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712/30/2025
<br /> E(MM/DD/YYYY)
<br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE
<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
<br /> NAME: Jennifer Fleming
<br /> Arthur J. Gallagher Risk Management Services, LLC PHONE FAX
<br /> 500 N Brand Boulevard, Suite 100 A/C No EXt: 818.449.0251 vc,No:
<br /> E-MGlendale CA 91203 ADDRESS: jennifer_fleming@ajg.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:OD69293 INSURERA: Berkley Regional Insurance Company 29580
<br /> INSURED INTEHOU-03 INSURERB: Service American Indemnity Company 39152
<br /> Interval House
<br /> P.O. Box 3356 INsuRERc:At-Bay Specialty Insurance Company 19607
<br /> Seal Beach, CA 90740 INSURERD: Kinsale Insurance Company 38920
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:757028886 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 LIMITS
<br /> LTR INSD WVD POLICY NUMBER MM/DD MM/DD
<br /> A X COMMERCIAL GENERALLIABILRY Y Y HHS8525626-19 10/1/2025 10/1/2026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE � OCCUR PREMISES DAMAGE TO
<br /> PREMISES Ea occurrence)
<br /> ccurrence $100,000
<br /> MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000
<br /> POLICY PRO ❑
<br /> JECT LOC PRODUCTS-COMP/OP AGG $3,000,000
<br /> X
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY Y Y HHS 8525626-19 10/1/2025 10/1/2026 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> D UMBRELLALIAB X OCCUR 0100418321-0 12/12/2025 10/1/2026 EACH OCCURRENCE $2,000,000
<br /> X EXCESS LAB CLAIMS-MADE AGGREGATE $2,000,000
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION Y SATISO405004 2/1/2025 2/1/2026 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICE R/M EMBER EXCLUDED? ❑ 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 Cyber Liability AB-6794310-02 10/1/2025 10/1/2026 Limit $1,000,000
<br /> Claims-Made form Aggregate $1,000,000
<br /> Retro Date:Full Prior Ads Retention $2,500
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Digitallysigne
<br /> Policy:Crime Coverage Tu Tran by Tu Tran
<br /> Policy Term: 10/1/2025 To 10/1/2028 Nguyen
<br /> Policy#: 107707393 Nguyen Date:2026.01.2
<br /> Carrier:Travelers Casualty and Surety Company of America 15:28:05-08'0
<br /> Employee theft: Limit:$2,000,000/Deductible:$15,000
<br /> ERISA: Limit:$2,000,000
<br /> Forgery&Alteration: Limit$2,000,000/Deductible:$15,000
<br /> Theft Money and Securities: Limit:$2,000,000/Deductible:$15,000 APPROVED
<br /> See Attached... By Tu Tran Nguyen at 3:27 pm,Jan 12,2026
<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 /> City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attention: Executive Director, Community
<br /> Development Agency AUTHORIZED REPRESENTATIVE
<br /> Santa Ana CA 92702
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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