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AC" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 06/03/2025
<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 NAME: Paychex Insurance Agency Inc
<br /> PAYCHEX INSURANCE AGENCY, INC. PHONE 877-266-6850 FAX 585-389-7426
<br /> A/C No Ext: A/C No):
<br /> 225 KENNETH DRIVE E-MAIL certs@paychex.com
<br /> ROCHESTER, NY 14623 ADDRESS:
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA: Hartford Underwriters Insurance Company 30104
<br /> INSURED INSURERB: Security National Insurance Company
<br /> PROUDCITY
<br /> INSURER C
<br /> DBA: PROUDCITY INSURER D:
<br /> 2219 DAM UTH ST INSURER E:
<br /> OAKLAND, CA 94602 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 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 /> TYPE OF INSURANCE
<br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
<br /> j( COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAM
<br /> CLAIMS-MADE FV1 OCCUR PREM SES Ea occurrDence $ 1,000,000
<br /> MED EXP(Any one person) $ 10,000
<br /> A �/ �/ 76SBMBC3ROR 07/05/2025 07/05/2026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> JECT
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> AOWNED SCHEDULED AUTOS ONLY AUTOS / V 76S B M B C3 RO R 07/05/2025 07/05/2026 BODILY INJURY(Per accident) $
<br /> X HIRED X 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 /> WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y STATUTE ER
<br /> BOFFICER//MEMBEREXCLUDED?ECUTIVE � N/A SWC152836 01/15/2025 01/15/2026 E.L.EACH ACCIDENT $ 1,000,000
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A FailSafe Technology Errors or �/ �/ 76SBMBC3ROR 07/05/2025 07/05/2026 Each Wrongful Act$2,000,000
<br /> Omissions Liability /� /� Aggregate Limit $2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana, officers, agents, employees, and volunteers are additional insured per Additional Insured: Owners, Lessees,
<br /> or Contractors; Scheduled Person or Organization Form SS4170 attached to this policy. Waiver of Subrogation applies in favor
<br /> of the Certificate Holder per the Business Liability Coverage Form SL 00 00, attached to this policy and the Hired Auto and Non
<br /> Owned Auto Endorsement SSO438 attached to this policy. Coverage is primary and noncontributory per the Business Liability
<br /> Coverage Form SL 00 00, attached to this policy. Notice of Cancellation will be provided in accordance with Form SL9013
<br /> attached to this policy.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Attention: Information Technology THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 20 Civic Center Plaza, M-42 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE
<br /> APPROVED
<br /> By Tu Tran Nguyen at 8:57 am,Jun 11,2025
<br /> ©1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) Digitallysigned The ACORD name and logo are registered marks of ACORD
<br /> Tu Tran by Tu Tran
<br /> Nguyen
<br /> Nguyen o85 45-0700'
<br />
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