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<br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE DATEIMMrooYYYY)
<br /> 1 10 6120 24
<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 CONSTITUTEA 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 David Saechao-RM
<br /> NAME:
<br /> The Liberty Company Insurance Brokers PHONE
<br /> Ext: (888)918-3960 Arc No
<br /> Lic#OD79653 E-MAIL David.Saechao@libertycompany.com
<br /> ADDRESS:
<br /> 5955 De Sato Ave,Ste 250 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Woodland Hills CA 91367 INSURER A: Continental Casualty Company 20443
<br /> INSURED INSURER B: Valley Forge Ins Co 20508
<br /> TRB AND ASSOCIATES INSURER c: Transportation Insurance Co 20494
<br /> 3180 CROW CANYON Pt_#216 INSURER D: Employers Preferred Ins.Co. 10346
<br /> INSURER E: U.S.Specialty Insurance Co. 29599
<br /> SAN RAMON CA 94583 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: CL2411541740 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE 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 TYPE OF INSURANCE POLICY EFF POLICY EXP
<br /> LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIODIYYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000
<br /> CLAIMS-MADE ®OCCUR PREMISES Ea ggcu D nce $ 1,OOODAWGE ,D00
<br /> MED EXP(Any one person) $ 10,QOG
<br /> A Y 2097186534 11/10/2024 11/10/2025 -PERSONAL sADVINJURY $ 2,000,000
<br /> GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4.000,000
<br /> J
<br /> X POLICYY rC 4,000,000
<br /> EGT LOC PRODUCTS-COMPIOPAGG S
<br /> X1 OTHER: Cyber liability occur/aggregate $ 1,000,000
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000
<br /> Ea accident
<br /> ANYAUTO BODILY INJURY(Per person) S
<br /> B X OWNED SCHEDULED Y 7013446068 11/1012024 11/1012025 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X' HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> Medical payments $ 5.000
<br /> IDX UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 2,OQQ,000
<br /> C EXCESS LIAS CLAIMS-MADE 7036238862 11/10/2024 11/10/2025 AGGREGATE $ 2,000,000
<br /> DIED X RETENTION$ 0 5
<br /> WORKERS COMPENSATION X STATUTE EORH
<br /> AND EMPLOYERS'LIABILITY Y I N
<br /> ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S 1,000,000
<br /> OFFICERIMEMBER EXCLUDED`? NIA Y EIG463819504 1111 D12024 11/10/2025
<br /> (Mandatory in NHI F.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 /> per occ 2,000,000
<br /> E profesisonal liability USS2435165 11/1012024 11/1012025 aggregate 2,000,000
<br /> retention 25,000
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,maybe attached if more space is required)
<br /> Whereby required by written contract or agreement,City of Santa Ana,its officers,employees,agents and representatives are included as additional insured
<br /> with respect to general liability and auto liability.Insurance is primary and non-contributory.Waiver of subrogation applies to workers compensation.
<br /> APPROVED
<br /> By Cynthia Mora at 5:30 pm, Dec 02, 2024
<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 Manangement Division
<br /> 20 Civic Center Plaza,4th FI AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92701
<br /> O 198�8-2015�ACJORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
<br />
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