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712/22/2025
<br /> E(MM/DD/YYYY)
<br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br /> `�
<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: Heffernan Insurance Brokers
<br /> (OC) Heffernan Insurance Brokers PHONE FAX
<br /> 18004 Sky Park Circle, Suite 210 A/C No Ext: 925-934-8500 A/c,No:925-934-8278
<br /> E-MIrvine CA 92614 ADDRESS: hibcertrequest@HeffINS.Com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> License#:0564249 INSURERA: Philadelphia Indemnity Insurance Company 18058
<br /> INSURED ORANCOU-05 INSURERB:Travelers Casualty and Surety Company of America 31194
<br /> Orange County's United Way
<br /> 18012 Mitchell South INSURERC: Lloyd's of London
<br /> Irvine CA 92614-6008 INSURERD:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:697321237 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 L TYPE OF INSURANCE ADD SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICY NUMBER MM/DD MM/DD
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y PHPK2618575-024 11/1/2025 11/1/2026 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE � OCCUR PREMISES TO ccED
<br /> PREMISES Ea occurrence) $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 PHPK2618575-024 11/1/2025 11/1/2026 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 FIR ERTYDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> A X UMBRELLALIAB X OCCUR PHUB887255-024 11/1/2025 11/1/2026 EACH OCCURRENCE $5,000,000
<br /> EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000
<br /> DED X RETENTION$1 n nnn $
<br /> WORKERS COMPENSATION AT OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STTUTE ER
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> OFFICE R/M EMBER EXCLUDED? ❑ N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A ProfessionalLiability PHPK2618575-024 11/1/2025 11/1/2026 Occ$1MM/Agg 3,000,000
<br /> B Crime 107338302 11/1/2023 11/1/2026 Empl.ThefUForgery 1,000,000
<br /> C Cyber Liability ES01140541480 11/1/2025 11/1/2026 1st&3rd Occ$2MM/Agg 2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
<br /> Accidental Death& Dismemberment-Policy Number:MAR16270-Policy Term: 11/01/2025-11/01/2026-Aggregate Limit:$250,000-Carrier:Markel
<br /> Insurance Company
<br /> Sexual Abuse and Molestation Coverage Policy#PHPK2618575-024-Policy Term: 11/01/2025-11/01/2026-Limit:$1,000,000 Per Occurrence/$2,000,000
<br /> Aggregate
<br /> City of Santa Ana,officers,agents,employees,and volunteers are named as additionally insured on this policy pursuant to written contract,agreement,or
<br /> See Attached...
<br /> CERTIFICATE HOLDER APPROVE® 7Trran
<br /> CANCELLATION
<br /> By Tu Tran Nguyen at 8:35 am,
<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 TU TrbyACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attn: Executive Director, Communit Development Agency yNgUyen :36:,2 . .
<br /> oa:3e:tz-oa,00, AUTHORIZED REPRESENTATIVE
<br /> 20 Civic Center Plaza, M-25
<br /> Santa Ana, CA 92701 f /
<br /> � G
<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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