 THIS HE TEROLICY TNHICH CERTIFICATE MAY B ISSUE OR P IN, E INS C� RTP REIJ �/ALL EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOW, MP. HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS B X COMMERCIAL GENERAL LIABILITY Y Y G71832193 004 10/1/2023 10/1/2024 EACH OCCURRENCE $ 4,000,000 CLAIMS -MADE OCCUR PREMISES ETORENTED PREMISES Ea occurrence) ccurrence $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 4,000,000 Deductible $ 10,000 OTHER: C AUTOMOBILE LIABILITY CAL H08475210 003 10/1/2023 10/1/2024 COMBINED SINGLE LIMIT COMBINED $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ FIR ER DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY L $ D UMBRELLALIAB X OCCUR NHA255354 10/1/2023 10/1/2024 EACH OCCURRENCE $5,000,000 X AGGREGATE $ 5,000,000 EXCESS LAB CLAIMS -MADE DED X RETENTION $ n $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE WVE507214001 7/1/2024 7/1/2025 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Professional Liability G71832193 004 10/1/2023 10/1/2024 Each Claim 4,000,000 B Contractors Pollution Liability Retro Date 10/1/2021 G71832193 004 10/1/2023 10/1/2024 Each Pollution Cond. Ded. For Each 4,000,000 10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Third Party Crime- Pol #106602012 - Effective: 10/1/2023-10/1/2024 - Carrier: Travelers Casualty and Surety Company of America - Each Occurrence $1,000,000 - Retention $10,000 RE: COSA New Agreement Request City of Santa Ana is General Liability Additional Insured per terms and conditions of the attached endorsement(s). Primary Wording for General Liability applies per terms and conditions of the attached endorsement. General Liability Waiver of Subrogation applies per terms and conditions of the attached endorsement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PRC Risk Management Division RAManagmumtDivisian 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE REVIEWED&APPROVED BY. Santa Ana CA 92701 - 4Acev44 ®' Risk Management Specialist © 1988-2015 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD