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AC RO o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMlODIYYYY) <br /> 4/22/2025 <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: <br /> IMA, Inc. PHONE 626 799-7000 FAX No: 626 583-2117 <br /> 3475 E. Foothill Blvd., Suite 100 E-MAIL <br /> Pasadena, CA 91107 ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> www.boltonco.com OH64724 INSURERA: Fireman's Fund Insurance Company 21873 <br /> INSURED INSURER B: Benchmark Insurance Company 41394 <br /> CWF, Inc. INSURER C: American Automobile Insurance Company 21849 <br /> DBA:Al Party Rentals <br /> 251 E. Front Street INSURER D <br /> Covina CA 91723 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 84938255 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 JUM WVD POLICY NUMBER MMIDDlYYYY MMIDDIYYYY LIMITS <br /> A / COMMERCIAL GENERAL LIABILITY �/ �/ UST006799250 2/1/2025 2/1/2026 EACH OCCURRENCE $1 000 000 <br /> DAMAGE TO CLAIMS-MADE ❑✓ OCCUR PREMISES Ea occurrence)nce $100,000 <br /> MED EXP(Any one person) $10,000 <br /> PERSONAL&ADV INJURY S11000.000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> ✓ IPOLICY JP,-_ LOC PRODUCTS-COMP/OP AGG $2,000 000 <br /> OTHER: $ <br /> C AUTOMOBILE LIABILITY SCV0121192501 2/1/2025 2/1/2026 COMBINED SINGLE LIMIT $ 000 OOO 1✓ ✓ Ea accident , <br /> `/ ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> ✓ AUTOS ONLY ✓ AUTOS ONLY Per accident $ <br /> A UMBRELLA LIAB �/ OCCUR UST004376251 2/1/2025 2/1/2026 EACH OCCURRENCE 65,000,000 <br /> ✓ EXCESS LIAB CLAIMS-MADE AGGREGATE s5.000.000 <br /> DED I ✓I RETENTION$10,000 1 $ <br /> B WORKERS COMPENSATION ✓ 99WC0000334400 11/1/2024 11/l/2025 PER/ STATUTE OERH <br /> AND EMPLOYERS'LIABILITY Y I N � <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE N 1 A E.L.EACH ACCIDENT $1,000,000 <br /> OFFICERIMEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1 0 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT 1 $1 000 000 <br /> A Equipment Floater UST006806250 2/1/2025 21112126 Limit 5,500,000 Deductible$10,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> GL Additional Insured applies per ENTGLO180119 attached,only if required by written contractlagreement. <br /> GL Primary&Non-Contributory Wording applies per ENTGLO180119 attached.GL Waiver of Subrogation applies per CG24041219 attached. <br /> GL Cancellation Clause applies per IL00171198 attached.Auto Additional Insured&Waiver of Subrogation apply per CA70841014&CA04441013 attached <br /> WC Waiver of Subrogation applies per form to follow.Additional Insured(s):City of Santa Ana,its City Council,officers,officials,employees, <br /> agents,and volunteers <br /> Tu Tran Digital) gu d APPROVED <br /> Tu TranN Nguyyen <br /> Nguyen Date:2025.04.24 <br /> 08:54a 3-0I'00 �By Tu Tran Nguyen at 8:53 am,Apr,24,2025 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Santa Ana, Parks, Recreation and Community Service ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 20 Civic Center Plaza <br /> Santa Ana CA 92701 <br /> AUTHORIZED REPRESENTATIVE <br /> Ron Wanglin <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> 54938255 1 CWFIMCA-01 125-26 Master Certificate 24-25 WC I Sara Powell 14/22/2025 11:27:06 AM (PDT) I Page 1 of 3 <br />