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AC Ro o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) L../ 05/23/2024 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(les) 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 hold ri in lieu of succchh!`eennddorrsementt(s).�J PRODUCER Dig it*• rsi n d Michael Geffre Insurance ency • �iF'HONZQ L 9-494-77261 Iac,No): 949.494-4481 32392 Coast Hwy Ste 260M 1 g i e _ by.A l e Laguna Beach,CA 92651 INSURER 5 AFFORDING COVERAGE NAIC# Ace OA: ATEGRITY SPECIALTY INSURANCE CO 16427 INSURED Ce V e d 0 IM R �fMID-CENTURYINSURANCE COMPANY 21687 URBAN FUTU N Datel;•'� :`t'��.3'dINSURANCECOMPANY 10673 dba ISOM AD IS R INS R D: WE TCHFFSTER SURPLUS LINES 10172 oO n 1470 MARIA LANE,SUITE 315 Zs r RITERS AT LLOYDS OF LONDON 15792 WALNUT CREEK,CA 94596 INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDOIYYYYI (MMIDDIYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A 1 CLAIMS-MADE X OCCUR Y Y 01-C-PK-P20094043-0 12/27/202312/27/2024 DAMAGETORENTED 100,000 PREMISES(Ea occurrence) $ : MED EXP(Any one person) _ $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY of LOC PRODUCTS-COMP/OPAGG $ Not Covered OTHER: $ B AUTOMOBILE LIABILITY (Ee eocltleop INGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ - OWNED X SCHEDULED 605900024 03/11/202403/11/2025 BODILY INJURY(Per accident) $ AUTOS ONLY NUTOS _ HIRED AU OS NLY PROPERTYaccident) DAMAGE .X AUTOS ONLY X AUTOS ONLY (Per accident) $ _ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ 2,000,000 C X EXCESSLIAB CLAIMS-MADE XPA0010121 12/27/202312/27/2024 AGGREGATE __$ 2,000,000 DED RETENTION$ $ WORKERS COMPENSATION I PER OTH- ANDEMPLOYERS'LIABILITY YIN STATUTE ER OFFICER/MEMB REXCLUDED7 ECUTIVE NIA EL.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ if yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A SEXUAL/PHYSICAL ABUSE 01-C-PK-P20094043-0 12/27/202312/27/2024 LIMIT $25K/$50K D PROFESSIONAL LIABILITY G74382708002 12/23/202312/23/2024 PER OCCURRENCE $2,000,000 E CYBER LIABILITY E5M0039844278 12/23/202312/23/2024 LIMIT $2,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) COMMERCIAL GENERAL LIABILITY DEDUCTIBLE$500 PER CLAIMANT I.. BLANKET ADDITIONAL INSURED,WAIVER OF SUBROGATION AND PRIMARY&NONCONTRIBUTORY CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA RISK MANAGEMENT DIVISION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 20 CIVIC CENTER PLAZA,4TH FLOOR ACCORDANCE WITH THE POLICY PRC` 7 SANTA ANA,CA 92701 RIAManagemeatDMWsion c. S THORROOREPRES ATIVE...7Yr Risk Management Specialist \ I ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD