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ACOR" CERTIFICATE OF LIABILITY INSURANCE `� DATE(MM/DD/YYYY) 1 7/31/2025 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 endorsement(s). PRODUCER Dodge Insurance Services, Inc. DBA Arroyo Insurance Services East Spring Street, Suite 570 CONTACT NAME: Charity Koehler PHONE FAX A/C No EXt: 310-237-8706 vc,Noy 310-316-1825 E-M5000 ADDRESS: charityk@arroyoins.com INSURER(S) AFFORDING COVERAGE NAIC# Long Beach CA 90815 INSURERA: Philadelphia Indemnity Insurance Company 18058 License#:0735912 INSURED ORANCOU-01 Orange County Crazies 809 North Main Street INSURER B : INSURERC: INSURERD: Santa Ana CA 92701-3508 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1106639209 REVISION NUMBER: THIS IS 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y PHPK2581220-011 8/14/2025 8/14/2026 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISES DAMAGE TO PREMISES Ea occurrence) ccurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ JECT LOC X PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY L $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICE R/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Location: 809 N. Main address - De Pietro Performance Center. Who is an insured is amended to include City of Santa Ana, its' officers, employees, agents and representatives as additional insured as per policy endorsements when required by written contract. Primary and Non -Contributory and Waiver of Subrogation applies per attached policy endorsements. Tu Tran Digitally signed by Tu Tran Nguyen Nguyen 155z52-0 00' APPROVED CERTIFICATE HOLDER CANCELLATION I By Tu Tran Nguyen at 3:52 pm, Jul31, 2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Executive Director, Community Development Agency 20 Civic Center Plaza M-25 AUTHORIZED REPRESENTATIVE Santa Ana CA 92702 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD