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DATE(MM/DD/YYYY)
<br /> ACCOR" CERTIFICATE OF LIABILITY INSURANCE
<br /> 02/06/2026
<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 Jaime Ritchie
<br /> NAME:
<br /> CW Phillips Insurance Services PHONE (661)425-9322 FAx
<br /> A/C No Ext: A/C,No):
<br /> 5601 Truxtun Ave,Ste 170 E-MAIL ) @philli aime cw s.com
<br /> ADDRESS: P
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Bakersfield CA 93309 INSURERA: Scottsdale Indemnity Company 15580
<br /> INSURED INSURER B: RLI Insurance Company 13056
<br /> Pro Safety&Rescue,Inc. INSURER C: Scottsdale Ins.Co. 41297
<br /> 3700 Pegasus Dr.,Suite 200 INSURER D: State Compensation Fund 35076
<br /> INSURER E: Landmark American 33138
<br /> Bakersfield CA 93308 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 26-27 Master 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP
<br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDrence $ 50,000
<br /> MED EXP(Any one person) $ 5,000
<br /> A Y Y VRS0008671 02/15/2026 02/15/2027 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> JECT
<br /> OTHER: Contractors Pollution $ 1,000,000
<br /> AUTOMOBILE LIABILITY 60AHB!I11E&,)6iN GLE 4--W-9 $ 1,000,000
<br /> Ea accident
<br /> ANYAUTO BODILY INJURY(Per person) $
<br /> B OWNED �/ SCHEDULED Y Y CAP9509944 02/15/2026 02/15/2027 BODILY INJURY(Pe r accide nt) $
<br /> AUTOS ONLY /� AUTOS
<br /> X HIRED �/ NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY /� AUTOS ONLY Per accident
<br /> Comp/Coll Deductibles $ $2500/$2500
<br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> C X EXCESS LAB CLAIMS-MADE Y Y VES0005373 02/15/2026 02/15/2027 AGGREGATE $
<br /> DED I I RETENTION $ $
<br /> WORKERS COMPENSATION X1
<br /> SPTER
<br /> EORH
<br /> AND EMPLOYERS'LIABI LI TY YIN 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> D OFFICER/MEMBER EXCLUDED? NIA Y 9089448-26 02/15/2026 02/15/2027
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> Medical Malpractice Liability General Aggregate $3,000,000
<br /> E LHC873905 02/15/2026 02/15/2027 Products/Completed Ops $3,000,000
<br /> Personal&Advertising $1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Whereby required by written contract or agreement,The City of Santa Ana,it's City Council,its officers,officials,employees,and volunteers are an
<br /> additional insured and waiver of subrogation under the general liability,professional liability and pollution policy,on a Primary/Non-Contributory basis per
<br /> form#CG 2026,and#CG 2037 0413,and#VP E 201 0622 Additional insured and waiver of subrogation applies to the automobile policy per attached#TRS
<br /> 700&#TRS 713 endorsement.Waiver of Subrogation applies to the workers compensation policy per attached#1 021 7-041 8 endorsement.Thirty(30)Days
<br /> Notice of Cancellation will be provided to the additional insured.
<br /> APPROVED
<br /> By Tu Tran Nguyen at 12:40 pm,Feb 09,2026
<br /> CERTIFICATE HOLDER CANCELLATION
<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 Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> AUTHORIZED REPRESENTATIVE
<br /> 20 Civic Center Plaza,M-85
<br /> Santa Ana CA 92701
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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