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�►Ca►�l7'� CERTIFICATE OF LIABILITY INSURANCE FDATE (MM/DD/YYYY) <br />�11 06/14/2024 <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 CONTACT h Gr enwo d <br />NAME: �✓� = <br />Michael Scott Greenwood o/ONN Ex t 71 74 0 ryJn0A5b1 <br />17853 Santiago Blvd Ste E-MAADDRIESS: n'Ic0 ee c <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />Ana <br />Villa Park 2861 INSURERA: 'clin a I r`n1 r^A rV1090 <br />INSURED <br />Elite Executive Charter, LLC. <br />13281 Eton Plana <br />Cowan <br />COVERAGES <br />INSURER B • Li V S 0 <br />INSURER( SiriL �ooint America Insurance <br />INSUREF J: 7+'/1• <br />IN�2JGIlC. L' <br />0 %0 ff 16 <br />413111.1 <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW ,1AV - BEEN ISSUED 1U T E k%JV4ftr.70VE U AE ERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDI' i01' 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 <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICYNUMBER <br />POLICY EFF <br />MM/DD <br />POLICY EXP <br />MM/DD <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />X <br />5ST11201-01 <br />01/24/2024 <br />01/24/2025 <br />EACH OCCURRENCE <br />$ 2,000,000 <br />CLAIMS -MADE � OCCUR <br />PREM SES Ea occu ante <br />$ 100,000 <br />MED EXP (Any one person) <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />$ 2,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 4,000,000 <br />POLICY PRO LOC <br />El JECT <br />PRODUCTS - COMP/OP AGG <br />$ 4,000,000 <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />X <br />5ST11201-01 <br />01/24/2024 <br />01/24/2025 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 2,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />XHIRED <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />NON -OWNED <br />AUTOS ONLY /� AUTOS ONLY <br />A <br />UMBRELLALIAB <br />X <br />OCCUR <br />X <br />5ST11201-01 <br />01/24/2024 <br />01/24/2025 <br />EACH OCCURRENCE <br />$ 3,000,000 <br />X <br />EXCESS LIAB <br />CLAIMS -MADE <br />AGGREGATE <br />$ <br />DED RETENTION $ <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />WC PI 813008 -000 <br />02/23/2024 <br />02/23/2025 <br />X PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />OFFICE R/M EMBER EXCLUDED? ❑ <br />(Mandatory in NH) <br />N/A <br />E.L. DISEASE - EA EMPLOYEE <br />$ 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />B <br />Sexual Abuse &Molestation <br />W350BF240201 <br />06/01/2023 <br />06/01/2025 <br />Each Victim <br />$1,000,000 <br />A <br />Comp & Coll <br />5ST11201-01 <br />401/244/202 <br />01/24/2025 <br />Less $2,500 Ded <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) <br />The certificate holder is to be named as additional insured. <br />Coverage Includes: Waiver of Subrogation and Primary and non contributory <br />CERTIFICATE HOLDER CANCELLATION <br />City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />20 Civic Center Plaza THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN <br />Santa Ana, CA. 92701 ACCORDANCE WITH THE POLICY PRC <br />w,3knougmumtDMsimt <br />AUTHORIZED REPRESENTATIVE x REVIEWED & APPROVED BY: <br />4g�z Aat,4 Z <br />® Risk Management Specialist <br />© 1988-2015 ACORD <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />