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CERTIFICATE OF LIABILITY INSURANCE r <br /> AT112 IYMIDD YY) <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: Matthew Povoln <br /> NFP Property&Casualty Services, Inc. PHONE 516-327-6300 ac No:516-730-2800 <br /> 45 Executive Drive E-MAIL <br /> Plainview NY 11803 ADDRESS: matthew.povolny@nfp.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:ACE American Insurance Company 22667 <br /> INSURED ANAHDUC-02 INSURER B: <br /> Anaheim Ducks Hockey Club, LLC <br /> c/o H& S Ventures LLC INSURER C: <br /> 2101 East Coast Hwy 3rd Floor INSURER D: <br /> Corona Del Mar CA 92625 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:308628055 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 WVDPOLICY NUMBER MMIDDIYYYY MM/DDIYYYY LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY Y Y CGOG48895785 10/1/2024 10/1/2025 EACHOCCURRENCE $2,000,000 <br /> CLAIMS-MADE � OCCUR DAMAGE (RENTED <br /> PREMISESS Ea occurrence $2,000,000 <br /> MED EXP(Any one person) $EXCLUDED <br /> PERSONAL&ADV INJURY $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 <br /> POLICY PHO LOC PRODUCTS-COMP/OPAGG $4,000,000 <br /> X JECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> A WORKERS COMPENSATION Y SCFC58090268 10/1/2024 10/1/2025 X STATUTE �RH <br /> AND EMPLOYERS'LIABILITY Y I N <br /> ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 <br /> OFFICERIMEMBER EXCLUDE F7 N I A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> "Subject to$5,000,000 Designated each Location Aggregate and$5,000,000 each Project Aggregate. <br /> City of Santa Ana,its City Council,its officers,officials,employees,agents,and volunteers are included as additional insureds as required by written contract or <br /> agreement in connection with the 2025 Title Level Partnership events.The insurance is Primary and Non-contributory and a Waiver of Subrogation is included <br /> in favor of the additional insureds on the above policies as required by written contract.The General Liability policy Contains a Separation of Insureds clause. <br /> APPROVED Tu Tran n'gUly signed by <br /> Tu Tran Nguyen <br /> D-2025.os.g2 <br /> By Tu Tran Nguyen at 8:52 am,MayOZ 2025 N Juyen M52,39-07W <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 /> Attention: Parks, Recreation, & ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Community Services Agency <br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE <br /> M-23 <br /> Santa Ana CA 92701 <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />