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712/29/2025
<br /> E(MM/DD/YYYY)
<br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE
<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 CONTACT
<br /> NAME: Certificate Unit
<br /> Edgewood Partners Insurance Center PHONE FAX
<br /> 1140 Avenue of the Americas, 8th Floor A/C No Ext: 404-781-1700 A/C,No):
<br /> E-MNew York NY 10036 ADDRESS: certificate@epicbrokers.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:OB29370 INSURERA: Liberty Insurance Corporation 42404
<br /> INSURED CLIFLAR INSURERB: Liberty Mutual Fire Ins Co 23035
<br /> Clifton Larson Allen LLP INSURERC:The Continental Insurance Company 35289
<br /> 220 South 6th Street#300
<br /> Minneapolis MN 55402 INSURERD:
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1702815091 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICYNUMBER MM/DD MM/DD
<br /> A X COMMERCIAL GENERAL LIABILITY TB5Z11C4R2H6025 12/31/2025 12/31/2026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE � OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea occurrence) $1,000,000
<br /> X Includes OH,ND, MED EXP(Any one person) $10,000
<br /> X WY&WA Stop Gap PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> PRO-
<br /> POLICY JECT ❑ LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> X
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY AS2Z11C4R2H6035 12/31/2025 12/31/2026 COM EaBINEDaccident SINGLE LIMIT $1,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> A X UMBRELLA LAB X OCCUR TH7Z11C4R2H6055 12/31/2025 12/31/2026 EACH OCCURRENCE $25,000,000
<br /> EXCESS LAB CLAIMS-MADE AGGREGATE $25,000,000
<br /> DED RETENTION$ $
<br /> A WORKERS COMPENSATION WC5Z11C4R2H6015 12/31/2025 12/31/2026 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? ❑ N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> C Excess Liability$25M xs$25M 8037509960 12/31/2025 12/31/2026 Each Occ/Agg 25,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> Certificate holder(s)is included as additional insured on General Liability per form CG 20 43 12 19 and on Automobile per form AC 84 07 11 17 when required
<br /> in prior written contract. Certificate holder(s),to the extent required by written contract are additional insured on a primary and non-contributory basis with
<br /> respect to general liability per form CG 20 01 12 19 and auto liability per form CA 04 49 11 16.A waiver of subrogation applies in favor of the additional insureds
<br /> to the extent required by written contract as allowed by applicable law with respect to general liability per form CG 24 53 12 19 auto liability per form WC 00 03
<br /> 13 and worker's compensation. 30-day notice of cancellation,except 10 days for non-payment of premium,applies to the extent required by written contract
<br /> per forms GC 02 24 10 93 and AC 02 11 10 17 respectively.Workers'Compensation coverage is not provided in the following monopolistic states: ND; OH,
<br /> WA;and WY.
<br /> Digitally signed
<br /> Tu Tra n by Nguyen
<br /> n �APPROVED
<br /> Nguyen
<br /> bate: n Nguyen at 7:41 am,Jan 06,2026
<br /> CERTIFICATE HOLDER CANCELLA OT42:26-08'0
<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 /> City of Santa Ana, Risk Management Division
<br /> 20 Civic Center Plaza, 4th FI. AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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