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DATE(MMfDDNYYY) ACCO " CERTIFICATE OF LIABILITY INSURANCE 09/08/2025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements PRODUCER CONTACT- NAME. MARSH RISK&INSURANCE SERVICES FOUR EMBARCADERO CENTER,SUITE 1100 PHONE M6e. CALIFORNIA LICENSE NO.0437153 EMAIL SAN FRANCISCO,CA 94111 ADDRESS: INSUi AFFORDING COVERAGE NAIC# INSURERA: Chubb Indemnityn r n 12777 INSURED INSURER B: BLX GROUP,LLO 355 S.GRAND AVE„SUITE 2700 INSURER C; LOS ANGELES,CA 90017 wsURER D; INSURER E I ENSURER F t COVERAGES CERTIFICATE NUMBER: SEA-004085813-02 REVISION NUMBER: 4 THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLSUBR POLICYNUMBER PM1DD/OLICY EYY M POLICY MDDtYYYY LIMITS L COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE RENTE CLAIMS-MAOE OCCUR PREM SESOEa occurance $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY❑JECOf 171 LOC PRODUCTS-COMPIOP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ Ee accident ANY AUTO BODILY INJURY(Per peaon) $ OWNED SCHEDULED BODILY SNJURY(Per accidenl) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Par e $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTIONS $ A WORKERS COMPENSATION X 7175544 1011 10/0112025 X SEATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETORIPARTNERIEXECUTIVE YIN NIA E,L.EACH ACCIDENT $ 11000,000 OFFICERIMEMBEREXCLUr N� (Mandatory In Ni E.L.DISEASE-EA EMPLOYEE $ 1,000,000 IF yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY L{MIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additlonal Remarke Schedule,maybe attached if more apace Is required) Evidence of Insurance Re: Arbitrage Rebate Compliance Services N-2021-037 City of Santa Ana,Its City Counsel,officers,officials,employees,agents and volunteers-Waiver of Subrogallon Is applicable where required bywritten contract and subject to policy terms and conditions with respect ID Workers'Compensation. APPROVED By To Tran Nguyen at 7:12 am,Apr 10,,20 5 CERTIFICATE HOLDER CANCELLATION City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Allengom Rosie Perez THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza M17 ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE d�. �KQcvtacrce$'Phvleea 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD