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Act CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYYI 11/25/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT (WC) Heffernan Insurance Brokers PHONE FAX 1350 Carlback Avenue A&No Ext:925-934-8500 1AIC,No):925-934-8278 Walnut Creek CA 94596 E�I ADDR Ess: INSURER(S)AFFORDING COVERAGE NAIC# License#:0564249 INSURER A:Valley Fore Insurance Company 20508 INSURED VISIINT-02 INSURERS:Continental Casualty Company 20443 Meridian Knowledge Solutions, LLC 80 Iron Point Circle, Suite 100 INSURERC:Transportation Insurance Company 20494 Folsom CA 95630 INSURERD:Continental Insurance Company 35289 INSURER E:At-Bay Specialty Insurance Company 19607 INSURER F: Federal Insurance Company 20281 COVERAGES CERTIFICATE NUMBER:1947558657 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - ADDLSUBR - - LTR TYPE OF INSURANCEINSD WVDIPOLICY NUMBER MNIDDY EFF MMIDD EXP LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 7004828100 10115/2024 10/15/2025 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1,000.000 MED EXP(Any one parson) $15.000 PERSONAL BADVINJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2.000,000 POLICY[X]JEC'TT LOG PRODUCTS-COMPIOP AGO $2,000,000 OTHER: $ C AUTOMOBILE LIABILITY BUA 7094828095 10/15/2024 1011512025 EOa�BIINdE�DtSINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident).. $ X HIRED X NON-OWNFD PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident J $ D X UMaRELLALIAB X OCCUR CUE7094828128 10/15/2024 10/15/2025 EACH OCCURRENCE $10,000.000 EXCESS LIAR GLAIMS-MADE AGGREGATE $10,000,000 DIED X RETENTION$ $ A WORKERS COMPENSATION Y WC 7 34823993 10/15/2024 10/15/2025 X PER OTH- B AND EMPLOYERS'LIABILITY STATUTE ER YIN WC 7 34824013 10/15/2024 10/15/2025 ANYPROPRIETORIPARTNERIEXECUTIVE ❑ N 1 A E.L.EACH ACCIDENT $1.000,000 OFFICERIMEMBEREXCLUDED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 E TECH F8O Retro 11/14124 AB-6636808-01 11/14/2024 10/15/2025 LMIT I RETENTION $5M 1$50K F CRIME 8264-5216 10/15/2024 10/15/2025 LIMITIDEDUCTIBLE $1M1$25k DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached it more space is required) Re:As Per Contract or Agreement on File with the Insured.The City,its officers,officials,employees,and volunteers are included as an additional insured (primary and non-contributory)on General Liability policy per the attached endorsement,if required.Waivers of Subrogation are included on General Liability and Workers Compensation policies per the attached endorsements,if required.Cancellation notice endorsement for the General Liability policy is attached,if required.The General Liability declarations page is attached,it required. TU Tran ugitdyogne by Tu Tran Nguyen Nguyen ss 2ourzmo''oe APPROVED CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 8:20 am,Jun 18,2025 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. Human Resource Department 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana,CA 92701 iy / O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD