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ACic - CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) <br /> 04/0812025 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br /> THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br /> POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUE A CONTRACT BETWEEN THE ISSUING INSURER(S), <br /> AUTHORIZED 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 1S 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 an endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: <br /> STRATUM INSURANCE AGENCY PHONE FAX <br /> 10620 SOUTHERN HIGHLANDS PKWY STE 110-276 (AIC.No.Ext.):(888)661-3038 (A/C.No.Ext.):(877)872-7604 <br /> LAS VEGAS,NV 89141-4372 E-MAIL <br /> ADDRESS:service.center@travelers.eom <br /> INSURED INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA <br /> NOGALIS INC <br /> 4540 CAMPUS DR INSURER B <br /> NEWPORT BEACH,CA 92660 INSURER C <br /> INSURER D: <br /> INSURER E: <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 AODL SUER POLICYEFF pDLICY EXP LIMITS <br /> LTR TYPEOFINSURANCE INSR .0 D POLICYNIIMBER MMIDDA'YYY MNl'PDy Y <br /> COMMERCIAL GENERAL LIABILITY EACH OGCURRENCE $ <br /> CLAIMS-MADE ❑ OCCUR DAMAGES(RENTED <br /> PREMISES Ea Occurrence $ <br /> MED EXP(Any one pamonj $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY F-1 PROJECT F-1LOC PRODUCTS-COMPfOPAGG $ <br /> OTHER <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO Ea aocldent $ <br /> BODILY INJURY Perperson) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY IFer accident $ <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> AUTOSONLY AUTOSONLY Per accident $ <br /> $ <br /> UMBRELLALIA13 OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE <br /> AGGREGATE $ <br /> DED ❑RETENTION <br /> WORKERS COMPENSATION x PER OTH <br /> AND EMPLOYERS'LIABILITY YIN NIA x UB-7P572611-25-42 0310312025 03103M26 STATUTE -ER <br /> ANY PROPRIETORMARTNEWEXECUTIVE <br /> OFFICERIMEMBER EXCLUDED? E.L.FACH ACCIDENT $1 000 000 <br /> A (Mandatory In NH) <br /> If yes.describe under <br /> DESCRIPTION OF OPERATIONS BELOW E.L.DISEASE EA EMPLOYEE 1 000,000 <br /> E.L.DISEASE-POLICY LIMIT 91.00000 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) <br /> Waiver of subrogation applies per the policy farm WC 040306(01) APPROVED <br /> By TO Tran Nguyen at 7:06 am,Apr 09,_209'25 <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> RISK MANAGEMENT DIVISION BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> 20 CIVIC CENTER PLAZA ACCORDANCE WITH THE POLICY PROVISIONS <br /> SANTA ANA,CA 91702 AUTHORIZED REPRESENTATIVE <br /> R&V aw M. 13v( rak- <br /> 01993-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(201613) The Acord name and logo are registered marks of ACORD <br />