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IMIJUA550-09 C NC S DAM EIMMIDDIYYYY) 614 02024 A tom' CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ODES 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 policyieo-) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVQD, a act to the termI17� and conditions of the p0cy, cilifthil poliaie may {Lille an endorsement. A Element on this certificate does not cofiV rights to the ceniflcat>Tholder in lieu of such on(, wse en PRODUCER lj)�q C T t_iCl- Ke11ey, Jiggins & Associat 455 NN El Molino Ave. /A n ieE-MAIL Pasadena, CA 91101 9 jplc No,' a : 26) 396- 035 , uAixc 1045 --;;,. •._,.,.. in - SURER S AFFO G COVERAGE NAIC N rlC-llnls r I393 N'7j ERA Y -Am C �0 INSURED -MDG An w / `` ,/ ` D. _ IRERRER B%d'IerlCalr1 P.$(ea$Nalt (i _ 082 D62 2406610722 IN Arrow 22Rancho Cuc 0 C V C INS E. z-_AI INSURER F : COVERAGES CERTIFICATE NUMBER' 6 4W aFvrclnh! wUMBER: 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 CONTRACTOR OTHER DOCUMENT NTH 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 LTR rypE OF ADDLSUBR N O POLICY NUMBER POLICY EFF MMODITINY POLICY EXP DD W LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X X BKW57179298 7/1/2024 711/2025 EACH OCCURRENCE 1,000,DOO DAMAGE TO RENTED Y00000 MED EXP (Anyone erson 15,000 PERSONAL a DV INJURY 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER', qq POLICY ❑ jE� LOC GENERAL AGGREGATE 2,DOO,g00 PRODUCTS-COMPIOPAGG 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBIINdEED SINGLE LIMIT $ 1,000,000 X ANYAUTO OWNED SCHEDULED AUTOS ONLY X X BAS57179298 7/112024 7/1/2026 BODILY INJURY Per erson BODILYV Per accident $ XAUTOSS MRS ON LV 00pw rOOcAMAGElX C X UMBRELLA LIAS EXCESS LIA6 X OCCUR CLAIMS -MADE ESA57179298 71112024 7/1/2025 EACH OCCURRENCE S 4,000,000 AGGREGATE 4,000,000 DEO RETENTION$ WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY YIN AAQNNpFIRREMERCPROPRIETOR/PARTNER/EXECUTIVE ❑ (mandatory In NH) Ityyes describe under DESCRIPTION OF OPERATIONS below NIA PER NTH E. L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedule, may be attached If more space Is raqulredl Certificate Holders are named as Additional Insured on General Liability per blanket form CG8810 0413 and on Auto Liability per form AC8543 061 B. Complete Additional Insured: The City of Santa Ana, Its officers, employees, agents and Volunteers, but only as respects the Insured's operations as It relates to their signed contract in regards to the CDBG Administration Consulting Services per form CG8810 0413; Primary Insurance and Transfer of rights or recovery against others is included in the form. '30day Notice of Cancellation except 10 days for non-payment payment or premium. City of Santa Ana Risk Management Department 20 Civic Center Plaza, 4th Floor Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DEI THE EXPIRATION DATE THE[ ACCORDANCE WITH THE POLICY AUTHORIZED REPRESENTATIVE RE ACORD 25 (2016103) ©1988-2016 ACORD The ACORD name and logo are registered marks of ACORD