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A� " CERTIFICATE ®F LIABILITY INSURANCE
<br />(MMIDDfYYYY
<br />DAT712612025 )
<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 />It 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 endorsements .
<br />PRODUCER
<br />Arthur J. Gallagher Risk Management Services, LLC
<br />500 N Brand Boulevard, Suite 100No.Ex
<br />Glendale CA 91203
<br />CONTACT
<br />NAME; Jennifer Fleming
<br />PHONE FAX
<br />: 818.449.0251 we No):
<br />ADDRESS: 'ennifer flemin.q@a'g.com
<br />INSURERS AFFORDING COVERAGE
<br />NAIC#
<br />INSURERA: Berkley Regional Insurance Company
<br />29580
<br />Liqgnse* OD69293
<br />INSURED INTEMOU-03
<br />Interval House
<br />P.O. Box 3356
<br />INSURER B : Service American Indemnity COm an
<br />39152
<br />INSURER C : Underwriters at Lloyd's, London
<br />32727
<br />INSURER D :
<br />Seal Beach, CA 90740
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER:2046022536 REVISION NUMRFR-
<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 />ILTR
<br />TYPE OF INSURANCE
<br />ADDLSUER
<br />POLICYNUMBER
<br />MM�t7IDT"Y
<br />MMl POLICYEXP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE L"J OCCUR
<br />Y
<br />HHN8525626-18
<br />10/1/2024
<br />10/1/2025
<br />EACH OCCURRENCE
<br />$1,000,000
<br />DAMAGE TO ED
<br />PREMISES Ea ocENTcurrence
<br />$ 500,000
<br />MED EXP (Any oneperson)
<br />$ 20,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />GEN'L
<br />X
<br />AGGREGATE LIMIT APPLIES PER:
<br />PRO
<br />POLICY ❑ LOC
<br />JECT
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />PRODUCTS - COMPIOP AGG
<br />$ 3,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />HHN 8525626-18
<br />10/1/2024
<br />10/1/2025
<br />COMBINE❑ SINGLE LIMIT
<br />Ea accident
<br />$1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANYAUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />PROPERTYDAMAGE
<br />Per accident
<br />$
<br />A
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />HHS8525626-18
<br />10/1/2024
<br />10/1/2025
<br />EACH OCCURRENCE
<br />$2,000,000
<br />X
<br />AGGREGATE
<br />$ z,aoo,oDa
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X RETENTION $ a
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y 1 N
<br />ANYPROPRIETORIPARTNERIFXECUTIVE ❑
<br />OFFICERIMEMBEREXCLUDED?
<br />N !A
<br />Y
<br />SATISO405004
<br />2/1/2025
<br />211/2026
<br />X STATUTE EORH
<br />E.L. EACH ACCIDENT
<br />$1,000,000
<br />E.L. DISEASE - EA EMPLOYEE
<br />$1,000,000
<br />(Mandatory In NH)
<br />Ityyes describe under
<br />DESGtRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />C
<br />CyyberLlability
<br />Claims -Made form
<br />Retro Date: Full Prior Acts
<br />RPS-P-50252618M
<br />10/1/2024
<br />10/1/2025
<br />Limit
<br />Aggregate
<br />Retention
<br />$1,000,000
<br />$1,000,000
<br />$2,500
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) u i ran y 9n
<br />Policy: Crime Coverage Tute:2Tyan Nguyen
<br />a
<br />y 9 Date: 2025,n7-28
<br />Policy Term: 101112022 To 10/1/2025 Nguyen 07:35:51-07'0U'
<br />Policy #: 107707393
<br />Carrier: Travelers Casualty and Surety Company of America
<br />Employee theft: Limit:$2,000,0001 Deductible: $15,000
<br />ERISA: Limit:$2,000,000 [APPROVEForgery
<br />& Alteration: Limit $2,000,0001 Deductible: $15,000 u TYan Nguyen at 7:34 am, JuI28, 2025
<br />Theft Money and Securities : Limit:$2,000,0001 Deductible: $16,000
<br />See Attached...
<br />01-t alxtal. 07.111-faL-Jal-1-10
<br />City of Santa Ana
<br />Attention: Executive Director,
<br />Community Development Agency
<br />20 Civic Center Plaza, M-25,
<br />Santa Ana, CA 92702
<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 />AUTHORIZED RE
<br />R
<br />U 19BU-2015 ACORD CORPORATION. All rights reserved.
<br />ACORRD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
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