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A`" L> CERTIFICATE OF LIABILITY INSURANCE DATE(MMil025 Y) <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 INSUREll AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(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 /> PROOUCER CONTACT <br /> The Baldwin Group West, LLC PHONE The Tran FAX <br /> 15901 Red Hill Ave, Ste 100 714 505-7000 Arc Nc: 714 573-1770 <br /> Tustin CA 92780 ADDRESS: michael.tran@wgbib.com <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> License#:OF69771 INSURER A:Zurich American Insurance Comp 16535 <br /> INSURED ONYAPAV-01 INSURERB:American Zurich Insurance Comp 40142 <br /> Onyx Paving Company, Inc.2890 E. La Cresta Avenue INsuRERc:Evanston Insurance Company 35378 <br /> Anaheim CA 92806-1816 INSURERD:Great American Insurance Coma 16691 <br /> INSURER E:Scottsdale Insurance Company 41297 <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:1367072593 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP <br /> LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS <br /> E X COMMERCIAL GENERAL LIABILITY BCS2001934 10/1/2024 10/112025 EACH OCCURRENCE $2,000,000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE X OCCUR PREMISES En occurrence $100.000 <br /> MED EXP(Any one erson} $5,000 <br /> PERSONAL 8 ADV INJURY $2,000,000 <br /> GEN'LAGGREGATH LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 <br /> POLICY J7C7 LOC PRODUCTS-COMPIOPAGG $4,000,000 <br /> OTHER: $ <br /> B AUTOMOBILE LIABILITY BAP106300606 10/1/2024 10/1/2025 COMBINEDSINGLELIMIT $2,000,000 <br /> Ea accident <br /> X ANYAUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED tid Per accident)AUTOS ONLY AUTOS BODILY INJURY( ) $ <br /> X HIRED X NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ <br /> ❑ X UM13RVLLALIAS X OCCUR TUE490440202 10/1/2024 10/1/2025 EACH OCCURRENCE $6,000,D00 <br /> EXCESSI.lAl3 CLAIMS-MADE AGGREGATE $6,000,000 <br /> DIED RETENTION$ $ <br /> A WORKERS COMPENSATION WC106300506 101112024 10/1/2025 X STATUTE ER" <br /> AND EMPLOYERS'LIABILITY Y I N <br /> ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 <br /> OFFICERIMEMBEREXCLUDED? ❑ N/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 /> C Contractors Pollution Liability MKLVBENV104880 10/1/2024 10J1/2025 Aggregate $10,000,000 <br /> Occurence $5,000,000 <br /> Deductible $10,000 <br /> DESCRIPTION OF OPERATIONS!LOCATIONS-I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) <br /> —Excess Policy#TUE490440202 is Excess over the General Liability,Auto Liability,and Workers Compensation— <br /> Certificate holdor(s)is/are named as additional insured per the attached endorsements as required by written Contract subject to the terms&conditions of the <br /> policy: <br /> GL Additional Insured Farm#CG 2010 1219 and CG 20 3712 19 Tu Trdn`.by TuTao ned <br /> GL Additional Insured State-Permits Form#CG 20 12 12 19 Nguyen <br /> GL Prima and Non-Contribute Form#CG 20 01 12 19 NgUyen eate;2025.07.09 APPROVED <br /> Primary Non-Contributory r 1e3:s5-07'00' <br /> See Attached... By.Ty Tran Nguyen at 111:33 am,fur 09,2ozs. <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 /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> City of Santa Ana <br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE <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 />