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DATE(MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE
<br /> 07/28/2025
<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 Lynne Arruda
<br /> NAME: y
<br /> Alera Group,Inc. pAHCNr o Ext: (508)995-4553 FAAic,No): (508)995-4525
<br /> 500 Faunce Corner Road E-MAIL lynne.arruda@aleragroup.com
<br /> ADDRESS:
<br /> Building 100,Suite 120 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Dartmouth MA 02747 INSURERA: Lexington/RTS
<br /> INSURED INSURER B: Coalition Insurance Solutions,Inc.
<br /> FGP-02X Holding LLC INSURER C:
<br /> 1 Mill Wharf Plaza INSURER D:
<br /> Unit S12 INSURER E:
<br /> Scituate MA 02066 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 24-2:24-25 GL/PROF EXC 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP
<br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO RE
<br /> X CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 300,000
<br /> X Professional Liability MED EXP(Any one person) $ 1,000,000
<br /> A X Ded$10,000 Y Y 1070632 09/19/2024 01/01/2026 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 3,000,000
<br /> X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 1,000,000
<br /> JECT
<br /> OTHER: Healthcare GLAgg $ 3,000,000
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> ANYAUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED Y Y 1070632 09/19/2024 01/01/2026 BODI LY I NJ U RY(Pe r accide nt) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED �/ NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY X AUTOS ONLY Per accident
<br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000
<br /> A X EXCESS LAB CLAIMS-MADE 6798924 09/19/2024 01/01/2026 AGGREGATE $ 1,000,000
<br /> DED I I RETENTION $ $
<br /> WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED?
<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 /> Cyber Liability
<br /> B C-4LPL-107922-CYBER-2024 11/17/2024 01/01/2026 Limit $1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Abuse&Molestation-Policy#1070632 eff 09/19/2024-Coverage Limit:$1,000,000 Each Perpetrator/$2,000,000 Aggregate Digitally igned
<br /> by Tu Tr n
<br /> City of Santa Ana,its City Council,its officers,officials,employees,agents and volunteers are Additional Insureds with respects to General Liability and Tu Tran Nguyen
<br /> Automobile Liability,on a primary and non-contributory basis including waiver of subrogation,as required by written contract only,per attached policy form. U °at
<br /> ofe:
<br /> Policy includes 30 Day Notice of Cancellation. Nguyen 2o25.o9.7
<br /> Retro-active dates:Professional Liability 9/19/2021,General Liability 9/19/2018 08:24.46 07'00'
<br /> Employee Benefits Liability-Policy#1070632 eff 09/19/2024-Coverage Limit:$1,000,000/$3,000,000
<br /> APPROVED
<br /> CERTIFICATE HOLDER CANCELLATION By Tu Tran Nguyen at 8:24 am,Sep 17,2025
<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 /> Attn:Santa Ana Police Dept
<br /> AUTHORIZED REPRESENTATIVE
<br /> 60 Civic Center Plaza(M-18)
<br /> Santa Ana CA 92701
<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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