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A�'�'R" CERTIFICATE OF LIABILITY INSURANCE FDATE(M M2t12Y)
<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: Nancy Garcia
<br /> Bowermaster Insurance Brokers PHONE FAX
<br /> A Division of Patriot Growth Insurance Services, L 714-733-6230 ac No
<br /> PO Box 1310 A R'i ngarcia@bowermaster.com
<br /> Huntington Beach CA 92647 INSURERS AFFORDING COVERAGE NAICiI
<br /> Licenses OU56067 INSURER A:Valley Fore Insurance Company 20508
<br /> INSURED FMTHOMA-01 INSURER 13:Continental Casualty Co. 20443
<br /> PM Thomas Air Conditioning, Inc.
<br /> 231 Gemini Ave INSURER :Continental Insurance Company 35289
<br /> Brea CA 92821 INSURER Q:Underwriters at Lloyds of London 15642
<br /> INSURERS:Omaha National Insurance Company 16219
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:102172102 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 ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMrQQ1YYYY (MMIDDIYYYYI LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y 6057223216 4/112024 411/2026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE I X I OCCUR DAMAGE TO-RENTED
<br /> PREMISES Ea occurrence $100,000
<br /> MED EXP(Any one person) 515,000
<br /> PERSONAL&AOV INJURY 5 1.000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> � PRO-
<br /> POLICY LOC
<br /> PRODUCTS-COMPIOP aGG $2,00O,OOD
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY Y Y 6057258063 411/2024 41112025 COMBINED accidentSINGLELIMIT $1,000,000
<br /> Ea
<br /> X ANY AUTO BODILY INJURY(Per person) S
<br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY{Per accident} S
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE S
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> 5
<br /> C X UMBRELLA LIAB N
<br /> OCCUR 6057258077 4/1/2024 4/1/2025 EACH OCCURRENCE S4,000,000
<br /> EXCESS LABCLAIMS-MADE AGGREGATE $4.000.000
<br /> DED I X I RETENTION$innnn $
<br /> E WORKERS COMPENSATION Y ONCC17012356-01 1/112025 Wt2026 X $TATUTE QRH
<br /> AND EMPLOYERS'LIABILITY Y!N
<br /> ANYPROPRIETORIPARTNERIEXECUTIVE ❑ E.L EACH ACCIDENT S 1,000,000
<br /> OFFICERIMEMBEREXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1,000,000
<br /> D Errors&Omissions Ind Tech E&O P5NO040075968 8/30/2024 8130/2025 Aggregate 2,000,000
<br /> D Cyber Liability PSNO040075968 8/30/2024 8130/2025 Aggregate 2,000,000
<br /> Deductibe-E&O and Cyber Deductible 2,500
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 161,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana,its officers,agents,employees,and representatives are Additional Insured as respects to General Liability and Commercial Auto per
<br /> attached policy endorsement forms;Primary and Non-Contributory wording and Waiver of Subrogation apply to General Liability and Commercial Auto per
<br /> same forms.
<br /> Waiver of Subrogation applies to Workers Compensation per attached form.
<br /> 30-day notice of cancellation is provided per policy provisions;10-day notice of cancellation for non-payment.
<br /> APPROVED
<br /> By Tu Trarr Nguyen at 11:09 am,Feb J2025
<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 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Risk Management Division
<br /> 20 Civic Center Plaza, 4th floor AUTHORIZED REPRES�, '
<br /> Santa Ana CA 92701
<br /> vr�
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Tu Tran Digitally signed by Tu
<br /> Tran Nguyen
<br /> Date;2025.02.03
<br /> Nguyen11:1 :03-as'00'
<br />
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