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Generated using Certificial's Smart COI Network TM—Track your Suppliers in real-time at certificial.com/coi COI ID:4MGAZ FDA7(MM/DDIYYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE /2025 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(ies) 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 holder in lieu of such endorsement(s). PRODUCER CONTACT Dustin Keeney WRIS, Inc.dba Western Republic Insurance Services A CC No Ext: 8884671718 ON FAX No): 19900 Beach Blvd. E-MAIL ADDRESS: dustin@wrinsurance.com Suite F1 INSURER(S)AFFORDING COVERAGE NAIC# Huntington Beach CA 92648 INSURERA: Berkley Assurance Company 39462 INSURED INSURER B: Evanston Insurance Company 35378 J&L Constructors Inc State Compensation Insurance Fund 35076 10062 Cynthia Drive INSURERC: P INSURER D INSURER E: Huntington Beach CA 92646 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICYNUMBER MM/DD MM/DD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DA CLAIMS-MADE � OCCUR PREM SESOEa occurrDence $ 100,000 MED EXP(Any one person) $ 5,000 A Y Y VUMA0310932 04/27/2025 04/27/2026 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY❑ PRO- ❑ JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 3,000,000 B X EXCESS LAB CLAIMS-MADE EZXS3198813 04/27/2025 04/27/2026 AGGREGATE $ 3,000,000 DED RETENTION$ $ WORKERS COMPENSATION X STATUTE OERH AND EMPLOYERS'LIABILITY C OFFICER/MEMBER EXCLUDED?ECUTIVE Y❑ N/A Y 9170623-24 12/03/2024 12/03/2025 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 Per Occurrence $5,000,000 B Pollution CPLMOL127653 11/20/2024 11/20/2025 Aggregate $10,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Those usual to the insured's operations.The City of Santa Ana,its City Council,officers,officials,employees,agents and volunteers are named as additional insured where applicable per the attached CG 20 10 12 19.Waiver of subrogation applies per the attached CG 24 04 12 19 and 10217(REV.4-2018). Insurance is primary and non-contributory per the attached VCAS2035 11 10. Digltallysigned TU Tran byTuTran Nguyen Nguyen 59z2 0o 6 4 APPROVED By Tu Tran Nguyen at 11:58 am,Jun 24,2025 CERTIFICATE HOLDER CANCELLATION City of Santa Ana Public Works Agency Water Resources Division,20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 _ — ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD COI ID:4MGAZ Generated using Certificial's Smart COI Network TM—Track your Suppliers in real-time at certificial.com/coi