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DATE(MM/DD/YYYY) <br /> A�" CERTIFICATE OF LIABILITY INSURANCE 8/25/2025 <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: The Certificates Team <br /> Arthur J. Gallagher Risk Management Services, LLC PHONE FAX <br /> 595 Market Street, Suite 2100 A/C No Ext: 415-546 9300 A/c,No):415-536-8499 <br /> San Francisco CA 94105 ADDRESS: Certrequests@ajg.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> License#:OD69293 INSURERA: Nationwide Mutual Insurance Company 23787 <br /> INSURED SUPEPRO-04 INSURER B: <br /> Superior Property Services, Inc. <br /> 2181 S. DuPont Dr. wsuRERc: <br /> Anaheim CA 92806 INSURERD: <br /> INSURER E <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:1597701571 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 ACPCGO13079630195 6/22/2025 6/22/2026 EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE � OCCUR DAMAGE TO RENTED <br /> PREMISES Ea occurrence) $100,000 <br /> MED EXP(Any one person) $5,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> X PRO- <br /> POLICY� ECT1:1 LOC PRODUCTS-COMP/OP AGG $2,000,000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY ACPBA013079630195 6/22/2025 6/22/2026 COMBINED SINGLE LIMIT $1,000,000 <br /> Ea accident <br /> X 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 /> UMBRELLA LAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> A WORKERS COMPENSATION ACPWC013079630195 6/22/2025 6/22/2026 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 /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> Agreement#A-2022-076 I Job: Pavement Cleaning and Infectious Waste Removal <br /> The City of Santa Ana, its officers,employees,agents,volunteers and representatives are additional insureds when you have agreed, in a written contract or <br /> written agreement,only with respects to the General Liability, Umbrella and Business Auto as per business liability coverage forms CG 20 33 04 13,CG 20 37 <br /> 04 13 and CA 88 10 01 13. Primary and non-contributory wording is included as per form CG 20 01 04 13.A waiver of subrogation is included regarding the <br /> General Liability as per form CG 24 04 05 09. Certificate of Insurance shall provide thirty(30)day prior written notice of cancellation. <br /> Tu Tran Digitally signed by T <br /> Nguyen 954;020 00' APPROVED <br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 9:53 am,Aug 25,2025 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Risk Management Division <br /> 20 Civic Center Plaza, 4th floor AU HORIZEDREPRESENTATIVE <br /> Santa Ana CA 92702 <br /> USA 6&40� <br /> @ 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />