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<br /> AC DATE(MMIDDIYYYY)
<br /> `� CERTIFICATE OF LIABILITY INSURANCE 2/1/2025 1/24/2024
<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 Lockton Insurance Brokers,LLC NAME:
<br /> 777 S.Figueroa Street,52nd Fl. PHONE FAX
<br /> fA/C.No.Eat); LA/C,No):
<br /> CA License#0F15767 E-MAIL
<br /> Los Angeles CA 90017 A EqS,
<br /> (213)689-0065 !RI ' l As1I jej NAIC#
<br /> _�INSURER rum ster Sp a ty Insurance Co 44520
<br /> •
<br /> INSURED Rincon Consultants,' iNFf\t/$ Qr eT°surance Company 19682
<br /> 1462718 180 N Ashwood Ave ' e �INbE 1:tilt lafloter Insurance Company 42471
<br /> Ventura CA 93003 •NSURER D:Palomar xcess and Surplus Insurance Co. 16754
<br /> I,Ai eved tironal Insurance Company 25496
<br /> INSL °RF: �•/
<br /> —
<br /> COVERAGES RINCO01 C F IQ'TJ N Gi Fa�� �Q R 1 N ER: XXXXXXX
<br /> TNHIS IS TO DICATED.CERTIFY THAT NOTW THSTAN H G A I ECI) aI "T OF Y�'O A•CT OR DTHER Db CM©NI ITR RESPECTFOR
<br /> TOLWHICH PERIOD
<br /> HIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSU )W'. _ AFFORDED HE POLICIES DESCRIBED HE13Elj1 ISi SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SI-',./W'.MAY HAVE BE C li ID LAI 7.
<br /> INSR TYPE OF INSURANCE ADDLSUER r
<br /> LTR INSD WVD JLICY NUMBER IMMIDD/YYYY) (MMIDDIYYYY) LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y EPK-142587 2/1/2023 2/1/2025 EACH OCCURRENCE $ 3,000,000
<br /> CLAIMS-MADE X OCCUR DAMAGE TO RENTED
<br /> PREMISES(Ea occurrence) $ 100,000
<br /> X SIR:$50,000 MED EXP(Any one person) $ 10,000
<br /> X P&I • PERSONAL&ADV INJURY $ 3,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 4,000,000
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY y y 72UENOL5481 2/1/2024 2/1/2025 COMBINED NGLE LIMIT $
<br /> (Ea accident)SI 1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY _ AUTOSXXXXXXX
<br /> OPERTY
<br /> X AUTOS ONLY X AUTOS ONLY (Per HIRED NON-OWNED a c dent)DAMAGE $ XXXXXXX -
<br /> Comn./Coll.Ded $ 1,000
<br /> C UMBRELLA LIAR X OCCUR N N EFX-I 19720 2/1/2024 2/1/2025 EACH OCCURRENCE $ 1 0,000,000
<br /> D X EXCESS LIAB CLAIMS-MADE EVEQ-0000005 2/1/2024 2/1/2025 AGGREGATE $ 10,000,000
<br /> DED X RETENTION S 10,000 $ XXXXXXX
<br /> E WORKERS COMPENSATION Y X PER OTH-
<br /> AND EMPLOYERS'LIABIUTY YIN T10220329 2/1/2024 2/1/2025 STATUTE ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N 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 /> A Contractors Pollution Liab N N EPK-142587 2/1/2023 2/1/2025 Limit:$3,000,000/$4,000,000
<br /> E&O Liab. Limit:$3,000,000/$4,000,000
<br /> Retro Date:12/9/1994
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Effective 2/1/2024--8/1/2025,Cyber Liability$5M Limit,$25k Retention,Carrier:HCC;Policy#H24NGP224923-01,$5M x$5M Limit,Carrier:Corvus,Policy#CXS-107946155-00.The City of
<br /> Santa Ana and Community Development Agency and their officers,employees,agents and volunteers are an Additional Insured to the extent provided by the policy language or endorsement issued or
<br /> approved by the insurance carrier.Waiver of Subrogation applies per attached endorsement(s)or policy language.Insurance provided to Additional Insured(s)is primary and non-contributory as per the
<br /> attached endorsement or policy language.Excess policy follows General Liability,Auto Liability and Employers Liability form.Notice of Cancellation applies per the applicable policy language or
<br /> endorsements.
<br /> CERTIFICATE HOLDER CANCELLATION See Attachments
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 16059509 THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
<br /> City of Santa Ana ACCORDANCE WITH THE POLICY PRC\ /
<br /> Risk Management Divison '"�" RWIMano,gattentDivie(o
<br /> AUTHORIZED REPR o' z REVIEWED&APPROVED BY:
<br /> 20 Civic Center Plaza,4th Floor
<br /> Santa Ana CA 92701 ` E; �ceve<f
<br /> I �---- Risk Management Specialist
<br /> ©1 88-201 AC D/ \,
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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