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ACOR" CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM/DD/YYYY)
<br />10/27/2025
<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 />Woodruff -Sawyer & Co.
<br />2 Park Plaza, Suite 500
<br />Irvine, CA 92614
<br />CONTACT
<br />NAME: WS Certificates
<br />PHONE FAX
<br />A/C No Ext : 844-972-6326 A/c, No):
<br />ADDRESS: certificates@woodruffsawyer.com
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA: Federal Insurance Company
<br />20281
<br />INSURED PROCORE-01
<br />Procore Technologies, Inc.
<br />6309 Carpinteria Ave.
<br />INSURERB: Chubb National Insurance Company
<br />10052
<br />INSURERC: Vigilant Insurance Company
<br />20397
<br />INSURER D: Pacific Employers Insurance Company
<br />22748
<br />Carpinteria, CA 93013
<br />INSURER E : Lloyds Of London
<br />INSURERF: QBE Specialty Insurance Company11515
<br />COVERAGES CERTIFICATE NUMBER:919470351 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 />I
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DD/YYYY
<br />POLICY EXP
<br />MM/DDIYYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />36085196
<br />7/14/2025
<br />7/14/2026
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />CLAIMS -MADE OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea or
<br />$ 1,000,000
<br />MED EXP (Any one person)
<br />$ 15,000
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />POLICY � ECT � LOC
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />$
<br />OTHER:
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />73643846
<br />7/14/2025
<br />7/14/2026
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />HIRED NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />Comp Ded / Coll Ded
<br />$ 1,000
<br />A
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />56723213
<br />7/14/2025
<br />7/14/2026
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED RETENTION $
<br />$
<br />B
<br />C
<br />D
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANYPROPRIETOR/PARTNER/EXECUTIVE
<br />71840303 - AOS
<br />71840304 - FL
<br />71840305 - NJ NY WI
<br />7/14/2025
<br />7/14/2025
<br />7/14/2025
<br />7/14/2026
<br />7/14/2026
<br />7/14/2026
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />OFFICER/MEMBER EXCLUDED? MN
<br />NIA
<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 />E
<br />Primary Cyber/E&O
<br />01 MRCT000015003
<br />7/14/2025
<br />7/14/2026
<br />Limit/Dad
<br />$5M / $250K
<br />F
<br />D
<br />1st Excess Cyber/E&O
<br />2nd Excess Cyber/E&O
<br />130007614
<br />NPL006696504
<br />7/14/2025
<br />7/14/2025
<br />7/14/2026
<br />7/14/2026
<br />Per Claim/Aggregate:
<br />Per Claim/Aggregate:
<br />$5M xs $5M
<br />$5M xs $10M
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers are included as Additional Insured as respects General Liability on a
<br />Primary and Non-contributory basis with a waiver of subrogation to the extent provided in the selected pages of the attached forms.
<br />Tu Tran Digitally signed byTu
<br />Tran Nguyen
<br />Nguyen \, Date: 2025,10.27
<br />10:33:11-07'00'
<br />APPROVED
<br />By Tu Tran Nguyen at 10:31 am, Oct 27, 2025 1
<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: Emily Ho, Public Works Agency
<br />20 Civic Center Plaza, M-93 AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92701 � 5
<br />@ 1988-2015 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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