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AC ROI CERTIFICATE 4F LIABILITY INSURANCE SAT (MMIO25�) kk.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 CONTACT �G NAME: alla her Client Service Team Arthur J. Gallagher Risk Management Services, LLC PHONE FAX 2850 Golf Road -833-391-6524 Arc_No):725-735-3800 ML Roiling Meadows IL 60008 A DRESS: Select_Certificates@a'q.com INSURERS AFFORDING COVERAGE NAIL# INSURER A:United States Liability Insurance Company 25895 INSURED 1101NCO-01 INSURER B: 110%, Inc. P.O. Box 538 INSURER C: Salida CO 81201 INSURER D: INSURER E INSURER F; COVERAGES CERTIFICATE NUMBER:1738553669 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 ADDLTYPE OF INSURANCE INSD SUER POLICY NUMBER MM POLICY EFF POLICY EXP LTR f DffYYY MM1DlYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) S PERSONAL BADVINJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY D PROJECT LOC PRODUCTS-COMPfOP AGG S OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) S HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DEO I I RETENTION$ S WORKERS COMPENSATION PER. O TH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETORIPARTNERIEXECUTIVE ❑ E.L.EACH ACCIDENT S OFFICERIMEMBEREXCLUDED? NIA (Mandatary in NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT S A Professional Liability Y Y SP1564907H 1/24/2025 112412026 Each ClaimJAggregale $1,000,000 DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) City of Santa Ana,its City Council,officers,officials,employees,agents,and volunteers are included as Additional Insured as respects to the Professional Liability policy,pursuant to and subject to the policy's terms,definitions,conditions and exclusions.Waiver of Subrogation applies to Certificate Holder as respects to Professional Liability policy,pursuant to and subject to the policy's terms,definitions,conditions and exclusions. APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Iran Nguyen at 2:33pm,.tun if,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana 20 Civic Center Plaza Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD