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<br /> CERTIFICATE OF LIABILITY DATE(MM2025 Y)
<br /> ITY INSURANCE 1ar2or2ozs
<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 NAME: Alexander Russell
<br /> Premier Associates Insurance Brokers NE , 800-5003 FAX
<br /> AIC No Ext: ( A/C,No):
<br /> 3931 BIRCH ST. ADDRESS: alex@premieroc.com
<br /> prenueroaeom
<br /> STE.,B INSURER(S)AFFORDING COVERAGE NAIC#
<br /> NEWPORT BEACH CA 92660 INSURER A: BERKLEY ASSUR CO 39462
<br /> INSURED INSURER B: STARSTONE SPECIALTY INS CO 44776
<br /> Triangle Decon Services,Inc. INSURER C: UNITED FINANCIAL CA.CO 11770
<br /> 25422 ADRIANA ST INSURER D; PIE INSURANCE COMPANY 21857
<br /> INSURER E;
<br /> MISSION VIH10 CA 9269 1-3 820 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 /> INUK PLUM
<br /> LTR TYPE OF INSURANCE INSD DkjmK 1MVD POLICY NUMBER (VULIU )IYYYY) r4l DDIYYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY
<br /> EACH OCCURRENCE $ I,000,000
<br /> CLAIMS-MADE ®OCCURLJXMA[3t
<br /> PREMISES(Ea occurrence) $ 100,000
<br /> MED EXP(Any one person) $ 5,000
<br /> A Y VLJMD0365421 09/22/2025 09/22/2026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY ❑JET FILOC PRODUCTS-COMPIOPAGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY UUMHINFLJ
<br /> Eaaccidentl $ 1,000,000
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> C OWNED X SCHEDULED
<br /> AUTOS ONLY AUTOS 973762079 09/22/2025 09/22/2026 BODILY INJURY(Per accident) $
<br /> HIRED x NON-OWNED $
<br /> AUTOS ONLY AUTOS ONLY (Per accident
<br /> UMBRELLA LIAB I OCCUR EACH OCCURRENCE $ 2,000,000
<br /> B x EXCESS LIAB CLAIMS-MADE Y CSX9078823OP-00 10/15/2025 09/22/2026 AGGREGATE $ 2,000,000
<br /> DED RETENTION$ $
<br /> WORKERS COMPENSATION _
<br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER
<br /> ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> D OFFICERIMEMBER EXCLUDED? NIA WC PI 2800953-000 08/19/2025 08/19/2026
<br /> (Mandatory in E.L.DISEASE-FA EMPLOYEE $ 1,000,000
<br /> If yes,describe under und
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> Per Claim 2,000,000
<br /> A Professional Liability P,S00240504128 09/22/2025 09/22/2026 General Aggregate 4,000,000
<br /> Deductible $25,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Addlttmnal Remarks Schedule,maybe attached if more space Is required)
<br /> Additional Insured and primary&Non Contributory: City of Santa Ana, officers, agents, employees, and
<br /> volunteers are named as additionally insured on this policy pursuant to written contract, agreement, or
<br /> memorandum of understanding. Such insurance as is afforded by this policy shall be primary, and any insurance
<br /> carried by City shall be excess and noncontributory. "30 Days notice Of Cancellation"
<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 Attention: Public Works Agency...PFRR ACCORDANCE WITH THE POLICY PROVISIONS,
<br /> 220 S Daisy St T1.1 I Tran Dlg6yTuaallyTianalgned AUTHORIZED REPRESENTATIVE
<br /> Nguyen
<br /> Nguyen oate:2a25.1g.21
<br /> Santa Ana CA 92701 o7:srr.4e-oroc'
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> gistered marks of ACORD
<br /> ACORD 25(2016103) APPROVE -
<br /> - e_
<br /> By T"u Tran Nguyen at 7.36 am,Oct 2i,2025
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