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ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DDmYY)
<br />12/30/2025
<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
<br />Arthur J. Gallagher Risk Management Services, LLC
<br />500 N Brand Boulevard, Suite 100
<br />CA 91203
<br />CONTACT
<br />NAME: Jennifer Fleming
<br />PHONE FAX
<br />A/C No Ext: 818.449.0251 vc,No:
<br />E-MGlendale
<br />ADDRESS: jennifer_fleming@ajg.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: Berkley Regional Insurance Company
<br />29580
<br />License#:OD69293
<br />INSURED INTEHOU-03
<br />INSURERB: Service American Indemnity Company
<br />39152
<br />Interval House
<br />P.O. Box 3356
<br />INsuRERc: At -Bay Specialty Insurance Company
<br />19607
<br />INSURERD: Kinsale Insurance Company
<br />38920
<br />Seal Beach, CA 90740
<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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD
<br />POLICY EXP
<br />MM/DD
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERALLIABILRY
<br />Y
<br />Y
<br />HHS8525626-19
<br />10/1/2025
<br />10/1/2026
<br />EACH OCCURRENCE
<br />$1,000,000
<br />CLAIMS -MADE � OCCUR
<br />PREMISES DAMAGE TO
<br />PREMISES Ea occurrence)
<br />ccurrence
<br />$ 100,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />POLICY PRO-
<br />JECT LOC
<br />X
<br />PRODUCTS - COMP/OP AGG
<br />$ 3,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />HHS 8525626-19
<br />10/1/2025
<br />10/1/2026
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />FIR ERTYDAMAGE
<br />Per accident
<br />$
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />D
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />0100418321-0
<br />12/12/2025
<br />10/1/2026
<br />EACH OCCURRENCE
<br />$2,000,000
<br />X
<br />AGGREGATE
<br />$ 2,000,000
<br />EXCESS LAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y / N
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />Y
<br />SATISO405004
<br />2/1/2025
<br />2/1/2026
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICE R/M EMBER EXCLUDED? ❑
<br />N/A
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />C
<br />Cyber Liability
<br />AB-6794310-02
<br />10/1/2025
<br />10/1/2026
<br />Limit
<br />$1,000,000
<br />Claims -Made form
<br />Aggregate
<br />$1,000,000
<br />Retro Date: Full Prior Ads
<br />Retention
<br />$2,500
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe 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.
<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
<br />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
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attention: Executive Director, Community
<br />AUTHORIZED REPRESENTATIVE
<br />Development Agency
<br />Santa Ana CA 92702
<br />ACORD 25 (2016/03)
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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