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A� D® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDr4 n 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 IT Dld t PRODUCER A,Jhur J. Gallagper Risk Ypnagernent Services, L C %/ ��\, ACeve Y e 0 Date: 2 fA01P Jenne er re&nq DNE FAx . 818-449-0251 pIC Nn: Jd RIL ennlfersuW( 8 m s. .0 COVERAGE NAICN INSURERA: Employers Mutual Casualty Company 21415 Liceniiii _ INSURED -LAirvelantuci Rove Charging, LLC 2060 Placentia Ave #C INSURERS: INSURER C: INSURER D: Costa Mesa, CA 92627 INSURER E NSURER F: COVERAGES CERTIFICATE NUMBER: 116296016 REVISION NUMBER: 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR TYPEOFINSURANCE ADDLM BU a POLICYNUMBER MM/DDYEFF MMIOUY/YV PY LIMBS A X COMMERCIALGENERALLIABILITY CLAIMS -MADE � OCCUR Y Y 6A59836 9/1/2023 9/1/2024 EACH OCCURRENCE $1,000,000 ERENTED PREMISESS(Eaoccurrence) PREMI $500,000 MED EXP (Any one person) $10,000 PERSONAL& ADV INJURY $1.000,000 GENL AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT 1-1LOC OTHER: GENERA -AGGREGATE $2,000,000 PRODUCTS - COMPIOP AGG $2.000.000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Par person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB E%CESS LIAB X OCCUR CLAIMS -MADE 6A59836 9/1/2023 9/1/2024 EACH OCCURRENCE $2,000,000 AGGREGATE $2.000,000 OEO RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNEMEXECUTIVE ❑ OFFICERIMEMBEREXCLUDED'! (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS helmv NIA I PER IOTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD ID1, Additional Remarks Schedule. may be attached if more space is required) Cityof Santa Ana, its CityCouncil, its officers, officials, employees, agents, or volunteers are included as additional insured with Primary- Non Contributory Wording with Waiver of Subrogation per form# CG7578 (2-19) City of Santa Ana 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PRC RIAMm"emadDifislon �I EVIEWED R&APPROVEDBY: . ; Ay�rAdwato ® Risk Management SpedAist ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD