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DATE(MM/DD/YYYY)
<br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br /> `� 08/29/2025
<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 CONTACT NAME: Julie Noonan
<br /> Embroker Insurance Services LLC a/coNN E (844)436-2765 FAX No
<br /> 5214F Diamond Heights Blvd.\nUnit#1261 E-MAIL
<br /> ADDRESS: certificates@embroker.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> San Francisco CA 94131 INSURER A: Hartford Fire Insurance Company 19682
<br /> INSURED INSURERB: SENTINEL INS CO LTD 11000
<br /> Graviton Consulting Services Inc. INSURERC: EVERSPAN IND INS CO 16882
<br /> 8801 Folsom Blvd INSURER0: HARTFORD UNDERWRITERS INS CO 30104
<br /> Suite 120 INSURERE:
<br /> Sacramento CA 95826 INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: 04c67350-84da-11f0-933 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 POLICY NUMBER MM/DD MM/DD
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> DAMAGE TO RENTED
<br /> CLAIMS-MADE LX OCCUR PREMISES(Ea occurrence) $ 1,000,000
<br /> MED EXP(Any one person) $ 10,000
<br /> D Y Y 57SBABA5W2R 04/22/2025 04/22/2026 PERSONAL&ADV INJURY $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000
<br /> X POLICY PRO ❑LOC PRODUCTS-COMP/OPAGG $ 4,000,000
<br /> JECT
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000
<br /> Ea accident
<br /> ANY AUTO BODILY INJURY(Per person) $
<br /> D OWNED SCHEDULED AUTOS ONLY AUTOS Y Y 57SBABA5W2R 04/22/2025 04/22/2026 BODILY INJURY(Per accident) $
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> ✓ AUTOS ONLY ✓ AUTOS ONLY Per accident $
<br /> UMBRELLA LIAB �/ OCCUR EACH OCCURRENCE $ 8,000,000
<br /> D EXCESS LIAB CLAIMS-MADE Y Y 57SBABA5W2R 04/22/2025 04/22/2026 AGGREGATE $ 8,000,000
<br /> DED ✓ RETENTION$ 10,000 $
<br /> WORKERS COMPENSATION ✓ SPER
<br /> TATUTE EORH
<br /> AND EMPLOYERS'LIABILITY
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000
<br /> B OFFICER/MEMBEREXCLUDED? Fy] NIA Y 57WECGI2855 12/23/2024 12/23/2025
<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 /> A Technology Errors And Omissions 57TE026853524 12/23/2024 12/23/2025 Aggregate 3,000,000
<br /> C Employee Theft of Insured Property EM3EII-CR-000466-02 08/25/2025 08/25/2026 Aggregate 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> City of Santa Ana,Attention:Jack Ciulla,Chief Technology Innovations Officer Information Technology Department is included as an Additional Insured on the
<br /> General Liability,Auto Liability and Umbrella Liability policies as per written contract.
<br /> A Waiver of Subrogation applies to the Additional Insured with respect to the Workers Compensation,General Liability,Auto Liability and Umbrella Liability
<br /> policies as per written contract.
<br /> City of Santa Ana,Attention:Jack Ciulla,Chief Technology Innovations Officer Information Technology Department is included as an Additional Insured on
<br /> a primary non-contributory basis on the General Liability,Auto Liability and Umbrella Liability policies as per written contract.
<br /> CERTIFICATE HOLDER CANCELLATION APPROVED
<br /> By Tu Tran Nguyen at 12:16 pm,Sep 02,2025
<br /> City of Santa Ana, Attention: Jack Ciulla, Chief Technology SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Innovations ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Officer Information Technology Department Digitally signed b,.
<br /> 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE u Tran Nguyen
<br /> Date 2025.09.02
<br /> Santa Ana, CA, 92701 Nguyen 12:1709-07'00'
<br /> 12:17:09-0T00'
<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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