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MEKOPRI-01 ALORRAINE <br />, i. o CERTIFICATE OF LIABILITY INSURANCE <br />�� <br />DAT12012024 Y) <br />sno/zoza <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 endorsemen s . <br />PRODUCER <br />COMNTAE:CT <br />PHONE FAX <br />(A/C, No, Eat): (323) 400-6705 (A/C, No): <br />PIASC Insurance Services, Inc. <br />5800 S. Eastern Avenue <br />Suite 400 <br />EDURIESs: info@piascins.com <br />Los Angeles, CA 90040 <br />INSURE S AFFORDING COVERAGE <br />NAICN <br />INSURER A: Hanover Insurance Company <br />22292 <br />INSURED <br />INSURER B: Alimerica Financial Benefit <br />41840 <br />Mekong Printing, Inc. <br />Hoan Truong <br />INSURER C:Employers Preferred Ins. Co. <br />10346 <br />2421 W. First Street <br />INSURER D : <br />INSURER E : <br />Santa Ana, CA 92703 <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 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 <br />LTRfYYYI <br />TYPE OF INSURANCE <br />ADDINSO <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE N OCCUR <br />GL BROADEN ENDT <br />X <br />ZH3914586513 <br />5/1912024 <br />5/19/2025 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO RENTED <br />PREMISES fE. cermnence <br />100,000 <br />$ <br />X <br />MED EXP (Any oneperson) <br />$ 10,000 <br />PERSONAL &ACV INJURY <br />$ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />'R' LOC <br />X POLICY JE <br />OTHER: <br />GENERALAGGREGATE <br />21000,000 <br />PRODUCTS - COMPIOP AGG <br />Included <br />Emp. Ben. <br />$ 1,000,000 <br />IS <br />AUTOMOBILE <br />X <br />X <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />XO <br />ONLY AO0V <br />AW3914743413 <br />5119/2024 <br />5/1912025 <br />EO BIN DSINGLE LIMIT <br />$ 1,000,000 <br />BODILY INJURY Per person <br />$ <br />BODILY INJURY Per accident) <br />$ <br />eAROS Oaccdenl AMAGE <br />$ <br />A <br />X <br />UMBRELLA LIAR <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />UH3909155012 <br />5119/2024 <br />511912025 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />AGGREGATE <br />$ 1,000,000 <br />DIED X I RETENTION$ 0 <br />C <br />WORKERS COMPENSATION <br />ANDEMPLOYERS'LIABILITY YIN <br />ANY PROPRIETORIPARTNEWEXECUTIVE � <br />(Mandatary in NX) EXCLUDED? <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />EIG287806905 <br />7/1/2024 <br />711/2025 <br />X PER OTH- <br />SAT ER <br />E.L. EACH ACCIDENT <br />1,000,000 <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />1,000,000 <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />1,000,000 <br />A <br />Printers E&O <br />ZH3914586513 <br />5119/2024 <br />5119/2025 <br />Ded: $1000 <br />1,000,000 <br />DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (ACORD 1D1, AUdiUonal Remarks Schedule, ma be attached if more space is required) <br />The City of Santa Ana, it's officers, employees, agents and representative are namewas Additional Insured in regards to General Liability per COMMERCIAL <br />GENERAL LIABILITY SPECIAL BROADENING & ENHANCEMENT ENDORSEMENTS, with respects to services provided and/or performed by the Named <br />Insured as required by written contract, per the attached endorsement. <br />The City of Santa Ana <br />Attn: Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />ACORD 25 (2016/03) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREO <br />ACCORDANCE WITH THE POLICY PRC <br />AUTHORIZED REPRESENTATIVE <br />lih(eMnuemodD(ulelon <br />@ 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />